early warning symptoms of kidney disease

As we all know, every person has two kidneys in the body, which are mainly responsible for filtering the nitrogenous wastes such as urea, creatinine, acids, etc. from the blood. (all products of the body’s metabolism) and thus produce urine.

Lakhs people live with different types of kidney disease and most of them are not even aware of it. This is why kidney disease is often referred to as a ‘silent killer’ as most people are not diagnosed with the disease until it has taken on a serious form. While people have their blood pressure, blood sugar and cholesterol checked regularly, they don’t even get a simple blood creatinine test to detect any problems with their kidneys. According to the 2015 Global Burden of Disease (GBD) study, chronic kidney disease (CKD) ranks as one of the eighth leading causes of death in India.

There are many warning signs of kidney disease, but they are usually ignored or confused by people who think of a different kind of problem. Therefore, one should be very vigilant and have confirmatory tests (including blood, urine and imaging) done as soon as possible if symptoms of kidney disease appear. Such a person should visit a nephrologist and have their doubts cleared up. But if you have high blood pressure, diabetes, obesity, metabolic syndrome or a family history of coronary artery disease and/or kidney failure, or if you are over 60 years old, you should have regular kidney tests in this age. keep getting it done.

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

  • One of the first signs is the appearance of swelling in the ankles, feet or heels: Edema will appear in areas that pit when applied, and this is called pitting edema. As the kidneys begin to work less well, salt builds up in the body, causing your calves and ankles to swell. Basically, if someone shows such symptoms, they should get an immediate evaluation of their kidney function by visiting a nephrologist.
  • Periorbital Edema: It is characterized by swelling around the eyes caused by the accumulation of fluid in the cells or tissues. This is one of the first symptoms of kidney disease. This is especially true in individuals with a large amount of protein leakage through the kidneys. The loss of protein from the body lowers intravascular oncotic pressure and leads to excessive accumulation of fluid in various places around the eye.
  • Weakness: A common symptom of kidney disease is early fatigue. This symptom becomes more pronounced as renal failure progresses. The person may feel more tired and unable to perform many activities than on normal days, and may need regular rest. This is largely due to the accumulation of toxins and impurities in the blood, resulting in kidney failure. Because it is a non-specific symptom, it is often ignored by most people and not thoroughly investigated.
  • loss of appetite: Due to the accumulation of toxins such as urea, creatinine, acid, the person’s appetite begins to decrease. In addition, as the kidney disease progresses, there is a change in the patient’s taste, which is often described by patients as metallic. If a person feels full even without eating anything during the day then alarm bells should be ringing in the mind and their kidneys should be examined.
  • Morning sickness and vomiting: Another early symptom of kidney failure is early morning nausea and vomiting, and this is noticed when the patient brushes his teeth in the bathroom in the morning. This also decreases the person’s appetite. In the end stage of renal failure, the patient often has vomiting and loss of appetite.
  • Anemia: Hemoglobin levels begin to drop and the person may appear pale, with no blood being lost from the body. It is one of the most common complications of kidney disease. It can also cause weakness and fatigue. This anemia can be caused by many reasons including low levels of erythropoietin (erythropoietin is synthesized in the kidneys), low iron levels, bone marrow suppression due to toxin accumulation, etc.
  • Change in frequency of urination: One should watch their urine output very closely. For example, the patient may have decreased urine output or feel the need to urinate more often, especially at night (called nocturia). This can be a warning and indicate that the filter units of the kidneys are damaged or are becoming damaged. Sometimes it can also be a sign of a urinary tract infection or an enlarged prostate in men. Therefore, any change (increase or decrease) in urine output should be reported immediately to your nephrologist.
  • Foam or blood in the 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 filtration system is or becomes damaged, proteins and blood cells can leak out of the urine. In addition to being an indication of kidney disease, blood in the urine can indicate a tumor, kidney stone, or any infection. Also, pus in the urine along with fever or chills can be serious and again a sign of a serious urinary tract infection. Therefore, any change in color, consistency or nature of the urine should be reported to the nephrologist as soon as possible.
  • Dry and itchy skin: Dry and itchy skin can be a sign of advanced kidney disease. As kidney function declines, toxins build up in the body, causing itching, dryness, and a foul odor in the skin.
  • back pain or pain in the lower abdomenPain in the back, side, or under the ribs can be an early symptom of kidney disease, such as kidney stones or pyelonephritis. Similarly, lower abdominal pain may be associated with a bladder infection or a stone in a ureter (the tube that connects the kidney and bladder). Such symptoms should not be ignored and should be further investigated through routine imaging studies such as X-ray KUB or abdominal ultrasound.
  • high bloodpressureHigh blood pressure can be a symptom of kidney disease. Anyone diagnosed with hypertension should have a detailed assessment of renal function and renal imaging to rule out a renal etiology of hypertension. As kidney function deteriorates, sodium and water build up in the body, leading to high blood pressure. Symptoms of high blood pressure include headache, abdominal pain, fainting, and possibly early signs of kidney disease.

