Without treatment for end-stage kidney disease (ESKD), survival is typically days to a few weeks, as toxins build up and organs fail, but this varies greatly by individual health, with some potentially living longer with supportive care. For earlier stages of chronic kidney disease (CKD), life expectancy can be years with management, but without treatment for ESKD, the decline is rapid once the body can no longer filter waste.
Many people with chronic kidney disease (CKD) are able to live long lives without being unduly affected by the condition. Although it's not possible to repair damage that has already happened to your kidneys, CKD will not necessarily get worse. CKD only reaches an advanced stage in a small proportion of people.
Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little.
Causes of CKD
CKD can be caused by: high blood pressure – over time, this can put strain on the small blood vessels in the kidneys and stop the kidneys working properly. diabetes – too much glucose in your blood can damage the tiny filters in the kidneys.
Your kidneys perform a critical job in your body by getting rid of waste and extra fluid. If you have kidney failure, your kidneys no longer work effectively. Without treatment, it can be fatal. Dialysis or a kidney transplant can help you continue to live a long life.
You feel kidney pain near the middle of your back, just under your ribcage, on each side of your spine where your kidneys are. Your kidneys are part of the urinary tract, the organs that make and remove urine from the body. (pee). You may feel kidney pain on one or both sides of your back.
Immediate treatment is important
Untreated kidney infections can cause permanent kidney damage or spread to your bloodstream (sepsis), which can be life-threatening. Never wait to see if symptoms improve or go away on their own.
Chronic kidney disease usually progresses slowly. Regular blood and urine tests can help doctors to decide whether the kidneys are still working well enough, whether the treatment needs to be adjusted, or whether dialysis will be needed soon, for example.
A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired or weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can cause weakness and fatigue.
What can I do to keep my kidneys healthy?
Diabetes and high blood pressure are the top culprits damaging kidneys most, as they harm the delicate filtering blood vessels, leading to chronic kidney disease (CKD) and failure; other major factors include smoking, obesity, dehydration, poor diet (high sugar/salt/red meat), certain medications (NSAIDs), lack of sleep, and genetic conditions. These factors create a cycle where damaged kidneys worsen blood pressure, further damaging them.
For thousands of years 'fishy' smelling breath and urine have been associated with renal disorders. This smell is now known to be caused by the presence of unusually high concentrations of amines. Some amines are exogenous volatile organic compounds (VOC) that are ingested as part of normal diet.
Itching often happens on both sides of the body at the same time (for example, both arms or both legs). Itching is most common and severe in people with kidney failure,but those in the earlier stages of CKD may also notice milder itching.
Outlook (Prognosis) End-stage kidney disease leads to death if you do not have dialysis or a kidney transplant.
The goal of CKD treatment is to slow the damage to your kidneys and keep them working as well as they can for as long as possible. In time, though, many people's kidneys work less and less well, leading to kidney failure. If this happens, you will need dialysis or a kidney transplant.
High levels of metabolic waste products in the blood can damage nerve cells in the brain, trunk, arms, and legs. Uric acid levels may increase, sometimes causing gout. Diseased kidneys cannot excrete excess salt and water. Salt and water retention can contribute to high blood pressure and heart failure.
You will feel tired and weak because your body needs clean blood to function properly. Untreated uremia may lead to seizures or coma and will ultimately result in death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplant.
If your kidneys are not working well, toxins (waste products) build up in your blood and this can make you feel tired and weak. You may feel more tired as your CKD gets worse and your kidney function drops.
You can check kidney function at home using at-home test kits for urine (detecting protein/albumin) or finger-prick blood tests (checking creatinine/eGFR), often with smartphone apps for analysis, or by monitoring symptoms like increased nighttime urination (nocturia), swelling, or changes in urine (blood, foam) and discussing results with a doctor, as home tests screen but don't replace professional diagnosis.
Blood and urine tests determine which stage of CKD you're in. The stages range from very mild (stage 1) to kidney failure (stage 5). Healthcare providers determine the stage of your kidney function according to the glomerular filtration rate (GFR).
In the general population, approximately 38% of adults aged 70 or older have an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, with most having moderate reductions in eGFR in the 30-59 ml/min/1.73 m2 range (1).
You need dialysis when you develop end stage kidney failure, usually by the time you lose about 85 to 90 percent of your kidney function and have a GFR of <15.
The "21-second pee rule" comes from a scientific discovery that most mammals over about 3 kg (like dogs, cows, elephants) empty their bladders in roughly 21 seconds, regardless of their size, due to physics involving urethra length and gravity. For humans, this serves as a loose benchmark: urinating significantly faster (e.g., under 10 seconds) or slower (over 30 seconds) might signal holding it too long or an overactive bladder, though it's not an exact diagnosis.
In some cases, sepsis can develop within 24 to 48 hours after the onset of severe symptoms, especially if medical intervention is delayed.
If left untreated, a kidney infection can lead to potentially serious complications, such as: Kidney scarring. This can lead to chronic kidney disease, high blood pressure and kidney failure. Blood poisoning.