{{Short description|Pathological conditions of the kidney, impairing the organ's ability to filter blood}} {{Redirect-distinguish|Nephropathy|neuropathy}} {{Multiple issues| {{update|date=August 2017}} {{More medical citations needed|date=August 2019}} }} {{cs1 config|display-authors=6|name-list-style=vanc}} {{Use dmy dates|date=March 2026}}
{{Infobox medical condition (new) | name = Kidney disease | synonyms = Renal disease, nephropathy | image = Kidney – acute cortical necrosis.jpg | caption = Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker areas of surviving medullary tissue. The patient died with acute kidney injury. | pronounce = | field = | symptoms = | complications = Uremia, death | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}
'''Kidney diseases''', or '''renal diseases''', technically referred to as '''nephropathies''', are pathological conditions affecting the kidneys—the organs that facilitate removal of waste products and toxins from the bloodstream, regulate the body's concentration of electrolytes, maintain the appropriate acid-base balance of plasma, and produce urine as a byproduct of metabolism.<ref name="Chang_2021">{{Cite book |last1=Chang |first1=Anthony |title=Robbins & Coltran Pathologic Basis of Disease |last2=Laszik |first2=Zoltan |publisher=Elsevier |year=2021 |isbn=978-0-323-60992-0 |edition=10th |location=Philadelphia, PA |pages=895–952 |language=en}}</ref>
When used colloquially, the term ''kidney disease'' may refer to chronic kidney disease (CKD), an umbrella term for any progressive loss of kidney function over at least three months, from any cause.<ref>{{Cite web |title=Kidney Disease: Fact Sheet {{!}} National Kidney Foundation |url=https://www.kidney.org/about/kidney-disease-fact-sheet |access-date=16 October 2025 |website=www.kidney.org |language=en}}</ref> In contrast, kidney damage over a shorter period of time is known as acute kidney injury.<ref name="Chang_2021" />
From a technical standpoint, the heterogenous group of ''kidney diseases'' can be broadly divided into categories based on which anatomical structures are involved: the glomeruli, the filtering capillaries of the kidney; tubules, which carry filtered blood; the renal interstitium, the fluid-filled space between these structures; and the renal blood vessels, which deliver blood towards and away from the kidney.<ref name="Chang_2021" /> Glomerular disease, or ''glomerulonephritis'', can be further divided into the nephritic and nephrotic syndromes, which are respectively characterized by blood and protein leaking into the urine.<ref>{{Cite web |title=Patient education: Glomerular disease (Beyond the Basics), UpToDate |url=https://www.uptodate.com/contents/glomerular-disease-beyond-the-basics |access-date=16 October 2025 |website=www.uptodate.com}}</ref>
All forms of kidney disease, glomerular or otherwise, have the potential to damage all four components of the kidney, culminating in ''end-stage renal disease''—the stage of disease at which dialysis or a kidney transplant are necessary.<ref>{{Cite web |title=Definition and staging of chronic kidney disease in adults, UpToDate |url=https://www.uptodate.com/contents/definition-and-staging-of-chronic-kidney-disease-in-adults#H27258404 |access-date=16 October 2025 |website=www.uptodate.com}}</ref>
Rates for both chronic kidney disease and mortality have increased, associated with the rising prevalence of diabetes and the aging global population.<ref>{{cite journal |last1=Imai |first1=Enyu |last2=Matsuo |first2=Seiichi |date=28 June 2008 |title=Chronic kidney disease in Asia |url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60928-9/abstract |journal=The Lancet |volume=371 |issue=9631 |pages=2147–2148 |doi=10.1016/S0140-6736(08)60928-9 |pmid=18586155 |url-access=subscription |access-date=12 August 2024}}</ref><ref>{{cite journal |last1=James |first1=Matthew T |last2=Hemmelgarn |first2=Brenda R |last3=Tonelli |first3=Marcello |date=10 April 2010 |title=Early recognition and prevention of chronic kidney disease |url=https://www.sciencedirect.com/science/article/pii/S0140673609620043 |journal=The Lancet |volume=375 |issue=9722 |pages=1296–1309 |doi=10.1016/S0140-6736(09)62004-3 |pmid=20382326 |url-access=subscription |access-date=12 August 2024}}</ref> The World Health Organization has reported that "kidney diseases have risen from the world's nineteenth leading cause of death to the ninth, with the number of deaths increasing by 95% between 2000 and 2021."