Why 9 in 10 Americans With Kidney Disease Don't Know They Have It—And Why That Matters

Chronic kidney disease (CKD) is a silent epidemic: more than one in seven American adults have it, but as many as nine in 10 don't realize it. Your kidneys filter waste and extra fluid from your blood, control blood pressure, balance fluids, and keep your bones strong. When they're damaged, these critical functions break down—but you might not notice anything wrong until serious problems develop.

What Are the Early Warning Signs You Shouldn't Ignore?

Kidney disease often develops without symptoms in its early stages, which is why so many people miss it. If you notice any of these signs, it's time to talk to your doctor:

• Fatigue: Feeling tired or having unusually low energy levels throughout the day
• Swelling: Puffiness in your feet, ankles, or hands that doesn't go away
• Urinary changes: Needing to urinate more or less frequently, or noticing foamy urine

As kidney disease progresses, symptoms become harder to ignore. These include nausea, vomiting, shortness of breath, trouble concentrating, muscle cramps, and severe swelling. If you experience these, seek medical care right away.

How Do Doctors Catch Kidney Disease Before It's Too Late?

The good news: simple blood and urine tests can detect kidney disease years before serious problems develop. A blood test measures your estimated glomerular filtration rate (eGFR), which shows how well your kidneys filter waste. A urine test checks for protein in your urine, another sign of kidney damage. Early detection can slow disease progression, protect kidney function, and lower your risk of kidney failure.

You should talk to your doctor about screening if any of these apply to you:

• Diabetes or high blood pressure: These are the two leading causes of chronic kidney disease
• Family history: You have relatives who've had kidney disease or kidney failure
• Race and ethnicity: Black Americans are nearly four times more likely to experience end-stage kidney disease compared to white Americans

Why Are Some Groups at Higher Risk?

Black Americans face disproportionately higher rates of kidney disease and kidney failure. Research shows that Black adults are more likely to develop CKD compared to white Americans, driven by several interconnected factors. High blood pressure and diabetes—the two leading causes of CKD—are more common in the Black community. Additionally, certain genetic traits, like variants in the APOL1 gene, can increase kidney disease risk. Barriers to affordable and quality healthcare also play a significant role in these disparities.

What Causes Kidney Disease in the First Place?

Understanding what damages your kidneys is the first step toward prevention. The most common culprits include:

• Diabetes: High blood sugar damages the tiny blood vessels in your kidneys over time
• High blood pressure: This strains your kidneys and reduces their ability to function properly
• Heart disease: Cardiovascular problems can compromise kidney health
• Obesity: Extra weight puts additional stress on your kidneys
• Family history: Genetic predisposition increases your risk
• Age: Kidney function naturally declines as you get older

Kidney disease progresses through five stages, classified by how well your kidneys filter blood. Stages 1 and 2 involve mild damage with few or no symptoms. Stage 3 is moderate damage, Stage 4 is severe damage, and Stage 5 is kidney failure—which requires dialysis or a kidney transplant to survive.

Can Kidney Disease Be Reversed or Stopped?

In most cases, kidney disease cannot be fully reversed. However, if caught early, the damage can often be slowed or even stopped with the right treatment and lifestyle changes. This is why early detection is so important. For advanced CKD or kidney failure, treatments like dialysis or transplant are usually necessary.

The steps you can take to protect your kidneys are straightforward and actionable. Control your blood pressure and blood sugar—these are the top causes of kidney disease, so managing them is key. Stay hydrated by drinking enough water to help your kidneys filter waste. Eat a healthy diet low in salt and processed ingredients. Avoid long-term use of certain painkillers that can harm your kidneys. Finally, get regular check-ups with routine blood and urine tests to catch kidney problems early.

"By managing risk factors like high blood pressure and diabetes, you can protect your kidneys and improve your overall health," explains Dr. Sandeep K. Mallipattu, Chief of the Division of Nephrology and Hypertension at Stony Brook University. Kidney disease is a serious but often preventable condition. By understanding the risks, recognizing the early signs, and taking steps to protect your kidneys, you can reduce your chances of developing CKD or kidney failure.