Kidneys and Urinary System: Complete Guide to Function & Health

What Is the Urinary System and How Does It Work?

The urinary system consists of two kidneys, two ureters, the bladder, and the urethra. This system filters blood to remove waste products and excess fluids, producing urine that is stored in the bladder and eliminated from the body. The kidneys filter approximately 180 liters of blood daily, producing 1-2 liters of urine.

The urinary system, also called the renal system or urinary tract, is one of the body's most important waste elimination systems. It works continuously to maintain the delicate balance of fluids, electrolytes, and pH levels in your blood while removing harmful waste products that would otherwise accumulate and cause serious health problems.

Understanding how this system works is fundamental to recognizing when something is wrong and taking steps to protect your kidney health throughout life. Many kidney diseases develop silently over years, making it essential to understand both the normal function and the warning signs of dysfunction.

The urinary system performs several critical functions beyond simply producing urine. It plays a central role in blood pressure regulation, red blood cell production, bone health, and overall metabolic balance. When kidney function declines, these processes are affected, leading to a cascade of health problems that can affect virtually every organ system in the body.

The Four Main Components of the Urinary System

Each component of the urinary system has a specific and essential role in the filtration, transport, storage, and elimination of urine. Understanding these components helps you appreciate the complexity of this system and why problems in any area can have significant health consequences.

Kidneys: These bean-shaped organs, each about the size of a fist, are located on either side of the spine just below the rib cage. They are the workhorses of the urinary system, filtering blood, removing waste, and producing urine. Each kidney contains approximately one million tiny filtering units called nephrons. The right kidney sits slightly lower than the left due to the liver's position above it. The kidneys receive about 20-25% of the heart's blood output, making them one of the most highly perfused organs in the body.

Ureters: These are two thin tubes, each about 25-30 centimeters long, that carry urine from the kidneys to the bladder. Muscular contractions called peristalsis move the urine downward, preventing backflow. The ureters enter the bladder at an angle, creating a valve-like mechanism that normally prevents urine from flowing backward toward the kidneys, a condition called vesicoureteral reflux.

Bladder: A hollow, muscular organ that serves as a temporary storage reservoir for urine. In adults, the bladder can hold approximately 400-600 milliliters of urine, though the urge to urinate typically begins when it contains about 200-300 milliliters. The bladder wall contains smooth muscle called the detrusor muscle, which contracts during urination. The bladder's capacity and function can be affected by age, medical conditions, and certain medications.

Urethra: The tube through which urine exits the body. In females, the urethra is about 3-4 centimeters long, while in males, it is approximately 15-20 centimeters long, passing through the prostate gland and penis. This anatomical difference partly explains why urinary tract infections are more common in women – bacteria have a shorter distance to travel to reach the bladder.

What Do the Kidneys Do in the Body?

The kidneys perform multiple vital functions including filtering blood to remove waste products, regulating blood pressure, balancing electrolytes (sodium, potassium, calcium), producing hormones like erythropoietin for red blood cell production, and activating vitamin D for bone health. Each kidney contains about 1 million nephrons that filter 180 liters of blood daily.

The kidneys are remarkably complex organs that do far more than simply produce urine. They are essential for maintaining homeostasis – the stable internal environment that your body needs to function properly. When kidney function declines, multiple body systems are affected, which is why chronic kidney disease can have such widespread effects on health.

The functional unit of the kidney is the nephron, a microscopic structure that performs the actual work of filtering blood and producing urine. Each nephron consists of a glomerulus (a tiny cluster of blood vessels where filtration occurs) and a tubule (a small tube where the filtrate is processed). The kidney can adjust the function of millions of nephrons simultaneously to respond to the body's changing needs.

What makes the kidneys particularly remarkable is their ability to finely regulate what is retained and what is eliminated. While the kidneys filter about 180 liters of fluid daily, only about 1-2 liters become urine. The rest is reabsorbed, along with essential nutrients and electrolytes that the body needs to retain. This selective reabsorption is precisely controlled by hormones and the body's current needs.

Blood Filtration and Waste Removal

The primary function of the kidneys is filtering blood to remove metabolic waste products. The main waste products eliminated include urea (from protein metabolism), creatinine (from muscle metabolism), and uric acid (from nucleic acid breakdown). Without this filtration, these substances would accumulate to toxic levels within days, causing uremia – a potentially fatal condition.