<ref>{{Cite web |title=The top 10 causes of death |url=https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death |access-date=12 August 2024 |website=www.who.int |language=en}}</ref> In the United States, prevalence has risen from about one in eight in 2007,<ref>{{Cite journal |last1=Coresh |first1=Josef |last2=Selvin |first2=Elizabeth |last3=Stevens |first3=Lesley A. |last4=Manzi |first4=Jane |last5=Kusek |first5=John W. |last6=Eggers |first6=Paul |last7=Van Lente |first7=Frederick |last8=Levey |first8=Andrew S. |date=7 November 2007 |title=Prevalence of chronic kidney disease in the United States |journal=JAMA |volume=298 |issue=17 |pages=2038–2047 |bibcode=2007JAMA..298.2038C |doi=10.1001/jama.298.17.2038 |issn=1538-3598 |pmid=17986697}}</ref> to one in seven in 2021.<ref>{{Cite web |date=15 May 2024 |title=Chronic Kidney Disease in the United States, 2023 |url=https://www.cdc.gov/kidney-disease/php/data-research/ |access-date=12 August 2024 |website=www.cdc.gov |language=en-us}}</ref>
==Causes== thumb|upright=1.3|Deaths due to kidney diseases per million persons in 2012 {{Div col|small=yes|colwidth=10em}}{{legend|#ffff20|16–61}}{{legend|#ffe820|62–79}}{{legend|#ffd820|80–88}}{{legend|#ffc020|89–95}}{{legend|#ffa020|96–110}}{{legend|#ff9a20|111–120}}{{legend|#f08015|121–135}}{{legend|#e06815|136–160}}{{legend|#d85010|161–186}}{{legend|#d02010|187–343}}{{div col end}}
Causes of kidney disease include deposition of the Immunoglobulin A antibodies in the glomerulus, administration of analgesics, xanthine oxidase deficiency, toxicity of chemotherapy agents, and a long-term exposure to lead or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus, as well as diabetes mellitus and high blood pressure (hypertension), which lead to diabetic nephropathy and hypertensive nephropathy, respectively.{{cn|date=March 2026}}
=== Autosomal dominant polycystic kidney disease === Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disease, affecting a half million Americans.<ref>{{Cite web |title=Polycystic Kidney Disease, Autosomal Dominant |url=https://www.ucsfhealth.org/conditions/polycystic-kidney-disease-autosomal-dominant |website=UCSF Health}}</ref> The clinical phenotype can result from at least two different gene defects. One gene that can cause ADPKD has been located on the short arm of chromosome 16.<ref>{{cite journal |last1=Gabow |first1=Patricia A. |date=1 November 1990 |title=Autosomal Dominant Polycystic Kidney Disease – More Than a Renal Disease |journal=American Journal of Kidney Diseases |volume=16 |issue=5 |pages=403–413 |doi=10.1016/S0272-6386(12)80051-5 |pmid=2239929}}</ref>
===IgA nephropathy=== {{Main article|IgA nephropathy}} IgA nephropathy is the most common glomerulonephritis throughout the world <ref>{{cite journal |last=D'Amico |first=G |year=1987 |title=The commonest glomerulonephritis in the world: IgA nephropathy. |journal=Q J Med |volume=64 |issue=245 |pages=709–727 |pmid=3329736}}</ref> Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. The classic presentation (in 40–50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence ''synpharyngitic'') as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common the activation of mucosal defenses and hence IgA antibody production.
===Polycystic disease of the kidneys=== {{Main article|Polycystic kidney disease}} Additional possible cause of nephropathy is due to the formation of cysts or pockets containing fluid within the kidneys. These cysts become enlarged with the progression of aging causing renal failure. Cysts may also form in other organs including the liver, brain, and ovaries. Polycystic kidney disease is a genetic disease caused by mutations in the PKD1, PKD2, and PKHD1 genes. This disease affects about half a million people in the US. Polycystic kidneys are susceptible to infections and cancer.
