Chronic Kidney Disease (CKD) Overview

CKD is a progressive condition in which the kidneys are damaged and gradually lose their ability to filter waste products from the blood.¹ Because the kidneys also play key roles in regulating blood pressure, maintaining electrolyte balance, and supporting red blood cells and bone health, kidney damage can affect many parts of the body.^{2 , 3} CKD often develops slowly and may not cause noticeable symptoms in its early stages. As kidney function declines, symptoms can include fatigue, swelling in the legs, changes in urination, and difficulty concentrating. CKD progression can lead to kidney failure, which is treated with dialysis, kidney transplantation, or supportive care.¹

The most common causes of CKD are diabetes and hypertension.^{1 , 4 , 5} Other causes and risk factors include older age, obesity, cardiovascular disease, autoimmune disorders, glomerulonephritis, and a family history of kidney disease.^{1 , 5} Because CKD is frequently asymptomatic during the early stages of the disease, laboratory testing is critical to identify kidney damage before advanced disease develops.

CKD is more prevalent in women, particularly in earlier stages of the disease, although men are more likely to progress to kidney failure.⁶ The incidence and progression in women increase markedly after menopause.⁷ Sex differences have been reported in access to kidney care globally, including disparities in dialysis initiation and kidney transplantation, which may influence CKD outcomes.^{8 , 9} Women with CKD have a higher risk of cardiovascular disease than those without CKD, and pregnant women at any stage of CKD face a greater risk of adverse pregnancy outcomes and other reproductive health complications, with the risk rising as disease severity increases.^{10 - 12} Complications of pregnancy, such as pre-eclampsia and pregnancy-related acute kidney injury, may also increase the risk of developing CKD later in life.¹³

CKD is typically diagnosed using blood tests to estimate kidney function and urine tests to detect protein or other markers of kidney damage.^{1 , 4} Although there is no cure for CKD, medications, blood pressure control, treatment of diabetes mellitus, and lifestyle and nutrition changes can slow CKD progression and reduce the risk of complications. Including more women in CKD clinical trials and consistently reporting sex-specific outcomes will ensure that treatments work equally well for women and men.¹⁴

NIH supports a broad portfolio of research aimed at understanding CKD, improving early detection and treatment, and addressing sex differences in risk and outcomes. A 2024 study funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Office of Research on Women's Health (ORWH) analyzed electronic health records from nearly 8,000 patients with CKD who were receiving primary care in Boston, MA. The researchers found that women were significantly less likely than men to receive recommended testing for kidney function, albuminuria screening, guideline-recommended medications, and nephrology referrals, highlighting important gaps in the equitable management of CKD in women.¹⁵