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Canadian Med Center

Complications of Chronic Kidney Disease

Thursday 14 March 2024
Chronic Kidney Disease
6 minute(s) read

Table of Contents

I. Gout and Chronic Kidney Disease

II. Anemia and CKD

III. High Phosphorus and CKD

IV. Heart Disease and Chronic Kidney Disease

V. Itchy Skin and CKD

VI. Metabolic Acidosis and CKD

VII. Secondary Hyperparathyroidism and CKD

VIII. Conclusion

Chronic Kidney Disease (CKD) is a progressive condition involving the gradual decline in kidney function over time. While it may initially present with mild symptoms, if left untreated, CKD can lead to severe consequences that affect multiple organs within the body. 

In this article, we will discuss some common complications associated with CKD and how they impact overall health.

Gout and CKD

Gout and chronic kidney disease often go hand in hand. Gout is a form of arthritis that occurs when excess uric acid in the bloodstream crystallizes in the joints, causing inflammation and pain. Meanwhile, chronic kidney disease (CKD) impairs the kidneys' ability to filter uric acid from the blood, allowing it to accumulate. [1]

When gout flares up, the symptoms usually occur suddenly, often at night. For some, gout symptoms may appear just once, while for others, flare-ups happen several times a year. [1]

  • Joint pain: Severe pain can occur in any joint. However, the big toe, knees, ankles, wrists, elbows, and fingers are commonly affected.
  • Inflammation: When the uric acid crystals settle in, the joint becomes red and swollen.
  • Range of motion is limited: Your joints can feel stiff as the crystals form around the joint. [1]

Anemia and CKD

a person holding a test tube labelled anemia

Anemia is a common side effect of chronic kidney disease (CKD). When your kidneys are not working properly, they have trouble producing erythropoietin (EPO), an important hormone that tells your body to make red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body, providing you with energy. Without enough red blood cells, you can develop anemia. [2]

Anemia can develop at any stage of CKD, but it is especially common if you have moderate to severe kidney damage or kidney failure. Certain factors can also increase your risk for anemia: [2]

  • Being African-American
  • Female sex
  • Have diabetes
  • Have moderate to severe CKD (stages 3 to 5) [2]

Not everyone with anemia will experience symptoms, so it is essential to check your hemoglobin at least once a year. Hemoglobin is a component of red blood cells that transports oxygen throughout the body. If the hemoglobin level is found to be too low, it is likely anemia is present. [2]

If you do experience symptoms, they may include:

  • Looking pale
  • Feeling tired
  • Trouble sleeping
  • Shortness of breath
  • Rapid heartbeat
  • Trouble thinking clearly
  • Poor appetite [2]

High Phosphorus and CKD

Phosphorus is an important mineral that helps build and maintain your bones. Your kidneys normally regulate phosphorus levels in your blood to keep them balanced. However, when you have CKD, your kidneys struggle to remove excess phosphorus, which can lead to high phosphorus levels. [3]

High phosphorus levels can cause damage to your body:

  • Weak bones: Too much phosphorus in your blood can pull calcium from your bones, weakening them over time. 
  • Calcium deposits: High phosphorus causes calcium and phosphorus to build up in your blood vessels, heart, lungs, and eyes. This buildup, known as calcification, increases your risk of heart attack, stroke, and even death. [3]

Heart Disease and CKD

A doctor listening to patient’s heart with a stethoscope

If you have CKD, you are at a much higher risk of developing heart disease. In fact, heart disease is the leading cause of death for those with kidney disease. This is because the two conditions share common causes, such as diabetes and high blood pressure. [4]

  • Diabetes: Over time, high blood glucose levels from uncontrolled diabetes can damage the small blood vessels in the kidneys, leading to kidney disease. High blood sugar also damages blood vessels supplying the heart and increases plaque buildup, raising the risk of heart attacks.
  • High blood pressure: Uncontrolled high blood pressure makes the heart work harder to pump blood through the body. This extra strain damages blood vessels throughout the body, including in the kidneys and heart. [4]

Itchy Skin and CKD

Itchy skin, or pruritis, is a common symptom experienced by many people with CKD. While pruritis can occur at any stage of CKD, it tends to be more prevalent in advanced or end-stage kidney disease. The exact cause of itchy skin in CKD patients is not fully understood, but research has uncovered some theories behind this frustrating symptom. [5]

  • Immune response: The body's immune system responds to CKD by becoming overactive and inflamed, attacking healthy tissue and provoking itchiness.
  • Nerve damage: Signals sent to opioid receptors in nerve cells may become imbalanced, resulting in itching.
  • Uremia: The buildup of toxins and wastes in the bloodstream, called uremia, can provoke itchiness. When kidneys are damaged, the body cannot effectively remove wastes and toxins. Patients not getting adequate dialysis to filter their blood may be especially susceptible to itchy skin from uremia. [5]

Metabolic Acidosis and CKD

Metabolic acidosis occurs when the kidneys cannot remove enough acid from the body, resulting in an accumulation of acid in the body fluids. This can happen due to kidney disease or kidney failure. When the acid levels in the body are too high, it indicates that the body is either not eliminating enough acid, producing too much acid, or struggling to maintain a balance. [6]

For individuals with CKD, metabolic acidosis can lead to various complications:

  • Osteoporosis: Metabolic acidosis can contribute to the loss of bone density, making the bones more prone to fractures, especially in critical areas like the hips or backbone.
  • Kidney disease progression: The exact way metabolic acidosis affects kidney disease is not fully understood. However, it is known that as acid builds up, kidney function diminishes, and as kidney function declines, acid accumulates further. This vicious cycle can ultimately lead to the worsening of kidney disease.
  • Muscle loss: Albumin plays a crucial role in muscle health and development. Metabolic acidosis reduces albumin production, resulting in muscle wasting or loss.
  • Endocrine disorders: Metabolic acidosis can disrupt the normal functioning of the body's endocrine system, which is responsible for producing hormones. This interference can lead to insulin resistance, a condition where the body becomes less responsive to insulin, the hormone that regulates blood sugar levels. If left untreated, this can eventually lead to diabetes. [6]

Secondary Hyperparathyroidism and CKD

A person pointing to a parathyroid gland

The parathyroid glands are four tiny glands in your neck, each about the size of a pea. They produce and release parathyroid hormone (PTH), which regulates the amount of calcium in your blood and bones. [7]

When your blood calcium level drops too low, your parathyroid glands release more PTH. This signals your bones to release calcium into the bloodstream, bringing the blood calcium level back to normal. [7]

In people with CKD, a condition called secondary hyperparathyroidism can develop. This occurs when the parathyroid glands enlarge and secrete too much PTH, leading to elevated blood PTH levels. There are a few reasons why this happens in CKD patients:

  • High phosphorus levels
  • The kidneys are not producing active vitamin D. Vitamin D is needed to absorb calcium.
  • Low blood calcium levels [7]

Secondary hyperparathyroidism can have serious health consequences like bone disease and calcium buildup in the heart and blood vessels. [7]


Chronic kidney disease can lead to various health complications if not properly managed. However, with early detection and appropriate treatment, those affected by CKD can improve their quality of life. The key is to address issues as soon as they arise.

To learn more about CKD, visit our chronic kidney disease blog.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.