The glomerular filtration rate (GFR) measures how efficiently the kidneys filter blood and is the primary indicator of kidney function used by healthcare providers. A normal GFR is approximately 90-120 mL/min/1.73m², and values below 60 indicate chronic kidney disease. The GFR naturally declines with age, decreasing by approximately 1 mL/min per year after age 40.

Blood Pressure Regulation

The kidneys play a crucial role in long-term blood pressure control through the renin-angiotensin-aldosterone system (RAAS). When blood pressure drops, the kidneys release renin, an enzyme that triggers a cascade leading to blood vessel constriction and sodium retention, thereby raising blood pressure. This is why kidney disease often causes or worsens hypertension, and why many blood pressure medications target this kidney-based system.

The kidneys also regulate blood pressure through their control of fluid volume. By adjusting how much water and sodium are retained or eliminated, the kidneys can increase or decrease blood volume, which directly affects blood pressure. This is why reducing sodium intake is often recommended for people with high blood pressure.

Electrolyte Balance

The kidneys precisely regulate the levels of electrolytes in the blood, including sodium, potassium, calcium, phosphorus, and magnesium. These minerals are essential for nerve conduction, muscle contraction, heart rhythm, and countless other body functions. Even small imbalances can cause serious symptoms – for example, high potassium levels can cause dangerous heart arrhythmias.

This regulation is dynamic and responsive to the body's needs. After a potassium-rich meal, the kidneys increase potassium excretion. During dehydration, they conserve sodium and water. This constant fine-tuning occurs without conscious awareness and is essential for survival.

Hormone Production

The kidneys produce several essential hormones. Erythropoietin (EPO) stimulates the bone marrow to produce red blood cells. When kidney function declines, EPO production decreases, leading to anemia – a common complication of chronic kidney disease that causes fatigue and weakness.

The kidneys also activate vitamin D by converting it to its active form, calcitriol. This active vitamin D is essential for calcium absorption from the intestines and maintaining strong bones. Kidney disease often leads to bone problems due to decreased vitamin D activation and resulting calcium and phosphorus imbalances.

What Are Common Kidney and Urinary System Problems?

Common urinary system problems include urinary tract infections (UTIs), kidney stones, chronic kidney disease (CKD), acute kidney injury, bladder infections, and incontinence. UTIs affect about 150 million people annually worldwide. Chronic kidney disease affects approximately 10% of the global population, with diabetes and high blood pressure being the leading causes.

The urinary system can be affected by a wide range of conditions, from common infections that resolve quickly with treatment to chronic diseases that require lifelong management. Understanding these conditions helps you recognize symptoms early and seek appropriate care. Many urinary problems are highly treatable when caught early but can cause serious complications if ignored.

Risk factors for urinary system problems vary depending on the specific condition but often include age, gender, family history, certain medical conditions (especially diabetes and hypertension), and lifestyle factors. Being aware of your personal risk factors can help you take preventive measures and know when to seek medical attention.

Urinary Tract Infections (UTIs)

Urinary tract infections are among the most common bacterial infections, affecting approximately 150 million people worldwide each year. Women are significantly more affected than men – about 50-60% of women will experience at least one UTI in their lifetime, and many will have recurrent infections. The shorter female urethra allows bacteria easier access to the bladder.

UTIs are typically caused by bacteria, most commonly Escherichia coli (E. coli), which normally lives in the intestines. When these bacteria enter the urinary tract, they can multiply and cause infection. Lower UTIs (bladder infections or cystitis) are uncomfortable but usually not serious. However, if the infection spreads to the kidneys (pyelonephritis), it can become a serious condition requiring hospitalization.

Symptoms of a lower UTI include a strong, persistent urge to urinate, burning sensation during urination, passing frequent small amounts of urine, cloudy or strong-smelling urine, and pelvic pain. Upper UTIs affecting the kidneys may cause high fever, back or side pain, nausea, and vomiting in addition to lower UTI symptoms.

Kidney Stones

Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. They affect about 1 in 10 people at some point in their lives, with rates increasing in recent decades. Stones form when urine becomes concentrated, allowing minerals to crystallize and stick together. The most common types are calcium oxalate stones, though uric acid, struvite, and cystine stones also occur.

Small kidney stones may pass through the urinary tract without causing symptoms. However, larger stones can cause excruciating pain – often described as worse than childbirth – when they move through the ureter. This pain typically comes in waves as the ureter contracts to move the stone, and may radiate from the back to the groin.