===Xanthine oxidase deficiency=== {{Main article|Xanthine oxidase deficiency}} Another possible cause of Kidney disease is due to decreased function of xanthine oxidase in the purine degradation pathway. Xanthine oxidase will degrade hypoxanthine to xanthine and then to uric acid. Xanthine is not very soluble in water; therefore, an increase in xanthine forms crystals (which can lead to kidney stones) and result in damage to the kidney. Xanthine oxidase inhibitors, like allopurinol, can cause nephropathy.
===Diabetes=== {{Main article|Diabetic nephropathy}} Diabetic nephropathy is a progressive kidney disease caused by angiopathy of the capillaries in the glomeruli. It is characterized by nephrotic syndrome and diffuse scarring of the glomeruli. It is particularly associated with poorly managed diabetes mellitus and is a primary reason for dialysis in many developed countries. It is classified as a small blood vessel complication of diabetes.<ref>Longo et al., ''Harrison's Principles of Internal Medicine'', 18th ed., p. 2982</ref>
===Lupus=== Despite expensive treatments, lupus nephritis remains a major cause of morbidity and mortality in people with relapsing or refractory lupus nephritis.<ref>{{Cite journal |last1=Borchers |first1=Andrea T. |last2=Leibushor |first2=Naama |last3=Naguwa |first3=Stanley M. |last4=Cheema |first4=Gurtej S. |last5=Shoenfeld |first5=Yehuda |last6=Gershwin |first6=M. Eric |date=1 December 2012 |title=Lupus nephritis: a critical review |journal=Autoimmunity Reviews |volume=12 |issue=2 |pages=174–194 |doi=10.1016/j.autrev.2012.08.018 |issn=1873-0183 |pmid=22982174}}</ref>
=== COVID-19 === COVID-19 is associated with kidney disease. In patients hospitalized with COVID-19, the prevalence of acute kidney injury is estimated to be 28%, and the prevalence of renal replacement therapy is estimated to be 9%.<ref>{{cite journal |last1=Silver |first1=Samuel |last2=Beaubien-Souligny |first2=William |last3=Shah |first3=Prakesh |last4=Harel |first4=Shai |last5=Blum |first5=Daniel |last6=Kishibe |first6=Teruko |last7=Meraz-Muñoz |first7=Alejandro |last8=Wald |first8=Ron |last9=Harel |first9=Ziv |date=8 December 2020 |title=The Prevalence of Acute Kidney Injury in Patients Hospitalized With COVID-19 Infection: A Systematic Review and Meta-analysis |url=https://www.kidneymedicinejournal.org/article/S2590-0595(20)30257-0/fulltext |journal=Kidney Medicine |volume=3 |issue=1 |pages=83–98.e1 |doi=10.1016/j.xkme.2020.11.008 |pmc=7723763 |pmid=33319190 |access-date=5 April 2024}}</ref>
===Analgesics=== {{Main article|Analgesic nephropathy}} {{No footnotes|section|date=January 2025}} One cause of nephropathy is the long term usage of pain medications known as analgesics.<ref>{{Cite journal |last1=De Broe |first1=Marc E. |last2=Elseviers |first2=Monique M. |date=12 February 1998 |title=Analgesic Nephropathy |url=http://www.nejm.org/doi/abs/10.1056/NEJM199802123380707 |journal=New England Journal of Medicine |language=en |volume=338 |issue=7 |pages=446–452 |doi=10.1056/NEJM199802123380707 |pmid=9459649 |issn=0028-4793|url-access=subscription }}</ref><ref name="Roy_2007">{{Cite book |last1=Roy |first1=Neil |title=Essentials : Renal, Gastrointestinal and Hepatobiliary Systems |last2=Bennet |first2=David |date=Nov 2007 |publisher=iUniverse, Incorporated |isbn=9780595465125 |pages=23}}</ref> The pain medicines which can cause kidney problems include Tylenol, aspirin, acetaminophen, paracetamol,<ref>{{Cite web |last=Papich |first=Mark |year=2005 |title=Drugs and the kidneys: preventing and managing their potential adverse effects |url=https://www.cabidigitallibrary.org/doi/full/10.5555/20053197348 |url-access=subscription |access-date=23 March 2026 |website=CABI Digital Library |page=858 |language=en }}</ref> and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.<ref>{{Cite journal |last=Prescott |first=L. F. |date=1 January 1982 |title=Analgesic Nephropathy: A Reassessment of the Role of Phenacetin and Other Analgesics |url=https://doi.org/10.2165/00003495-198223010-00004 |journal=Drugs |language=en |volume=23 |issue=1 |pages=75–149 |doi=10.2165/00003495-198223010-00004 |pmid=7035123 |issn=1179-1950|url-access=subscription }}</ref> This form of nephropathy is "chronic analgesic nephritis" or Analgesic Nephropathy,<ref name="Roy_2007" /> a chronic inflammatory change characterized by loss and atrophy of tubules and interstitial fibrosis<ref>{{Citation |title=Tubulointerstitial Diseases |date=1 January 2013 |work=Practical Renal Pathology |pages=127–158 |url=https://www.sciencedirect.com/science/chapter/edited-volume/abs/pii/B978044306966600009X |access-date=23 March 2026 |publisher=W.B. Saunders |language=en-US |doi=10.1016/B978-0-443-06966-6.00009-X |isbn=978-0-443-06966-6 | vauthors = Arend LJ |url-access=subscription }}</ref> and inflammation (BRS Pathology, 2nd ed.).