Kidney dysfunction or renal failure can be prevented with timely treatment and awareness of the warning signs, otherwise the patient may undergo dialysis or kidney transplant and even die if left untreated.

Tips to keep the kidneys healthy:

There are many ways to prevent kidney disease. So why wait until you have kidney disease? The following are some ways to take care of your kidney health:

Drink plenty of water: This is the most common and simple way to keep your kidneys healthy. Consuming plenty of water, especially warm water, helps the kidneys remove sodium, urea, and toxins from the body.

Low Sodium/Salt Diet: Control sodium or salt intake in your diet. This means you should also avoid packaged foods/restaurant foods. Also, do not add extra salt to your food. A low-salt diet reduces the load on the kidneys and prevents the development of high blood pressure, hypertensive diseases, and also prevents the progression of kidney disease.

Maintain a good body weight: Eat healthy and keep your weight under control. Have your body’s cholesterol levels checked regularly to prevent cholesterol from building up in the arteries of your kidneys. Also, keep saturated fat/fatty fried foods away from the diet and emphasize eating plenty of fruits and vegetables daily. Increasing a person’s weight increases the burden on the kidneys. Try to aim for a BMI of 24 or less, especially in the Indian scenario.

Check blood sugar regularly and keep it below optimal levels: Kidney failure is very common in diabetic patients and can be prevented if caught early. Therefore, it is advised to check your blood sugar regularly, avoid sugary foods and see a doctor if your blood sugar (fasting or postprandial) or HbA1c is higher. Keep the HbA1c level below 6.0.

Check and control blood pressure regularly: If you have high blood pressure, take antihypertensive medications as prescribed by your doctor, and maintain a healthy lifestyle and make necessary changes in your diet. Normal blood pressure levels are <120/80. In addition to kidney failure, high blood pressure can also lead to a stroke or heart attack.

Have a kidney function test, including urinalysis, done regularly as part of your annual checkup: as I mentioned earlier if you have diabetes, high blood pressure, obesity or if you are over 60 years old Kidney function tests, kidney imaging and urinalysis should be be performed regularly. Consult your nephrologist if even a small amount of protein is detected in the urine. Diabetes patients in particular should keep an eye on this.

Quitting smoking: Smoking is one of the major risk factors for the progression of kidney disease. Even smoking 1 cigarette can cause further damage to an already weak kidney. Smoking is also a risk factor for diabetes, high blood pressure and CAD. Therefore, one should immediately stop smoking, which is important not only for the kidneys, but also for the overall health of the body.

If not daily, do sports such as jogging, cycling, swimming, racket games for about 45 minutes a day at least 5 out of 7 days a week and thus maintain a healthy healthy lifestyle by doing light exercise. Change your sedentary lifestyle, walk around the office or take a walk after lunch or exercise in the morning and evening.

Properly balance your lifestyle by getting at least 8 hours of restful sleep per night. To stay healthy, it is necessary to sleep well at night.

Dr. Sudeep Singh Sachdev, Senior Consultant & Clinical Lead – Nephrology, Kidney Transplant – Adults, Narayana Superspeciality Hospital Gurugram

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