About Chronic Kidney Disease

July 06, 2017

The number of people suffering from chronic kidney disease (CKD) in Thailand is increasing year by year, but most go unaware that they have the condition, as no obvious symptoms present themselves during the early stage. Identifying and treating CKD early-on can help prevent the disease from progressing – as well as protect against complications, and even death. If symptoms of chronic kidney disease start to show, seek immediate medical treatment. 

What is Chronic Kidney Disease?

The kidneys are responsible for helping our bodies expel waste, along with keeping our bodies’ fluids and minerals in balance. Once our kidneys are damaged, we cannot restore them to their original condition. 
With chronic kidney disease, the kidneys’ ability to function becomes impaired, causing both the regulation of fluids and minerals in the blood, as well as the removal of waste from the blood, to function improperly. CKD has a number of different causes, including diabetes, high blood pressure, nephritis, polycystic kidney disease (PKD), and being overweight or obese. Individuals with diabetes or high blood pressure hold the greatest risk. Other factors such as old age, smoking, use of certain medications (e.g. painkillers, chemotherapy), exposure to toxins, and a family history of chronic kidney disease are also risk factors for CKD.

People who fall under the risk factor groups above should have an annual health check-up. Generally, a doctor will carry out a urine protein to creatinine ratio to measure protein levels in the patient’s urine, as well as a creatinine blood test to measure liver function and determine the glomerular filtration rate (GFR).

Symptoms of Chronic Kidney Disease

People with early-stage CKD may not show any symptoms until the disease progresses to a more advanced stage. When that happens, they may experience weakness, confusion, loss of appetite, ammonia-like breath odor, itchiness, pallor (pale skin), swollen feet and ankles, or frequent urination during the night. Doctors will carry out tests to determine an appropriate treatment plan for patients, including a creatinine blood test to measure kidney function and determine the GFR, as well as an ultrasound or CT scan of the kidneys and urinary tract. In some cases, the doctor will also do a biopsy of the kidney for testing. Since CKD is a condition which does not present early-stage symptoms, only the creatinine blood test to measure kidney function and determine the GFR can measure how much the disease has progressed.


Stage of CKD


Glomerular Filtration Rate (GFR)

Stage 1

Kidney damage with normal kidney function

90 ml or more per minute

Stage 2

Kidney damage with mild loss of kidney function

60-89 ml per minute

Stage 3

Moderate loss of kidney function

30-59 ml per minute

Stage 4

Severe loss of kidney function

15-29 ml per minute

Stage 5

Final stage chronic kidney failure

Less than 15 ml per minute

The kidney function values indicate how well the kidneys are functioning. These results are very helpful in determining an appropriate treatment plan.
For information on CKD care, please visit:

By Dr. Sira Sooparb, Nephrologist, Nephrology Center, Bumrungrad Hospital
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