Specifically, long-term use of the analgesic phenacetin has been linked to renal papillary necrosis (necrotizing papillitis).<ref name="Roy_2007" />
===Iodinated contrast media=== {{Main article|Iodinated contrast media}}
Kidney disease induced by iodinated contrast media (ICM) is called contrast induced nephropathy (CIN) or contrast-induced acute kidney injury (AKI). Currently, the underlying mechanisms are unclear. But there is a body of evidence that several factors including apoptosis-induction seem to play a role.<ref>{{cite journal |last1=Idee |first1=J.- |last2=Boehm |first2=J. |last3=Prigent |first3=P. |last4=Ballet |first4=S. |last5=Corot |first5=C. |year=2006 |title=Role of Apoptosis in the Pathogenesis of Contrast Media-induced Nephropathy and Hints for its Possible Prevention by Drug Treatment |journal=Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry |volume=5 |issue=2 |pages=139–146 |doi=10.2174/187152306776872442}}</ref>
===Toxicity of chemotherapy agents=== {{Main article|Onconephrology}}
Nephropathy can be associated with some therapies used to treat cancer. The most common form of kidney disease in cancer patients is acute kidney injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. Several chemotherapeutic agents, for example cisplatin, are associated with acute and chronic kidney injuries.<ref>Portilla D, Safar AM, Shannon ML, Penson RT. "Cisplatin nephrotoxicity". In: UpToDate, Palevsky PM (Ed), UpToDate, Waltham, MA, 2013. http://www.uptodate.com/contents/cisplatin-nephrotoxicity</ref> Newer agents such as anti-vascular endothelial growth factor (anti-VEGF) are also associated with similar injuries, as well as proteinuria, hypertension, and thrombotic microangiopathy.<ref name="Robinson_2010">{{cite journal |last=Robinson |first=Emily S. |author2=Khankin, Eliyahu V. |author3=Karumanchi, S. Ananth |author4=Humphreys, Benjamin D. |date=1 November 2010 |title=Hypertension Induced by Vascular Endothelial Growth Factor Signaling Pathway Inhibition: Mechanisms and Potential Use as a Biomarker |journal=Seminars in Nephrology |volume=30 |issue=6 |pages=591–601 |doi=10.1016/j.semnephrol.2010.09.007 |pmc=3058726 |pmid=21146124}}</ref>
===Lithium=== {{Main|Lithium (medication)#Kidney damage}}
Lithium, a medication commonly used to treat bipolar disorder and schizoaffective disorders, can cause nephrogenic diabetes insipidus; its long-term use can lead to nephropathy.<ref>{{cite journal |last1=Grünfeld |first1=JP |last2=Rossier |first2=BC |date=May 2009 |title=Lithium nephrotoxicity revisited |journal=Nat Rev Nephrol |volume=5 |issue=5 |pages=270–276 |doi=10.1038/nrneph.2009.43 |pmid=19384328 |s2cid=36253297}}</ref> Long term lithium treatment is known to cause chronic kidney disease after 10-20 years of treatment in 1-5% of people.<ref>{{Cite journal |last1=Malhi |first1=Gin S |last2=Tanious |first2=Michelle |last3=Das |first3=Pritha |last4=Berk |first4=Michael |date=1 March 2012 |title=The science and practice of lithium therapy |url=https://doi.org/10.1177/0004867412437346 |journal=Australian & New Zealand Journal of Psychiatry |language=EN |volume=46 |issue=3 |pages=192–211 |doi=10.1177/0004867412437346 |pmid=22391277 |issn=0004-8674 |url-access=subscription}}</ref><ref>{{Cite journal |last1=Tondo |first1=Leonardo |last2=Alda |first2=Martin |last3=Bauer |first3=Michael |last4=Bergink |first4=Veerle |last5=Grof |first5=Paul |last6=Hajek |first6=Tomas |last7=Lewitka |first7=Ute |last8=Licht |first8=Rasmus W. |last9=Manchia |first9=Mirko |last10=Müller-Oerlinghausen |first10=Bruno |last11=Nielsen |first11=René E. |last12=Selo |first12=Marylou |last13=Simhandl |first13=Christian |last14=Baldessarini |first14=Ross J. |last15=for the International Group for Studies of Lithium (IGSLi) |date=22 July 2019 |title=Clinical use of lithium salts: guide for users and prescribers |journal=International Journal of Bipolar Disorders |language=en |volume=7 |issue=1 |pages=16 |doi=10.1186/s40345-019-0151-2 |issn=2194-7511 |pmc=6643006 |pmid=31328245 |doi-access=free}}</ref> End-stage renal disease due to lithium occurs in 0.53% of people versus 0.2% in the general population.