Prevention of kidney stones involves staying well-hydrated, reducing sodium intake, eating adequate calcium (but not excessive calcium supplements), limiting animal protein, and avoiding oxalate-rich foods if you've had calcium oxalate stones. People who have had one kidney stone have a 50% chance of developing another within 5-10 years without preventive measures.

Chronic Kidney Disease (CKD)

Chronic kidney disease is a gradual loss of kidney function over months or years. It affects approximately 10% of the global population – about 800 million people – making it one of the most common chronic diseases worldwide. CKD is often called a "silent killer" because it typically causes no symptoms until the disease is quite advanced.

The two leading causes of CKD are diabetes and high blood pressure, together accounting for about two-thirds of all cases. Diabetes damages the small blood vessels in the kidneys, while high blood pressure damages both the blood vessels and the kidney tissue itself. Other causes include glomerulonephritis (inflammation of the kidney filters), polycystic kidney disease (a genetic condition), and prolonged obstruction of the urinary tract.

CKD is classified into five stages based on the glomerular filtration rate (GFR). Stage 1 and 2 involve mild kidney damage with normal or near-normal GFR. Stages 3-4 represent moderate to severe reduction in kidney function. Stage 5 is kidney failure (end-stage renal disease), requiring dialysis or kidney transplantation to survive.

What Are the Warning Signs of Kidney Problems?

Warning signs of kidney problems include blood in urine (hematuria), foamy or bubbly urine, swelling in legs, ankles, feet, or face (edema), fatigue and weakness, decreased urine output, difficulty concentrating, persistent itching, nausea, high blood pressure, and lower back or flank pain. Many people with early kidney disease have no symptoms, making screening essential for those at risk.

Recognizing the warning signs of kidney and urinary problems is crucial because early detection and treatment can prevent progression to more serious disease. However, it's important to understand that many kidney conditions, particularly chronic kidney disease, can progress significantly before causing noticeable symptoms. This is why regular screening is so important for people with risk factors.

The kidneys have substantial reserve capacity, meaning that significant damage can occur before function is noticeably impaired. It's estimated that up to 90% of people with early-stage chronic kidney disease are unaware of their condition. By the time symptoms appear, considerable and often irreversible damage may have already occurred.

Changes in Urination

Changes in urination patterns are often the first noticeable signs of urinary system problems. These changes can include increased frequency (needing to urinate more often than usual), urgency (sudden strong urges), difficulty starting urination, weak urine stream, incomplete emptying, or needing to urinate frequently at night (nocturia).

Changes in urine appearance are also significant. Blood in the urine (hematuria) can make urine appear pink, red, or cola-colored and should always be evaluated by a healthcare provider. Foamy or bubbly urine may indicate protein in the urine, a sign of kidney damage. Cloudy urine or urine with an unusual odor may suggest infection.

Both increased and decreased urine output can be concerning. Producing very little urine may indicate kidney problems or dehydration, while producing excessive amounts may suggest diabetes or other conditions. Any persistent change from your normal pattern warrants attention.

Swelling (Edema)

Swelling in the legs, ankles, feet, hands, or face can indicate that the kidneys are not removing excess fluid effectively. This swelling, called edema, occurs because the kidneys can't eliminate enough sodium and water. The swelling typically worsens throughout the day and may leave an indentation when pressed (pitting edema).

Puffy eyes, particularly in the morning, can also be a sign of kidney problems. This may be related to protein loss in the urine (proteinuria), which causes fluid to shift into tissues. While occasional puffiness can have many causes, persistent facial swelling should be evaluated.

Fatigue and General Symptoms

Persistent fatigue and weakness are common symptoms of kidney disease, often related to anemia caused by decreased erythropoietin production. The kidneys normally produce this hormone that signals the bone marrow to make red blood cells. When production drops, red blood cell counts fall, leading to anemia and its symptoms of fatigue, weakness, and shortness of breath.

Other general symptoms that may indicate kidney problems include difficulty concentrating or "brain fog," persistent itching, loss of appetite, nausea or vomiting, muscle cramps, and feeling cold when others are comfortable. These symptoms result from the buildup of waste products that healthy kidneys would normally remove.

When Should You See a Doctor for Urinary Symptoms?

See a doctor if you have blood in your urine, pain or burning during urination lasting more than 2 days, inability to urinate, severe back or side pain, fever with urinary symptoms, or significant changes in urine color or frequency. Seek emergency care for complete inability to urinate, severe pain, high fever with chills, or signs of kidney failure like severe swelling or confusion.

