Chronic kidney disease (CKD) means the kidneys have been damaged or are working less well for three months or longer. It is common in Malaysia, and studies suggest it affects around one in seven adults. Because early CKD rarely causes symptoms, many people find out late. The good news: with early detection and good care, progression can often be slowed significantly.
What causes chronic kidney disease?
- Diabetes: the leading cause of kidney failure in Malaysia, responsible for more than half of new dialysis patients.
- High blood pressure: both a cause and a consequence of kidney damage.
- Glomerulonephritis (inflammation of the kidney filters), polycystic kidney disease and recurrent kidney stones or infections.
- Long-term use of some medicines, especially regular painkillers such as NSAIDs, and unregulated supplements or traditional remedies.
The stages of CKD
CKD is staged by eGFR (estimated glomerular filtration rate, calculated from a blood creatinine test) together with the level of albumin (protein) in the urine:
- Stage 1: eGFR 90 or above, with signs of kidney damage such as protein in the urine.
- Stage 2: eGFR 60–89, with signs of kidney damage.
- Stage 3a / 3b: eGFR 45–59 / 30–44, a moderate reduction in function.
- Stage 4: eGFR 15–29, a severe reduction; planning for future treatment begins.
- Stage 5: eGFR below 15, kidney failure; dialysis or transplant may be needed.
Warning signs
Symptoms usually appear only in later stages. They can include swelling of the ankles or around the eyes, foamy urine, passing urine more often at night, tiredness, itching, poor appetite and difficult-to-control blood pressure. If you have diabetes or high blood pressure, do not wait for symptoms. Get tested at least yearly.
Tests that detect CKD early
- Blood creatinine and eGFR to measure filtering function.
- Urine albumin-to-creatinine ratio (uACR), the earliest marker of kidney damage in diabetes.
- Blood pressure, blood glucose and HbA1c.
- Kidney ultrasound when your doctor needs to look at kidney structure.
How to protect your kidneys
- Control blood sugar: see our diabetes treatment guide.
- Control blood pressure: often to below 130/80 mmHg, as advised by your doctor.
- Use kidney-protective medicines your doctor prescribes, such as ACE inhibitors, ARBs or SGLT2 inhibitors.
- Reduce salt. Watch out for soy sauce, instant noodles, processed meats and salty snacks.
- Avoid unnecessary painkillers and unregistered supplements, and always check with your doctor before starting new products.
- Stop smoking, stay active and keep a healthy weight.
Supporting kidney health at Montis
At Montis we focus on early detection and risk-factor control. Our medical screening checks kidney markers alongside blood sugar, blood pressure and cholesterol. Our Diabetic Management and Heart Recovery programmes then help you manage the conditions that drive CKD. We work alongside your nephrologist where you already have one.
Frequently asked questions
Can chronic kidney disease be reversed?
Established kidney damage usually cannot be reversed, but progression can often be slowed significantly, especially when CKD is found early and blood sugar and blood pressure are well controlled. Some acute causes of reduced kidney function are reversible.
What foods should I avoid with CKD?
Most people should reduce salt and processed foods. Depending on your stage and blood tests, your doctor or dietitian may also advise limiting potassium, phosphate or protein. Dietary advice should be individual, so avoid restrictive diets without guidance.
How often should I check my kidneys?
If you have diabetes or high blood pressure, at least once a year with eGFR and a urine albumin test. If you already have CKD, your doctor will set a schedule based on your stage.
This article is for general information only and is not a substitute for personal medical advice. Treatments described may not be suitable for everyone. Please consult a qualified doctor before starting any treatment.