<ref>{{Cite journal |last1=Presne |first1=Claire |last2=Fakhouri |first2=Fadi |last3=Noël |first3=Laure-Hélène |last4=Stengel |first4=Bénédicte |last5=Even |first5=Christian |last6=Kreis |first6=Henri |last7=Mignon |first7=Françoise |last8=Grünfeld |first8=Jean-Pierre |date=August 2003 |title=Lithium-induced nephropathy: Rate of progression and prognostic factors |url=https://linkinghub.elsevier.com/retrieve/pii/S0085253815493652 |journal=Kidney International |volume=64 |issue=2 |pages=585–592 |doi=10.1046/j.1523-1755.2003.00096.x |issn=0085-2538 |pmid=12846754}}</ref><ref>{{Cite journal |last1=Tondo |first1=Leonardo |last2=Abramowicz |first2=Maria |last3=Alda |first3=Martin |last4=Bauer |first4=Michael |last5=Bocchetta |first5=Alberto |last6=Bolzani |first6=Lorenza |last7=Calkin |first7=Cynthia V. |last8=Chillotti |first8=Caterina |last9=Hidalgo-Mazzei |first9=Diego |last10=Manchia |first10=Mirko |last11=Müller-Oerlinghausen |first11=Bruno |last12=Murru |first12=Andrea |last13=Perugi |first13=Giulio |last14=Pinna |first14=Marco |last15=Quaranta |first15=Giuseppe |date=1 August 2017 |title=Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters |journal=International Journal of Bipolar Disorders |language=en |volume=5 |issue=1 |pages=27 |doi=10.1186/s40345-017-0096-2 |issn=2194-7511 |pmc=5537163 |pmid=28480485 |doi-access=free}}</ref><ref>{{Cite journal |last1=Barroilhet |first1=S. A. |last2=Ghaemi |first2=S. N. |date=2020 |title=When and how to use lithium |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13202 |journal=Acta Psychiatrica Scandinavica |language=en |volume=142 |issue=3 |pages=161–172 |doi=10.1111/acps.13202 |issn=1600-0447 |pmid=32526812}}</ref> Dosing lithium more than once per day is associated with more kidney damage.<ref>{{Cite journal |last1=Carter |first1=Lorie |last2=Zolezzi |first2=Monica |last3=Lewczyk |first3=Andrea |date=1 October 2013 |title=An Updated Review of the Optimal Lithium Dosage Regimen for Renal Protection |url=https://doi.org/10.1177/070674371305801009 |journal=The Canadian Journal of Psychiatry |language=EN |volume=58 |issue=10 |pages=595–600 |doi=10.1177/070674371305801009 |issn=0706-7437 |pmid=24165107}}</ref> Kidney harm can be mitigated by dosing lithium once per day at night and keeping the dose as low as possible.<ref>{{Cite web |last=MD |first=Chris Aiken |date=19 January 2026 |title=6 Ways to Protect the Kidneys While Prescribing Lithium |website=Psychiatric Times |url=https://www.psychiatrictimes.com/view/6-ways-protect-kidneys-while-prescribing-lithium |access-date=19 January 2026 |language=en}}</ref> Dosing lithium once per day allows for long periods where the kidney is exposed to low levels of lithium, which minimizes kidney harm.<ref>{{Cite journal |last1=Barroilhet |first1=S. A. |last2=Ghaemi |first2=S. N. |date=2020 |title=When and how to use lithium |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13202 |journal=Acta Psychiatrica Scandinavica |language=en |volume=142 |issue=3 |pages=161–172 |doi=10.1111/acps.13202 |issn=1600-0447 |pmid=32526812}}</ref>
