Understanding Kidney Disease: What You Need to Know
Your kidneys filter 50 gallons of blood a day. Here is how to keep them working.
1 in 7U.S. adults has chronic kidney disease
Last reviewed: April 2026
Chronic kidney disease (CKD) means your kidneys are not filtering blood as well as they should. It develops gradually, often over years, and most people do not feel symptoms until the disease is advanced. That silent progression is what makes it dangerous.
Your kidneys do more than make urine. They filter waste and excess fluid from your blood, help regulate blood pressure, produce hormones that make red blood cells, and balance minerals like sodium, potassium, and calcium. When they start to fail, the effects ripple through your entire body.
Arizona adds a unique twist: extreme heat and chronic dehydration stress the kidneys in ways that cooler climates do not. Outdoor workers, athletes, and anyone who underestimates how much water they need in 110-degree heat may be putting their kidneys at risk without realizing it.
The Five Stages of Kidney Disease
CKD is classified by how well your kidneys filter blood, measured by the glomerular filtration rate (GFR). Stage 1: GFR 90 or above with signs of kidney damage (normal filtration, but something is wrong). Stage 2: GFR 60-89 with kidney damage (mildly decreased). Stage 3a: GFR 45-59 (mild to moderate decrease). Stage 3b: GFR 30-44 (moderate to severe decrease). Stage 4: GFR 15-29 (severely decreased). Stage 5: GFR below 15 (kidney failure, dialysis or transplant needed).
Most people are diagnosed in stage 3, when blood tests start to show abnormalities. Stages 1 and 2 are often caught only if your doctor is specifically looking, usually because you have diabetes or high blood pressure.
Top Risk Factors
Diabetes is the leading cause of kidney disease, responsible for about 47% of new cases. High blood pressure is the second leading cause. Other risk factors include heart disease, obesity, family history of kidney disease, age over 60, and being of African American, Hispanic, Native American, or Asian American descent.
In Arizona, the high rates of diabetes and hypertension in Native American and Hispanic communities contribute to disproportionately high CKD rates. If you have any of these risk factors, regular kidney function screening is essential.
Arizona Heat and Your Kidneys
Chronic dehydration damages kidneys. When you do not drink enough water, blood flow to the kidneys decreases, waste products concentrate, and kidney tissue can be injured over time. This is not about a single hot day. It is about months and years of inadequate hydration in a desert climate.
Research has linked heat exposure in agricultural and outdoor workers to higher rates of CKD, sometimes called "heat nephropathy" or "Mesoamerican nephropathy." Arizona's construction workers, landscapers, and agricultural workers face similar risks. If you work outdoors in Arizona, drink water throughout the day (not just when you feel thirsty) and take breaks in shade or air conditioning.
Symptoms (Usually Late-Stage)
Early kidney disease has no symptoms. That is worth repeating. You will not feel stages 1, 2, or even early stage 3. By the time symptoms appear, significant kidney function has already been lost.
Later symptoms include fatigue and weakness, swelling in the feet, ankles, or hands (edema), foamy or bubbly urine, frequent urination (especially at night), poor appetite, nausea, difficulty concentrating, muscle cramps, dry and itchy skin, and high blood pressure that is hard to control.
See a Nephrologist If
Your primary care doctor manages early CKD, but you should see a nephrologist (kidney specialist) if your GFR drops below 30 (stage 4), your kidney function is declining rapidly, you have protein or blood in your urine that is not explained by another condition, your blood pressure is difficult to control despite multiple medications, or your potassium levels are consistently elevated. Early referral to a nephrologist has been shown to slow the progression of kidney disease and improve outcomes for patients who eventually need dialysis or transplant.
Slowing the Progression
CKD cannot be reversed in most cases, but its progression can be significantly slowed. The most important steps are controlling blood sugar if you have diabetes (A1C below 7%), controlling blood pressure (goal below 130/80), taking prescribed medications (especially ACE inhibitors or ARBs, which protect the kidneys), reducing sodium intake, maintaining a healthy weight, not smoking, and staying hydrated.
Newer medications like SGLT2 inhibitors (originally developed for diabetes) have shown strong kidney-protective effects even in people without diabetes. Ask your doctor or nephrologist if these are appropriate for you.
When Kidneys Fail: Treatment Options
If CKD progresses to stage 5, the two main treatment options are dialysis and kidney transplant. Hemodialysis filters your blood through a machine, typically 3 times a week at a dialysis center. Peritoneal dialysis uses the lining of your abdomen as a filter and can be done at home.
Kidney transplant offers the best long-term outcomes and quality of life. Arizona has transplant programs at Banner University Medical Center in Phoenix, Mayo Clinic in Scottsdale, and other centers. The average wait time for a deceased-donor kidney in Arizona is 3-5 years. Living-donor transplants have shorter waits and better outcomes.
Kidney Health Checklist
- Know your GFR (ask your doctor at your next checkup)
- Get a urine albumin test if you have diabetes or high blood pressure
- Keep blood pressure below 130/80
- Manage blood sugar if you have diabetes (A1C below 7%)
- Drink enough water daily (more in Arizona heat)
- Limit sodium to less than 2,300 mg per day
- Avoid regular use of NSAIDs (ibuprofen, naproxen) without medical guidance
- Do not smoke
- Ask your doctor about kidney-protective medications if you are at risk
Frequently Asked Questions
Can dehydration cause kidney disease?
Repeated, chronic dehydration can contribute to kidney damage over time. Single episodes of mild dehydration are unlikely to cause lasting harm. The concern is persistent under-hydration, especially common in Arizona's extreme heat.
Is kidney disease hereditary?
Some forms are. Polycystic kidney disease (PKD) is a genetic condition that causes cysts to form in the kidneys. Having a family member with CKD from any cause also increases your risk. Regular screening is recommended if you have a family history.
Do energy drinks affect the kidneys?
Excessive consumption of energy drinks, which are high in caffeine and sugar, can contribute to dehydration, high blood pressure, and kidney stress. Moderate intake is generally fine for healthy people, but those with kidney disease or risk factors should limit them.
How much water should I drink to protect my kidneys in Arizona?
There is no universal number. A good rule: drink enough so your urine is pale yellow. In Arizona summer, that usually means significantly more than the standard recommendation. Active adults may need a gallon or more per day during hot months.
Does AHCCCS cover dialysis in Arizona?
Yes. AHCCCS covers dialysis, kidney transplant evaluation, and transplant-related care. Medicare also covers dialysis for most people with end-stage kidney disease, regardless of age.