What Causes Chronic Kidney Disease?

Reviewed by: HU Medical Review Board | Last reviewed: December 2022

Chronic kidney disease (CKD) is a long-term health condition that makes the kidneys work less well. If kidney disease goes untreated, the kidneys may stop working completely.1

There are several reasons why the kidneys become damaged. The most common causes of kidney disease are:1

  • Diabetes (type 1 and type 2)
  • High blood pressure
  • Inflammation of the kidneys (glomerulonephritis)
  • Inherited kidney diseases like polycystic kidney disease
  • Repeated kidney infections, kidney stones, or enlarged prostate
  • Other health conditions like lupus

High blood pressure and diabetes account for 2 out of 3 cases of chronic kidney disease in the United States. In fact, high blood pressure and diabetes led to a 42 percent increase in new cases of people with end-stage kidney disease between 2000 and 2019.2,3

End-stage kidney disease refers to the most serious stage of kidney disease. End-stage means the kidneys are barely working or have stopped working completely. At this point, dialysis or kidney transplant are needed to prevent death.1

Risk factors for kidney disease

Some people are at higher risk of developing kidney disease, including those with:1,2,4

  • Heart disease
  • Higher weight (obesity)
  • A family history of CKD
  • Black, Native American, Asian American, or Hispanic heritage
  • Long-term use of drugs that damage the kidneys
  • Older age
  • A history of smoking

BIPOC and kidney disease

BIPOC stands for Black, indigenous, and people of color. People from these groups have higher rates of chronic kidney disease and worse outcomes than white people. Black and Hispanic people are hit hardest by kidney disease.4,5

While Black people make up 13 percent of the US population, they account for 35 percent of people with kidney failure. The number of Hispanic people with kidney failure has grown by 70 percent since the year 2000.5


Smoking is not good for the kidneys. Studies show that people with kidney disease who smoke develop worse CKD more quickly.6,7

Smoking is particularly risky if you are diagnosed with kidney disease and do not stop smoking. Once you are diagnosed with CKD, you have double the risk of dying if you continue smoking. The good news is that quitting smoking may help prevent you from developing CKD in the first place.6,7

Children and kidney disease

The most common causes of kidney disease in children and teens are:8

  • Birth defects, such as being born with 1 kidney or a kidney that does not work properly
  • Inherited conditions like polycystic kidney disease or Alport syndrome
  • Infection with E.coli or strep (streptococcus)
  • Nephrotic syndrome, which is a collection of symptoms that mean the kidneys are not working properly
  • Chronic health conditions like lupus or diabetes
  • Kidney injury due to accidents, burns, or dehydration
  • Conditions that block urine flow

The leading causes of kidney disease in children under age 4 are birth defects and genetic conditions. Between ages 4 and 14, genetic conditions and chronic diseases are the most common reason for kidney issues.8

Inherited and other chronic kidney conditions

Along with high blood pressure, heart disease, and diabetes, several health conditions can lead to kidney disease. Some of these conditions are inherited, or genetic. They include:2,9,10

  • Polycystic kidney disease
  • Alport syndrome
  • Cystinosis
  • Fabry disease
  • Gitelman syndrome
  • Nephronophthisis
  • Tuberous sclerosis complex

Other chronic health conditions that weaken or attack the kidneys include:10-14

  • Gout
  • Lupus
  • Glomerulonephritis
  • IgA nephropathy
  • Interstitial nephritis
  • Vesicoureteral reflux (urine that backs up into the kidneys)
  • Repeated kidney infections (pyelonephritis)
  • Uncontrolled HIV or infection with hepatitis C
  • Cystic fibrosis
  • Sickle cell disease

If you have any of these risk factors or chronic conditions, you should ask your doctor to test your kidney function once per year. They will use a GFR (glomerular filtration rate) test to measure how well your kidneys are working.15

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