===Anabolic-androgenic steroids=== Regular and long-term use of anabolic-androgenic steroids (AAS) can cause both acute and chronic kidney disease through several direct and indirect mechanisms.<ref>{{Cite journal |last1=Parente Filho |first1=Sérgio Luiz Arruda |last2=Gomes |first2=Pedro Eduardo Andrade de Carvalho |last3=Forte |first3=Guilherme Aguiar |last4=Lima |first4=Laio Ladislau Lopes |last5=Silva Júnior |first5=Geraldo Bezerra da |last6= Meneses |first6=Gdayllon Cavalcante |last7=Martins |first7=Alice Maria Costa |last8=Daher |first8=Elizabeth De Francesco |date= January 2020 |title=Kidney disease associated with androgenic–anabolic steroids and vitamin supplements abuse: Be aware! |journal= Nefrología |language=en |volume=40 |issue=1 |pages=26–31 |doi=10.1016/j.nefro.2019.06.003 |pmid=31585781 |doi-access=free}}</ref><ref name = davani>{{Cite journal |last1=Davani-Davari |first1=Dorna |last2=Karimzadeh |first2=Iman |last3=Khalili |first3=Hossein |date= December 2019 |title= The potential effects of anabolic-androgenic steroids and growth hormone as commonly used sport supplements on the kidney: a systematic review |journal=BMC Nephrology |language=en |volume=20 |issue=1 |article-number=198 |doi=10.1186/s12882-019-1384-0 |issn= 1471-2369 |pmc=6545019 |pmid=31151420 |doi-access=free}}</ref><ref>{{Cite web |date=10 December 2009 |title=Weightlifters Bulking Up With Anabolic Steroids Also Do Serious Harm To Kidneys |url=https://www.cuimc.columbia.edu/news/weightlifters-bulking-anabolic-steroids-also-do-serious-harm-kidneys |access-date=4 January 2026 |website=Columbia University Irving Medical Center |language=en}}</ref> Focal segmental glomerulosclerosis is the most common condition arising in such cases.<ref>{{Cite web |title=Bodybuilding With Steroids Damages Kidneys |url= https://www.sciencedaily.com/releases/2009/10/091029141202.htm}}</ref><ref>{{Cite journal |last=Ireland |first=Rebecca |date=March 2010 |title= Anabolic steroid abuse can lead to focal segmental glomerulosclerosis |url=https://www.nature.com/articles/nrneph.2010.5 |journal= Nature Reviews Nephrology |language=en |volume=6 |issue=3 |pages=130 |doi=10.1038/nrneph.2010.5 |issn=1759-5061}}</ref> Discontinuation of AAS in the early stage of Kidney Disease can result in a reversal of the kidney damage.<ref name =davani/><ref>{{Cite web |title=Using steroids to bulk up? Watch for kidney damage |url=https://www.reuters.com/article/business/healthcare-pharmaceuticals/using-steroids-to-bulk-up-watch-for-kidney-damage-idUSTRE59T446 |work=Reuters}}</ref>
===Diet=== Higher dietary intake of animal protein, animal fat, and cholesterol may increase risk for microalbuminuria, a sign of kidney function decline,<ref>{{Cite journal |last1=Lin |first1=Julie |last2=Hu |first2=Frank B. |last3=Curhan |first3=Gary C. |date=1 May 2010 |title=Associations of diet with albuminuria and kidney function decline |journal=Clinical Journal of the American Society of Nephrology |volume=5 |issue=5 |pages=836–843 |doi=10.2215/CJN.08001109 |issn=1555-905X |pmc=2863979 |pmid=20299364}}</ref> and generally, diets higher in fruits, vegetables, and whole grains but lower in meat and sweets may be protective against kidney function decline.<ref>{{Cite journal |last1=Lin |first1=Julie |last2=Fung |first2=Teresa T. |last3=Hu |first3=Frank B. |last4=Curhan |first4=Gary C. |date=1 February 2011 |title=Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses' Health Study |journal=American Journal of Kidney Diseases |volume=57 |issue=2 |pages=245–254 |doi=10.1053/j.ajkd.2010.09.027 |issn=1523-6838 |pmc=3026604 |pmid=21251540}}</ref> This may be because sources of animal protein, animal fat, and cholesterol, and sweets are more acid-producing, while fruits, vegetables, legumes, and whole grains are more base-producing.