Knowing when to seek medical attention for urinary symptoms can help you get appropriate treatment before problems become serious. While some symptoms may resolve on their own, others require prompt medical evaluation to prevent complications. Understanding the difference can help you make informed decisions about your care.

As a general rule, any new or unusual symptom involving the urinary system deserves attention, especially if it persists for more than a few days or is accompanied by other concerning symptoms like fever or severe pain. It's always better to have a potentially serious symptom evaluated and find out it's nothing than to ignore something that needs treatment.

Symptoms Requiring Prompt Medical Attention

Blood in the urine, even if it occurs only once, should be evaluated by a healthcare provider. While it can have benign causes like urinary tract infection or kidney stones, it can also be a sign of more serious conditions including bladder or kidney cancer. Don't assume blood in the urine is due to menstruation or a minor issue without proper evaluation.

Pain or burning during urination that lasts more than two days, especially when accompanied by frequent urination, urgency, or lower abdominal discomfort, typically indicates a urinary tract infection requiring antibiotic treatment. While some mild infections may resolve without treatment, most benefit from antibiotics to prevent complications and relieve symptoms more quickly.

New or worsening swelling in the legs, ankles, or around the eyes should be evaluated, especially if accompanied by decreased urination, fatigue, or shortness of breath. This combination of symptoms may indicate declining kidney function and needs prompt assessment.

When to Seek Emergency Care

Certain urinary symptoms require immediate medical attention. Complete inability to urinate (urinary retention) is a medical emergency that needs immediate treatment to prevent bladder damage and kidney problems. This can occur suddenly or develop gradually and may be caused by prostate enlargement, bladder dysfunction, or urinary tract obstruction.

Severe, sudden-onset pain in the back, side, or lower abdomen may indicate a kidney stone or other serious condition. While kidney stone pain is often described as excruciating, the presence of fever with this pain suggests possible infection – a combination that requires emergency evaluation.

High fever (above 101°F/38.3°C) with urinary symptoms suggests a kidney infection (pyelonephritis), which can become serious quickly and may require intravenous antibiotics. Symptoms of severe infection include high fever, chills, back pain, nausea, and vomiting.

How Can You Keep Your Kidneys Healthy?

Keep kidneys healthy by staying hydrated (8 glasses of water daily), maintaining blood pressure below 130/80 mmHg, controlling blood sugar if diabetic, eating a balanced low-sodium diet, exercising regularly, avoiding excessive painkillers (NSAIDs), not smoking, limiting alcohol, and getting regular check-ups if you have risk factors for kidney disease.

Prevention is the best approach to kidney health because much kidney damage is irreversible. The good news is that many of the most common causes of kidney disease – diabetes and high blood pressure – are largely preventable or controllable through lifestyle modifications. Taking steps to protect your kidneys can significantly reduce your risk of developing kidney disease.

Even if you already have some kidney damage or risk factors, the same lifestyle measures can help slow progression and protect remaining kidney function. Studies consistently show that controlling blood pressure and blood sugar can dramatically slow the decline of kidney function in people with early kidney disease.

Stay Properly Hydrated

Adequate hydration is essential for kidney health. Water helps the kidneys clear sodium, urea, and toxins from the body, reducing the risk of chronic kidney disease. For most people, drinking about 8 glasses (2 liters) of water daily is a reasonable goal, though individual needs vary based on climate, activity level, and health conditions.

A simple way to check hydration is to observe your urine color – it should be light yellow to clear. Dark yellow or amber-colored urine often indicates dehydration. However, some people, such as those with certain kidney conditions or heart failure, may need to limit fluids, so follow your healthcare provider's recommendations if you have these conditions.

Staying hydrated is particularly important for preventing kidney stones. Adequate fluid intake dilutes the substances in urine that can form stones. People who have had kidney stones are often advised to drink enough fluid to produce at least 2.5 liters of urine daily.

Control Blood Pressure

High blood pressure is the second leading cause of kidney disease and can both cause and accelerate kidney damage. The relationship works both ways – kidney disease can also cause high blood pressure, creating a vicious cycle. Keeping blood pressure below 130/80 mmHg is recommended for most people, with even lower targets sometimes appropriate for those with diabetes or existing kidney disease.

