5 Key Facts About CKD Treatment
June 27, 2026
5 Key Facts About CKD Treatment If you have been diagnosed with Chronic Kidney Disease (CKD), your first question is likely: “Can it be cured?” The short answer is no, not usually. Whilst ...
If you have been diagnosed with Chronic Kidney Disease (CKD), it is vital to understand that CKD is a syndrome—a set of symptoms and signs—rather than a single diagnosis. CKD has a cause, and the investigations below will find that cause.
Because there are dozens of underlying causes, from lifestyle-related conditions to rare autoimmune diseases, thorough investigation is required to tailor your treatment and prevent progression toward kidney failure.
Specialists simplify the investigation of kidney health into three primary metrics:
Kidney Function: How well are the filters working? Measured by Creatinine & eGFR (Blood).
Protein Leakage: Is there physical damage to the filters? Measured by uACR (Urine).
Physical Structure: Are there 2 kidneys and do they look normal? Measured by Renal Ultrasound (Imaging).
Biochemistry tests measure waste products and minerals to determine the efficiency of your biological “filters.”
Core Filtration Markers
Creatinine: A waste product from muscle metabolism. When kidney function declines, creatinine levels rise.
Normal range: 60–120 mcmol/L.
Clinical Threshold: If your creatinine exceeds 200 mcmol/L, you need to see a Nephrologist.
eGFR (Estimated Glomerular Filtration Rate): The ‘gold standard’ for kidney health, calculated using your creatinine, age, and sex – the higher, the better.
Normal range: 90–120 ml/min.
Staging and Clinical Threshold: A GFR below 30 ml/min represents Stage 4 CKD (Advanced), and you need to see a Nephrologist; whilst below 15 ml/min is Stage 5 (Kidney Failure).
Electrolytes, Acid-Base Balance and Diabetes Screen
Potassium (K): Normal: 3.5–5.3 mmol/L. Healthy kidneys regulate potassium to keep the heart beating steadily. Hyperkalaemia (high potassium) is a medical emergency that can cause cardiac arrest (>6.0 requires action, and >6.5 requires hospital admission today).
Bicarbonate (HCO3): Normal: 22–28 mmol/L. This measures blood acidity. As kidneys fail, the blood becomes too acidic (Metabolic Acidosis) and bicarbonate falls. Eventually dialysis may be required.
Kidneys activate (strengthen) Vitamin D and balance minerals. When they fail, the body enters a state called Chronic Kidney Disease-Mineral and Bone Disorder (or renal bone disease, RBD).
| Test | Normal Range | Importance in CKD |
| Calcium (Adjusted) | 2.2–2.6 mmol/L | Often low in CKD; essential for bone and nerve function. |
| Phosphate (PO4) | 0.8–1.4 mmol/L | Often high in CKD; can contribute to itchy skin and calcification of blood vessels. |
| PTH (Parathyroid Hormone) | 1.6–6.9 pmol/L | High levels indicate the body is leaking calcium from bones to keep blood levels steady. |
The kidneys produce erythropoietin (EPO), a hormone that stimulates red blood cell production in the bone marrow. Hence advanced CKD often leads to Renal Anaemia, with a Haemoglobin of 80-100 g/L, if untreated.
Haemoglobin (Hb): Low levels cause extreme fatigue.
Target: Men: 130–170 g/L | Women: 110–150 g/L.
Ferritin: Measures iron stores. CKD patients often require IV iron because their bodies cannot absorb enough from food.
Urine testing can detect kidney damage long before blood function (eGFR) begins to drop.
uACR (Albumin-to-Creatinine Ratio): This checks for Albuminuria. Large proteins should stay in the blood; if they appear in the urine, the kidney’s mini-sieves (glomeruli) are damaged.
Normal: < 3 mg/mmol.
Critical Level: > 100 mg/mmol often necessitates a Kidney Biopsy (see below).
MSU (Mid-Stream Urine): Checks for microscopic blood (haematuria) and infection (UTI).
If the cause of CKD isn’t clear (e.g. no Diabetes or High Blood Pressure), doctors look for other causes including a Glomerulonephritis—a group of autoimmune diseases where the immune system attacks the kidneys.
Autoimmune Markers
ANA & Anti-dsDNA: Used to diagnose Lupus (SLE), which can cause severe kidney inflammation.
ANCA (Antineutrophil Cytoplasmic Antibodies): Positive results indicate Vasculitis, an emergency where small blood vessels in the kidney are destroyed.
Complement (C3 & C4): Low levels suggest the immune system is consuming these proteins while attacking the kidneys.
PLA2R Antibody: A highly specific marker for Membranous Nephropathy. This often removes the need for a biopsy.
Infection Markers
Genetic Markers
Renal Ultrasound: This is the first-line scan. It measures kidney size (normal: 10–14 cm). Small kidneys suggest chronic scarring and long-term disease; enlarged kidneys may indicate Polycystic Kidney Disease (PKD).
CT Scan: Provides 3D detail but often requires contrast dye, which can be harmful to kidneys with low function, and risks short-term (and sometimes long-term) dialysis.
Renal Artery Doppler: Checks for narrowing in the blood vessels supplying the kidneys (Renal Artery Stenosis). It is not a 100% reliable test.
Understanding who is at risk helps in early detection, who needs to be investigated and targeted care.
| Demographic Group | Statistic / Risk Profile |
| Ethnicity (UK) | People of BAME backgrounds are 3–5 times more likely to progress to kidney failure. |
| Diabetes | Leading cause of kidney failure; 40% of people with diabetes develop CKD. |
| Global Prevalence | 1 in 10 people worldwide have some stage of CKD. |
| UK Undiagnosed | An estimated 1 million people in the UK have CKD but are currently undiagnosed. |
| Test | Normal Range | CKD Concern |
| eGFR | 90+ | < 60 (for 3+ months) |
| Creatinine | 60–120 | > 150 (and rising) |
| uACR | < 3 | > 30 (Higher risk of CKD progression) |
| Potassium | 3.5–5.3 | > 6.0 (Medical Emergency) |
If your GFR is under 30 ml/min, creatinine over 200 mcmol/L, or your uACR is over 100 mg/mmol, you require a Nephrologist.
Note: Many patients now use websites like PKB (Patients Know Best) to track their blood results in real-time. Spotting a downward trend in eGFR early is more important than any single “bad” reading.
This allows you to spot trends in your GFR and ACR before your next appointment.
5 Key Facts About CKD Treatment If you have been diagnosed with Chronic Kidney Disease (CKD), your first question is likely: “Can it be cured?” The short answer is no, not usually. Whilst ...
What is Chronic Tubulointerstitial Disease (TID) – also known as Chronic Tubulointerstitial Nephritis (TIN)? Chronic tubulointerstitial disease is a form of chronic kidney disease (CKD) that pri...
Do All UTIs Need Treatment with Antibiotics? Short answer: no — not all UTIs automatically require antibiotics, but many do. It depends on who you are, how severe the infection is, and where it&...
10 Questions to Ask Your Nephrologist About Chronic Kidney Disease Managing Chronic Kidney Disease (CKD) requires more than just showing up for appointments—it requires being an active par...
