11 Early Warning Signs of Kidney Disease by Narayana Health

Millions of people live with different types of kidney disease and most of them have no idea about it. This is why kidney disease is often referred to as a “silent killer,” as most people don’t feel any different until the disease is advanced.

There are a number of warning signs of kidney disease, but they are usually ignored or confused with alternative pathologies due to their non-specific nature. Therefore one should be very vigilant and have the confirmatory tests (including blood, urine and imaging) performed at the first signs of kidney disease.

While the only definitive way to diagnose kidney disease is to perform confirmatory tests, here are some early warning signs of kidney disease:

  1. Swelling above the ankles, feet, or legs: One will begin to notice edema at these sites that pits when pressure is applied and is called pitting edema. As kidney function begins to decline, there is sodium retention that causes swelling in your shin and ankles. Basically, anyone who notices a new onset of pedal edema should get an immediate evaluation of their kidney function after visiting a nephrologist.
  2. Periorbital edema: It indicates swelling or puffiness around the eyes caused by the accumulation of fluid in the cells or tissues. It is one of the first signs of kidney disease. It is especially prominent in individuals where a significant amount of protein leaks through the kidney. Loss of protein from the body lowers intravascular oncotic pressure and leads to extravascular accumulation of fluid in various sites, such as around the eyes.
  3. Weakness: Early fatigue is almost always a universal symptom of kidney disease. As renal impairment progresses, this symptom becomes more and more prominent. One may feel more tired or exhausted than on normal days and will not be able to perform more strenuous activities, requiring rest more often. This is largely due to a buildup of toxins and impurities in the blood, resulting from poor kidney function. Because it is a non-specific symptom, it is often ignored and not thoroughly investigated by most people.
  4. Decreased appetite: Secondary to a buildup of toxins such as urea, creatinine and acids, an individual’s appetite is suppressed. Also, as kidney disease progresses, there is a change in taste, often described as metallic by patients. If someone gets the feeling of early satiety despite barely eating anything during the day, that should set alarm bells ringing and their kidney function should be evaluated.
  5. Early morning nausea: Classically described as hitting the person when he or she goes to the bathroom in the morning to brush his or her teeth. It also contributes to the poor appetite of the individual.
  6. Anemia: The hemoglobin level starts to drop, one may look pale, without any obvious place of blood loss from the body. This can also cause weakness and fatigue. The cause of anemia is multifactorial, including low erythropoietin levels (erythropoietin is synthesized in the kidney), low iron levels, accumulation of toxins that cause bone marrow suppression, just to name a few.
  7. Changes in urinary frequency: One should keep a very close eye on his or her urine output. For example, you may feel the need to urinate more often, especially at night (called nocturia). It may be a warning and may indicate that the kidney filter units are damaged or are becoming damaged. Sometimes this can also be a sign of a urinary tract infection or an enlarged prostate in men.
  8. Change in color, consistency or nature of urine: Excessive foaming in the urine indicates the presence of protein in the urine (which should be negligible under normal circumstances). When the kidney’s filtering mechanism is or becomes damaged, proteins and blood cells begin to leak into the urine. In addition to signaling kidney disease, blood in the urine can indicate tumors, kidney stones, or any type of infection. Pus in the urine along with fever or chills can also be serious and may indicate pyelonephritis (infection of the kidneys).
  9. dry skin: Dry skin or xerosis can be an early sign of kidney disease. As kidney function declines, toxins tend to build up in the body, leading to itchy, dry, and smelly skin.
  10. Back pain or lower abdominal pain: Pain in the back, side or under the ribs can be an early symptom of kidney disease such as kidney stone or pyelonephritis. Likewise, pain in the lower abdomen can be associated with cystitis or stone in the ureter or urinary bladder. Such symptoms should not be ignored and further investigated through a routine imaging test such as XRAY KUB or abdominal ultrasound.
  11. high bloodpressure: A presenting sign of kidney disease can be high blood pressure. Any person diagnosed with hypertension should undergo a detailed examination of renal function and renal imaging to rule out the renal etiology of hypertension.

Recognition and awareness of warning signs and timely intervention can mean the difference between early detection and treatment of kidney disease or kidney failure, which can lead to dialysis, kidney transplantation or even death.

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