Blood pressure control involves multiple strategies: reducing sodium intake (aim for less than 2,300 mg daily, or less than 1,500 mg if you have hypertension), maintaining a healthy weight, exercising regularly, limiting alcohol, managing stress, and taking prescribed medications consistently.

Manage Blood Sugar

Diabetes is the leading cause of kidney disease, responsible for about 40% of all kidney failure cases. High blood sugar damages the small blood vessels in the kidneys' filtering units (nephrons), gradually reducing their ability to filter blood effectively. This condition, called diabetic nephropathy, develops in about 20-40% of people with diabetes.

If you have diabetes, keeping your blood sugar well-controlled is one of the most important things you can do to protect your kidneys. Work with your healthcare team to achieve target blood sugar levels, typically an HbA1c below 7% for most people with diabetes. Regular monitoring for early signs of kidney damage allows for intervention before significant damage occurs.

Eat a Kidney-Friendly Diet

A healthy diet supports kidney health in multiple ways. Reducing sodium intake helps control blood pressure and reduces strain on the kidneys. Most people consume far more sodium than needed, primarily from processed and restaurant foods rather than the salt shaker.

Eating plenty of fruits, vegetables, and whole grains provides antioxidants and fiber that support overall health. Limiting red meat and processed meats may reduce the kidney's workload from protein metabolism. If you already have kidney disease, you may need to limit certain nutrients like potassium, phosphorus, or protein based on your specific condition and stage.

Be Cautious with Medications

Regular use of certain over-the-counter pain medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, can damage the kidneys over time. These medications reduce blood flow to the kidneys and can cause acute kidney injury, chronic kidney disease, and electrolyte imbalances.

If you need regular pain relief, talk to your healthcare provider about kidney-safe alternatives. Acetaminophen (paracetamol) is generally safer for the kidneys when used as directed, though it has its own limitations. People with existing kidney problems should be especially cautious with all medications and consult their healthcare provider before taking anything new.

Get Regular Screenings

Because kidney disease often causes no symptoms until advanced, screening is essential for early detection. If you have risk factors – diabetes, high blood pressure, family history of kidney disease, age over 60, or cardiovascular disease – talk to your healthcare provider about regular kidney function testing.

Screening typically involves blood tests to measure creatinine and estimate GFR, and urine tests to check for protein (albumin). These simple tests can detect kidney disease in its earliest stages, when intervention is most effective at preventing progression.

How Are Kidney and Urinary Problems Diagnosed?

Kidney and urinary problems are diagnosed through blood tests (creatinine, BUN, GFR), urine tests (urinalysis, urine culture, protein/albumin), imaging (ultrasound, CT scan, MRI), and sometimes kidney biopsy. The estimated glomerular filtration rate (eGFR) calculated from blood creatinine is the primary measure of kidney function, with values below 60 mL/min indicating chronic kidney disease.

Accurate diagnosis of kidney and urinary problems requires a combination of medical history, physical examination, laboratory tests, and sometimes imaging studies or procedures. The specific tests used depend on the suspected condition and the symptoms present. Understanding these diagnostic tools can help you prepare for medical appointments and understand your results.

Blood Tests

Blood tests are fundamental to assessing kidney function. The most important tests include serum creatinine, blood urea nitrogen (BUN), and the estimated glomerular filtration rate (eGFR). Creatinine is a waste product from muscle metabolism that is normally filtered by the kidneys – elevated levels indicate reduced kidney function.

The eGFR, calculated from creatinine along with age, sex, and race, provides the most accurate assessment of kidney function. A normal eGFR is 90-120 mL/min/1.73m². Values between 60-89 may indicate mild kidney damage, 30-59 indicates moderate kidney disease, 15-29 indicates severe disease, and below 15 indicates kidney failure.

Other blood tests may check electrolyte levels (sodium, potassium, calcium, phosphorus), complete blood count (to check for anemia), and markers of bone metabolism. These tests help identify complications of kidney disease and guide treatment decisions.

Urine Tests

Urine tests provide valuable information about kidney and urinary tract health. A urinalysis examines the physical and chemical properties of urine, checking for blood, protein, glucose, bacteria, and other abnormalities. This simple test can detect signs of infection, kidney disease, diabetes, and other conditions.

The urine albumin-to-creatinine ratio (UACR) measures protein in the urine, an important marker of kidney damage. Healthy kidneys should keep protein in the blood, so finding protein in urine (proteinuria or albuminuria) indicates the kidney filters are damaged. This test is particularly important for people with diabetes.

