Most people are not aware of the fact that kidney diseases can be silent killers. They may not show any symptoms for a long time till the situation becomes critical. (Why is it silent?) Even young people are now prone to it. It is important to recognize the symptoms of kidney diseases to catch them early. There are many reasons why kidney disease is caused. The most common causes are diabetes and hypertension. Even an unhealthy lifestyle with a high calorie diet, certain medicines. lots of soft drinks and sugar consumption can also cause kidney damage. Here is a list of twelve symptoms which could indicate something is wrong with your kidney:.

Changes in your urinary function: The first symptom of kidney disease is changes in the amount and frequency of your urination. There may be an increase or decrease in amount and/or its frequency, especially at night. It may also look more dark coloured. You may feel the urge to urinate but are unable to do so when you get to the restroom.

Difficulty or pain during voiding: Sometimes you have difficulty or feel pressure or pain while voiding. Urinary tract infections may cause symptoms such as pain or burning during urination. When these infections spread to the kidneys they may cause fever and pain in your back.

Blood in the urine: This is a symptom of kidney disease which is a definite cause for concern. There may be other reasons, but it is advisable to visit your doctor in case you notice it.

Swelling: Kidneys remove wastes and extra fluid from the body. When they are unable to do so, this extra fluid will build up causing swelling in your hands, feet, ankles and/or your face. Read more about swelling in the feet.

Extreme fatigue and generalised weakness: Your kidneys produce a hormone called erythropoietin which helps make red blood cells that carry oxygen. In kidney disease lower levels of erythropoietin causes decreased red blood cells in your body resulting in anaemia. There is decreased oxygen delivery to cells causing generalised weakness and extreme fatigue. Read more about the reasons for fatigue.

Dizziness & Inability to concentrate: Anaemia associated with kidney disease also depletes your brain of oxygen which may cause dizziness, trouble with concentration, etc.

Feeling cold all the time: If you have kidney disease you may feel cold even when in a warm surrounding due to anaemia. Pyelonephritis (kidney infection) may cause fever with chills.

Skin rashes and itching: Kidney failure causes waste build-up in your blood. This can causes severe itching and skin rashes.

Ammonia breath and metallic taste: Kidney failure increases level of urea in the blood (uraemia). This urea is broken down to ammonia in the saliva causing urine-like bad breath called ammonia breath. It is also usually associated with an unpleasant metallic taste (dysgeusia) in the mouth.

Nausea and vomiting: The build-up of waste products in your blood in kidney disease can also cause nausea and vomiting. Read 13 causes for nausea.

Shortness of breath: Kidney disease causes fluid to build up in the lungs. And also, anaemia, a common side-effect of kidney disease, starves your body of oxygen. You may have trouble catching your breath due to these factors.

Pain in the back or sides: Some cases of kidney disease may cause pain. You may feel a severe cramping pain that spreads from the lower back into the groin if there is a kidney stone in the ureter. Pain may also be related to polycystic kidney disease, an inherited kidney disorder, which causes many fluid-filled cysts in the kidneys. Interstitial cystitis, a chronic inflammation of the bladder wall, causes chronic pain and discomfort.

Read more about causes, symptoms, diagnosis and treatment of kidney disease.

It is important to identify kidney disease early because in most cases the damage in the kidneys can’t be undone. To reduce your chances of getting severe kidney problems, see your doctor when you observe one or more of the above symptoms. If caught early, kidney disease can be treated very effectively.

Chronic kidney disease (CKD): It is an age related gradual loss of kidney function and is often symptomless in the initial stages. Because loss of kidney function is gradual in CKD, there are different stages of CKD.

  • Mild CKD: It occurs when the kidneys are damaged and cause slight decrease in GFR i.e., between 60 and 89 mL/min/1.73m2.
  • Moderate CKD occurs when the GFR decreases further and may lie anywhere between 30 and 59 mL/min/1.73m2.
  • In severe CKD, the filtration rate is reduced to 15-29 mL/min/1.73m2.
  • Finally, when the GFR reduces below 15 mL/min/1.73m2, the stage of kidney failure is reached, where the patient needs dialysis for carrying out the filtration function.
Risk factors

Risk factors for kidney disease are grouped under modifiable and non-modifiable categories. Although you cannot do anything about the non-modifiable risk factors, lifestyle related factors can be controlled well in time to reduce the progression of kidney disease.

  • 1. Diabetes
  • 2. Hypertension or high blood pressure
  • 3. Family history of kidney disease
  • 4. Old age
  • 5. Heart disease
  • 6. Obesity
  • 7. Recurrent urinary infection
  • 8. Renal stone diseases
  • 9. History of acute renal failure i
  • 10. Drug abuse/drug overdose
  • 11. Race/Ethnicity

Generally, with acute kidney disease you’ll develop symptoms based on which the doctor will recommend tests for assessing your kidney function. In chronic kidney disease, the symptoms are not seen in the early stages but the same tests if taken early can help diagnose kidney disease. Read about 3 good reasons to get a kidney check up done. When you go for an annual screening of your kidney function, you will have to undergo some or all of the following tests:

  • 1. Blood tests: Several markers in the blood can help identify the actual kidney function. Urea and creatinine are the gold standards to detect kidney disease.
  • 2. Urine tests: The ratio of values for blood and urine marker can give the actual rate of clearance of kidneys.
  • 3. Estimated GFR: eGFR is the estimate of filtration rate of the kidneys based on a formula that include serum creatinine values along with correction factors like age, gender and race.
  • 4. Imaging tests: Imaging test like renal ultrasound uses ultrasonic waves to analyse the size and shape of the kidneys to identify renal injury and changes in filtration capacity of the kidneys.

Here are 8 tests for checking if your kidneys are functioning fine.

Why should I be checked for kidney disease?

Diabetes and high blood pressure can damage the kidneys and lead to kidney disease. You need to get checked for kidney disease if you have one of these conditions. Here are some other reasons to get checked: Ea rly kidney disease has no signs or symptoms. The only way to know if you have kidney disease is to get checked for it. Kidney disease usually does not go away. It may get worse over time and can lead to kidney failure. If your kidneys fail, you may need to go on dialysis or have a kidney transplant to maintain health. K idney disease can be treated. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. Treating kidney disease may also help prevent heart disease.

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Dr. Sham Sunder Sr. Consultant Nephrology (Head of Nephrology Unit)Kailash Hospital Noida & Medical Research Center (New Delhi)

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