<ref>{{Cite journal |last1=Chen |first1=Wei |last2=Abramowitz |first2=Matthew K. |date=1 January 2014 |title=Metabolic acidosis and the progression of chronic kidney disease |journal=BMC Nephrology |volume=15 |article-number=55 |doi=10.1186/1471-2369-15-55 |issn=1471-2369 |pmc=4233646 |pmid=24708763 |doi-access=free}}</ref><ref>{{Cite journal |last1=Sebastian |first1=Anthony |last2=Frassetto |first2=Lynda A. |last3=Sellmeyer |first3=Deborah E. |last4=Merriam |first4=Renée L. |last5=Morris |first5=R. Curtis |date=1 December 2002 |title=Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors |journal=The American Journal of Clinical Nutrition |volume=76 |issue=6 |pages=1308–1316 |doi=10.1093/ajcn/76.6.1308 |issn=0002-9165 |pmid=12450898 |doi-access=free}}</ref><ref>{{Cite journal |last1=van den Berg |first1=Else |last2=Hospers |first2=Frédérique A. P. |last3=Navis |first3=Gerjan |last4=Engberink |first4=Marielle F. |last5=Brink |first5=Elizabeth J. |last6=Geleijnse |first6=Johanna M. |last7=van Baak |first7=Marleen A. |last8=Gans |first8=Rijk O. B. |last9=Bakker |first9=Stephan J. 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==Diagnosis== The standard diagnostic workup of suspected kidney disease includes a medical history, physical examination, a urine test, and an ultrasound of the kidneys (renal ultrasonography). An ultrasound is essential in the diagnosis and management of kidney disease.<ref>{{Cite journal |last1=Hansen |first1=Kristoffer Lindskov |last2=Nielsen |first2=Michael Bachmann |last3=Ewertsen |first3=Caroline |date=23 December 2015 |title=Ultrasonography of the Kidney: A Pictorial Review |journal=Diagnostics |volume=6 |issue=1 |page=2 |doi=10.3390/diagnostics6010002 |issn=2075-4418 |pmc=4808817 |pmid=26838799 |doi-access=free}}</ref>
== Treatment == Treatment approaches for kidney disease focus on managing the symptoms, controlling the progression, and also treating co-morbidities that a person may have.<ref name="Kim_2016">{{Cite journal |last1=Kim |first1=Kun Hyung |last2=Lee |first2=Myeong Soo |last3=Kim |first3=Tae-Hun |last4=Kang |first4=Jung Won |last5=Choi |first5=Tae-Young |last6=Lee |first6=Jae Dong |date=28 June 2016 |title=Acupuncture and related interventions for symptoms of chronic kidney disease |journal=The Cochrane Database of Systematic Reviews |volume=2016 |issue=6 |article-number=CD009440 |doi=10.1002/14651858.CD009440.pub2 |issn=1469-493X |pmc=8406453 |pmid=27349639}}</ref>
=== Transplantation === {{main|Kidney transplantation}}
Millions of people across the world have kidney disease. Of those millions, several thousand will need dialysis or a kidney transplant at its end-stage.<ref name="Tabarrok_2010">{{cite news |last1=Tabarrok |first1=Alex |date=8 January 2010 |title=The Meat Market |newspaper=Wall Street Journal |url=https://www.wsj.com/articles/SB10001424052748703481004574646233272990474}}</ref> In the United States, as of 2008, 16,500 people needed a kidney transplant.<ref name="Tabarrok_2010" /> Of those, 5,000 died while waiting for a transplant.<ref name="Tabarrok_2010" /> Currently, there is a shortage of donors, and in 2007 there were only 64,606 kidney transplants in the world.<ref name="Tabarrok_2010" /> This shortage of donors is causing countries to place monetary value on kidneys. Countries such as Iran and Singapore are eliminating their lists by paying their citizens to donate. Also, the black market accounts for 5–10 percent of transplants that occur worldwide.