Urine culture identifies the specific bacteria causing a urinary tract infection and determines which antibiotics will be effective. A 24-hour urine collection may be done to measure total protein excretion or to analyze substances that contribute to kidney stone formation.

Imaging Studies

Imaging studies visualize the kidneys, ureters, bladder, and surrounding structures. Ultrasound is often the first imaging test used – it's non-invasive, doesn't use radiation, and can detect kidney stones, cysts, tumors, and structural abnormalities. It can also assess kidney size and check for hydronephrosis (swelling due to urine backup).

CT scans provide more detailed images and are particularly useful for detecting kidney stones, evaluating kidney masses, and assessing trauma. A CT urogram uses contrast dye to visualize the entire urinary system. MRI may be used when CT is not appropriate or for specific indications.

Cystoscopy involves inserting a thin camera through the urethra to examine the bladder directly. This procedure is used to investigate blood in the urine, recurrent infections, or bladder symptoms, and can detect tumors, stones, or structural abnormalities.

How Are Kidney and Urinary Problems Treated?

Treatment varies by condition: UTIs are treated with antibiotics, kidney stones may require pain management, increased fluids, lithotripsy, or surgery. Chronic kidney disease treatment focuses on controlling underlying causes (diabetes, blood pressure), medications to slow progression, and eventually dialysis or kidney transplantation for kidney failure. Early treatment can significantly slow disease progression.

Treatment for kidney and urinary problems depends entirely on the specific condition, its cause, and its severity. The goal of treatment is to relieve symptoms, prevent complications, slow disease progression, and maintain quality of life. Many conditions are highly treatable, especially when caught early, while others require ongoing management.

Treatment for Urinary Tract Infections

Uncomplicated UTIs are typically treated with a short course of antibiotics. The specific antibiotic chosen depends on local resistance patterns and the patient's history. Common options include nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin. Symptoms usually improve within 24-48 hours of starting antibiotics, though it's important to complete the full course.

Complicated UTIs – those in men, pregnant women, people with diabetes, or those with structural abnormalities – may require longer treatment courses or different antibiotics. Kidney infections (pyelonephritis) typically require 7-14 days of antibiotics and may need initial intravenous treatment if severe.

Supportive measures include drinking plenty of fluids to help flush bacteria from the urinary tract, urinating when needed (not holding urine), and using pain relief as needed. Phenazopyridine can help relieve burning and discomfort but only treats symptoms – antibiotics are still needed for the infection itself.

Treatment for Kidney Stones

Small kidney stones (less than 5-6 mm) often pass on their own with supportive care. Treatment focuses on pain management with NSAIDs or opioids, anti-nausea medication, and increased fluid intake to help move the stone. Alpha-blockers may be prescribed to relax the ureter and facilitate stone passage.

Larger stones or those that don't pass may require intervention. Extracorporeal shock wave lithotripsy (ESWL) uses sound waves to break stones into smaller pieces that can pass more easily. Ureteroscopy involves passing a small scope through the urethra and bladder to the ureter to remove or break up stones. Very large stones may require percutaneous nephrolithotomy, a procedure that removes stones through a small incision in the back.

Prevention of recurrent stones involves identifying the stone type and addressing underlying causes. This typically includes increasing fluid intake, dietary modifications, and sometimes medications to reduce stone formation.

Treatment for Chronic Kidney Disease

Treatment for CKD focuses on slowing progression, managing complications, and treating underlying causes. Controlling blood pressure and blood sugar are the cornerstones of treatment, as these address the two leading causes of kidney disease. Target blood pressure for most people with CKD is below 130/80 mmHg.

Medications play important roles in CKD management. ACE inhibitors or ARBs help protect the kidneys beyond their blood pressure-lowering effects. SGLT2 inhibitors, originally developed for diabetes, have shown remarkable benefits for kidney protection even in people without diabetes. These medications can significantly slow the progression of kidney disease.

As kidney disease progresses, treatment of complications becomes important. This may include medications or dietary changes to manage anemia, bone disease, electrolyte imbalances, and fluid retention. Working with a nephrologist (kidney specialist) and a renal dietitian helps optimize care.

When kidneys fail (stage 5 CKD with GFR below 15), renal replacement therapy is needed to survive. Options include hemodialysis (typically three times weekly at a dialysis center), peritoneal dialysis (can be done at home daily), and kidney transplantation. Transplantation offers the best outcomes and quality of life when suitable and available.