The early symptoms of kidney disease are so subtle that they can go unnoticed for many years. Delays in medical treatment could be fatal, so it’s important to catch the signs early to prevent permanent kidney damage.

The American Kidney Fund estimates that one in three U.S. adults are at risk for chronic kidney disease (CKD), and many that have it don’t even know. It can take months or years for this condition to progress to noticeable kidney failure, which cannot be reversed. Understanding the early signs of kidney problems can help you act on them in a timely manner.

What Causes Kidney Disease?

According to the National Kidney Foundation, type 1 and type 2 diabetes and high blood pressure are the leading causes of kidney disease. These conditions cause about two-thirds of CKD cases. A person who has heart disease or a family history of kidney disease is also at an increased risk. Repeated urinary tract infections (UTIs) and the use of drugs that are toxic to the kidneys, such as over-the-counter pain medications, can also cause kidney damage.

The frightening thing about chronic kidney disease is that a person typically experiences no signs or symptoms in the early stages. The only way to know if someone is experiencing kidney problems is to see a doctor for testing.

Unfortunately, kidney disease does not go away. It may slowly get worse over time and most people don’t realize they have kidney disease until it is already quite severe. Once these organs fail, the damage is permanent. The only options for treating end-stage renal disease (ESRD) are dialysis or a kidney transplant. The sooner a diagnosis is made, the sooner steps can be taken to improve kidney health and prevent further damage.

Signs of Kidney Problems

If you or someone you love is at risk for developing kidney disease, be sure to keep an eye out for the following symptoms and signs that something is amiss.

1. Changes in Urination

The kidneys filter fluids and waste from the blood, which are then excreted as urine. Therefore, changes in kidney function often produce unusual changes in urination, such as:

  • Waking up at night to urinate (nocturia)
  • More frequent urination
  • Foamy or bubbly urine
  • Urinating less often, or in smaller amounts with dark colored urine
  • Blood in the urine (hematuria)
  • A feeling of pressure while urinating
  • Difficulty urinating

2. Swelling

Failing kidneys struggle to effectively remove extra fluids from the body. As a result, this fluid builds up, causing edema or swelling. While swelling can occur throughout the body, edema is usually most noticeable in the in the legs, ankles, feet, face and hands.

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3. Fatigue

Healthy kidneys make a hormone called erythropoietin (EPO) that tells the body to produce oxygen-carrying red blood cells. As the kidneys fail, they make less EPO and therefore the body experiences a shortage of red blood cells. This condition is known as anemia and is characterized by muscle weakness and an overall tired feeling.

4. Feeling Cold

Anemia can also cause a person to feel cold all the time, even in a warm room. A low red blood cell count affects oxygen circulation throughout the body, especially to the extremities. Therefore, anemia can cause a general cold feeling or a persistent cold sensation primarily in the hands and feet.

5. Dizziness and Trouble Concentrating

Anemia related to kidney failure can mean that the brain is not getting enough oxygen. This can lead to memory problems, difficulty concentrating and dizziness.

6. Shortness of Breath

When kidney disease is present, extra fluid in the body can build up in the lungs (a condition called pulmonary edema), making it difficult to get adequate oxygen. Anemia can compound this issue further because there aren’t enough red blood cells to accept and transport the limited oxygen a person breathes in.

7. Back Pain

Some people with kidney problems may experience pain in their back or one-sided pain near the affected kidney. An inherited disorder called polycystic kidney disease causes large, fluid-filled cysts in the kidneys and sometimes the liver, which can cause localized pain as well.

8. Rashes

When the kidneys fail, wastes build up in the bloodstream (a condition known as uremia) and can cause severely itchy skin and rashes.

9. Metallic Taste in the Mouth

Uremia can also make food taste different and cause bad breath. A person with kidney problems may even notice a peculiar metallic taste in their mouth. They may suddenly stop liking to eat meat, or they may lose weight because they don’t feel like eating.

10. Nausea and Vomiting

Severe cases of uremia can cause nausea, vomiting and a complete loss of appetite.

Testing for Kidney Disease

If you or someone you love is at risk for developing kidney disease and begins experiencing any of the above symptoms, it is crucial to make an appointment with a doctor for blood and urine tests right away.

The blood test that indicates how well the kidneys are working measures creatinine, a waste product. When kidney function is compromised, the organs have difficulty removing creatinine from the blood. A patient’s creatinine levels are then used in a formula that takes their age, sex and race into account to determine their glomerular filtration rate (GFR). A person’s GFR describes their overall level of kidney function.

Urinalysis is important for determining kidney health as well. A urine test to measure the amount of albumin, a type of protein, in the urine can point to compromised kidney function. Repeated tests that are positive for protein in the urine are an indicator of kidney disease.

These simple tests are vital for those who are at risk of developing kidney disease. Without prompt diagnosis and treatment, end-stage renal disease can be fatal. However, if CKD is caught early on, lifestyle changes and medications to control high blood pressure, cholesterol levels, anemia and swelling can be effective in slowing down the progression of kidney disease and minimizing complications.

Sources: Kidney Disease Risk Factors, Causes, & Prevention (https://www.kidneyfund.org/prevention/are-you-at-risk/); Chronic Kidney Disease (CKD) Symptoms, Causes, Treatment (https://www.kidney.org/atoz/content/about-chronic-kidney-disease); Which Drugs are Harmful to Your Kidneys? (https://www.kidney.org/atoz/content/drugs-your-kidneys); Chronic Kidney Disease (CKD) (https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd)