Levine, Hallie
8 to 10 minutes
According to the National renal Foundation (NKF), around 90% of persons with renal disease are unaware of their condition. It’s a sobering statistic, but it bears repeating.
Most people with kidney disease don’t show symptoms until the very late stages,” said David Goldfarb, MD, clinical chief of nephrology at NYU Langone Health in New York City. This is why, according to Dr. Goldfarb, persons who have risk factors for kidney disease, such as being over 60 or having a chronic medical condition like type 2 diabetes, high blood pressure, or an autoimmune disorder like lupus, should be frequently examined for kidney disease.
However, there are subtle signs that can appear in both the early and late phases, according to Staci Leisman, MD, a kidney specialist at New York’s Mount Sinai Hospital. Here are some warning symptoms of renal disease at various stages.
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According to Dr. Leisman, these symptoms can appear in the first three stages of renal disease, before too much harm has been done to your kidneys. (They can also appear in the later phases.)
If you observe any of these symptoms, consult your doctor as soon as possible to rule out renal illness.
Peeing in the Night
Excess fluid in your body accumulates in your ankles and calves from standing and sitting all day, according to Dr. Leisman. However, while you sleep, that additional fluid flows directly to your kidneys. If your kidneys are injured, they will not be able to filter that fluid as well. According to Dr. Leisman, the effect could be more nocturnal potty trips. If you wake up more than once in the middle of the night to use the restroom, it’s time to see your doctor.
Swelling
When your kidneys are damaged, they can’t filter out salt as well, causing edema, or swelling in your ankles, feet, and legs, according to Robert Greenwell, MD, chief of nephrology at Mercy Medical Center in Baltimore. You may also notice puffiness around your eyes, particularly in the morning, that does not go away with standard treatment (such as using cool washcloths or tea bags).
“Your kidneys are leaking protein into your urine, which means less protein goes into your blood,” Dr. Greenwell explained. “A protein deficiency can cause blood vessels to swell, which is most noticeable around the eyes.”
Anemia
Anemia is one of the first symptoms of renal illness, according to Dr. Leisman. A healthy kidney produces erythropoietin (EPO), a hormone that signals your body’s bone marrow to produce more red blood cells. However, if your kidneys aren’t operating properly, they won’t produce enough EPO, according to Dr. Leisman. You create fewer red blood cells as a result.
“We often see this in the middle stages of kidney disease,” said Dr. Leisman. Consult your doctor if you have symptoms of anemia such as dizziness, difficulty concentrating, extremely pale skin, or chest pain. They can perform a blood test to determine your hemoglobin levels, which are found in red blood cells.
Iron supplements are typically used as treatment. Red blood cell transplantation may be required in extreme circumstances.
Erythrocyte (aka red blood cell) stimulating drugs (ESAs) are another typical treatment for anemia induced by kidney failure. According to the Food and Drug Administration (FDA), ESAs are drugs that mimic EPO, instructing your bone marrow to produce more red blood cells.
If you’ve been diagnosed with anemia, Dr. Leisman recommends having your healthcare practitioner do tests to monitor your kidney function, such as your glomerular filtration rate (GFR). This is a blood test that will determine how successfully your kidneys filter blood. According to the National Institute of Diabetes and Digestive and renal Diseases (NIDDK), a GFR of at least 60 is considered normal, whereas less than that suggests renal disease.
“We typically see anemia when a patient’s GFR is in the 30s,” Dr. Leisman explained. In the late stages of kidney disease, you will also experience exhaustion and difficulty concentrating because the fast decline in kidney function causes a buildup of toxins in your blood.
Urine that is bloody or foamy
If you observe blood, it suggests your pee contains red blood cells. This could be due to a urinary tract infection (UTI) or a kidney stone, but it could also be an indication of renal disease. “When your kidneys are healthy, their filters actually prevent blood from entering your urine,” explained Dr. Greenwell. When they are injured, though, little volumes of blood flow in.
Sometimes you can see blood (it usually looks red or like tea or cola, according to Dr. Greenwell). However, because blood can be minuscule at times, it can only be detected during a normal urinalysis when your healthcare professional examines a sample of your pee under a microscope.
According to Dr. Leisman, white foam in your urine usually suggests high levels of albumin, a protein found in minute amounts in your urine. (Because it’s the same protein found in eggs, your urine will have the same foamy, egg-white consistency.) “When your kidneys become damaged, one of the first things they have trouble filtering out is protein,” noted Dr. Leisman.
These symptoms commonly appear around the fourth or fifth stage of the disease. They signal that your kidneys have gotten so damaged that they can no longer filter out the majority of pollutants. Toxins accumulate in your bloodstream as a result. Unfortunately, at this stage, treatment usually consists of dialysis or, eventually, a kidney transplant, according to Dr. Greenwell. (Dialysis, according to the NIDDK, is when a machine passes your blood through a filter outside your body, removing wastes.)
Itchy, dry skin
According to the National Kidney Foundation, your kidneys also help to keep your bones strong and the proper mineral balance in your blood. End-stage kidney disease can cause your kidneys to become so damaged that they can’t do either, according to Dr. Goldfarb. As a result, your skin may become rough and scaly, with fish-like scaling. According to the American Academy of Dermatology (AAD), you may find that it feels tight and cracks readily.
As your kidney function deteriorates, your kidneys will lose their ability to filter out waste, such as excessive levels of the mineral phosphorus, according to the NIDDK. According to the NKF, this can build up in your skin and create itching that can range from minor annoyance to a desire to scratch your skin, a condition known as uremic pruritis. Scratching so hard that you acquire raw, bleeding skin or sores is possible.
Toxin buildup in your body can cause your skin to turn an unhealthy pale, yellowish, or gray tone over time, according to the AAD. Your skin may darken and thicken, as well as grow bumps that resemble pimples or whiteheads and deep wrinkles. An itchy rash of little dome-shaped pimples that sometimes come together to form rough raised patches may also appear.
According to the AAD, symptoms of severe renal disease might also appear on your fingers or toes. The telltale symptom is half-and-half nails, which have white on the top of your nails and a normal color on the bottom.
Appetite Suppression
Toxins build up in your body when you have renal illness, which might affect your appetite, according to Dr. Goldfarb. According to Dr. Leisman, around one-third of patients with end-stage renal disease experience a metallic taste in their mouth, which is most likely due to a buildup of waste products in your body such as urea. This, in turn, can have an effect on your taste buds. It can also result in nausea and vomiting.
Cramps in the Muscles
According to Dr. Greenwell, people with severe kidney illness are more prone to electrolyte imbalances, which can cause cramping and a pins and needles sensation in their arms and legs.
According to a 2020 study published in Cureus, 6.6% to 80% of persons on dialysis for end-stage kidney disease suffer restless legs syndrome. Restless legs syndrome is a disorder in which you have an overpowering need to move your legs while lying down.
The symptoms of renal disease might be modest in both the early and late stages. Most people are unaware they have renal disease since it is so subtle. Consult your healthcare physician as soon as you discover signs and symptoms of renal issues or illness.
