[2][5] Initially, patients are usually asymptomatic, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion.

[10] Other recommended measures include staying active, and certain dietary changes such as a low-salt diet and the right amount of protein.

[6] CKD is initially without symptoms and is usually detected on routine screening blood work by either an increase in serum creatinine, or protein in the urine.

As the kidney function decreases, more unpleasant symptoms may emerge:[23] The most common causes of CKD are diabetes mellitus, hypertension, and glomerulonephritis.

[45] Diagnosis of CKD is largely based on history, examination, and urine dipstick combined with the measurement of the serum creatinine level.

Whether the underlying pathologic change is glomerular sclerosis, tubular atrophy, interstitial fibrosis, or inflammation, the result is often increased echogenicity of the cortex.

[56] Additional tests may include nuclear medicine MAG3 scan to confirm blood flow and establish the differential function between the two kidneys.

Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if protein loss is significant.

This might include a plant-dominant diet with less protein and salt, medications to control blood pressure and sugar, and potentially newer anti-inflammatory drugs.

Doctors may also focus on managing heart disease risk, preventing infections, and avoiding further kidney damage.

Any of these can help people with CKD lose weight, however, it is not known if they can also prevent death or cardiovascular events like heart complications or stroke.

[76] It is recommended that weight management interventions should be individualised, according to a thorough patients' assessment regarding clinical condition, motivations, and preferences.

For people with CKD, including those on dialysis, reduced salt intake may help to lower both systolic and diastolic blood pressure, as well as albuminuria.

The effect of salt restriction on extracellular fluid, oedema, and total body weight reduction is unknown.

[78] In people with CKD who require hemodialysis, there is a risk that vascular blockage due to clotting, may prevent dialysis therapy from being possible.

Even though Omega-3 fatty acids contribute to the production of eicosanoid molecules that reduce clotting, it does not have any impact on the prevention of vascular blockage in people with CKD.

[79] Regular consumption of oral protein-based nutritional supplements may increase serum albumin levels slightly in people with CKD, especially among those requiring hemodialysis or who are malnourished.

[83] It may also be useful at an earlier stage (e.g. CKD3) when urine albumin-to-creatinine ratio is more than 30 mg/mmol, when blood pressure is difficult to control, or when hematuria or other findings suggest either a primarily glomerular disorder or secondary disease amenable to a specific treatment.

The toxins show various cytotoxic activities in the serum and have different molecular weights, and some of them are bound to other proteins, primarily to albumin.

[84] Hemodialysis with high-flux dialysis membrane, long or frequent treatment, and increased blood/dialysate flow has improved removal of water-soluble small molecular weight uremic toxins.

Middle molecular weight molecules are removed more effectively with hemodialysis using a high-flux membrane, hemodiafiltration, and hemofiltration.

[94] Medical specialty professional organizations recommend that physicians do not perform routine cancer screening in people with limited life expectancies due to ESKD because the evidence does not show that such tests lead to improved outcomes.

As of 2020[update] a rapidly progressive chronic kidney disease, unexplained by diabetes and hypertension, had increased dramatically in prevalence over a few decades in several regions in Central America and Mexico, a CKDu referred to as the Mesoamerican nephropathy (MeN).

[104] African, Hispanic, and South Asian (particularly those from Pakistan, Sri Lanka, Bangladesh, and India) populations are at high risk of developing CKD.

[103] Denial of care in chronic kidney disease treatment and management is a significant issue for minority populations.

Structural barriers, such as lack of insurance and limited healthcare facilities, hinder access to timely care.

While certain racial and ethnic groups are at higher risk, using race as a reference range may reinforce stereotypes and perpetuate health disparities.

This approach fails to account for the complex interplay of genetic, environmental, and social factors influencing kidney function.

Alternative approaches that consider socioeconomic status, environmental exposures, and genetic vulnerability, are needed to accurately assess kidney function and address CKD care disparities.

These include the angiotensin receptor blocker (ARB) olmesartan medoxomil; and sulodexide, a mixture of low molecular weight heparin and dermatan sulfate.