<ref name="Tabarrok_2010" /> The act of buying an organ through the black market is illegal in the United States.<ref>{{cite web |last1=Scheve |first1=Tom |date=7 May 2008 |title=How Organ Donations Work |url=http://health.howstuffworks.com/medicine/modern-treatments/organ-donation7.htm |access-date=9 March 2015 |website=HowStuffWorks}}</ref> To be put on the waiting list for a kidney transplant, patients must first be referred by a physician, then they must choose and contact a donor hospital. Once they choose a donor hospital, patients must then receive an evaluation to make sure they are sustainable to receive a transplant. In order to be a match for a kidney transplant, patients must match blood type and human leukocyte antigen factors with their donors. They must also have no reactions to the antibodies from the donor's kidneys.<ref name="kidneylink">{{cite web |title=The Waiting List |url=http://www.kidneylink.org/TheWaitingList.aspx |archive-url=https://web.archive.org/web/20170713113505/http://www.kidneylink.org/TheWaitingList.aspx |archive-date=13 July 2017 |access-date=9 March 2015 |website=www.kidneylink.org}}</ref><ref name="Tabarrok_2010" />
=== Dialysis === {{main|Kidney dialysis}}
Because of the shortage of kidney donors, kidney dialysis is the most common method of renal replacement therapy for patients with kidney failure. Usually it is started at Stage 5 of chronic kidney failure, when the glomerular filtration rate is less than 15% of the normal.
For most patients, a kidney transplant offers a significant survival advantage and improved quality of life compared to remaining on dialysis, often adding years to life expectancy, though early risks exist, especially with certain donor types or in the elderly, but long-term outcomes favor transplant. Studies consistently show better long-term survival rates for transplant recipients, with one-year survival rates often above 90-95% for transplant, while dialysis patients face higher mortality.<ref>{{Cite web |title=Top 5 reasons to refer a patient early for kidney transplant |website=Mayo Clinic |url=https://www.mayoclinic.org/medical-professionals/transplant-medicine/news/top-5-reasons-to-refer-a-patient-early-for-kidney-transplant/mac-20575082 |access-date=4 January 2026}}</ref><ref>{{Cite web |title=Statistics |department=The Kidney Project |url=https://pharm.ucsf.edu/kidney/need/statistics |access-date=4 January 2026 |website=pharm.ucsf.edu}}</ref><ref>{{Cite journal |last1=Shi |first1=Bree |last2=Ying |first2=Tracey |last3=Chadban |first3=Steven J. |date=October 2023 |title=Survival after kidney transplantation compared with ongoing dialysis for people over 70 years of age: A matched-pair analysis |url=https://linkinghub.elsevier.com/retrieve/pii/S1600613523005786 |journal=American Journal of Transplantation |language=en |volume=23 |issue=10 |pages=1551–1560 |doi=10.1016/j.ajt.2023.07.006 |pmid=37460010 |url-access=subscription}}</ref>
==Prognosis== Kidney disease can have serious consequences if it cannot be controlled effectively. Generally, the progression of kidney disease is from mild to serious. Some kidney diseases can cause kidney failure.
==See also== * Hematologic Diseases Information Service * Mesoamerican nephropathy, an enigmatic chronic kidney disease of Central America * Protein toxicity
==References== {{Reflist}}{{Medical resources | DiseasesDB = | ICD10 ={{ICD10|N|00||n|00}}- {{ICD10|N|29||n|29}} | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D007674 }} {{Nephrology}} {{Glomerular disease}}
{{Authority control}}
Category:Kidney diseases