Am I at Risk for Kidney Disease? Early Signs of Kidney Problems

The kidneys are a pair of fist-sized, bean-shaped organs present in the back on either side, below the ribcage. They filter wastes, toxins, and extra fluid from the blood and remove them from the body as urine. Kidney diseases create a drop in the kidneys' ability to filter causing waste to build up in the body, leading to health complications. Continue reading to learn how to recognize the signs and symptoms of kidney disease for timely diagnosis and treatment.

What Is Chronic Kidney Disease?

Chronic kidney disease (CKD) is one of the most common types of kidney disease. It is a condition in which kidney function gradually declines. 

Chronic kidney disease does not usually become significantly symptomatic until it is advanced. Due to the slow progression and lack of initial symptoms, many patients are diagnosed with CKD when it has reached an advanced or severe stage. At this time, there can be complications due to dangerously high levels of waste, electrolytes, and fluid buildup in the body. Untreated chronic kidney disease can progress to end-stage kidney disease or kidney failure. End-stage kidney disease is fatal without dialysis or kidney transplant. 

Timely diagnosis and treatment can slow down the progression of chronic kidney disease. Due to the severity and the prevalence of kidney disease,it’s important to know the signs and symptoms that warrant medical attention.

Prevalence of CKD

It is estimated that about 37 million Americans, 15% of the population (more than 1 in 7 adults), have chronic kidney disease. As many as 9 out of 10 people with CKD do not know they have this condition. This is because there are only a few signs and symptoms in the early stages of chronic kidney disease, none of which are specific. 

Symptoms and Early Warning Signs

What Are The Early Signs of Kidney Disease?

The symptoms of chronic kidney disease are nonspecific, especially in the early stages. They include fatigue, weakness, loss of appetite, nausea, vomiting, sleep difficulties, changes in urination (you urinate more often), mental fogginess, muscle cramps, swollen ankles and feet, itching, chest pain, shortness of breath (this happens due to a buildup of fluid in the lungs), and difficulty in controlling blood pressure. All of these symptoms can be byproducts of other medical conditions, which is why it is important to discuss your symptoms with your primary care provider to undergo evaluation for the cause.

Common Symptoms of Kidney Disease

According to the National Kidney Foundation, some of the first signs and symptoms of kidney disease are:

• Low energy and difficulty concentrating

• Trouble sleeping

• Dry, itchy skin

• Urinating more often

• Blood in the urine

• Foamy urine

• Puffiness around the eyes

• Swelling of feet and ankles

• Shortness of breath

• Poor appetite

• Muscle cramps

• Anemia (lower than normal level of red blood cells)

Importance of Early Detection

Early detection and treatment of kidney disease can slow disease progression and preserve remaining kidney function for longer. Treatment can also prevent some of the complications of chronic kidney disease, such as anemia, gout, osteoporosis, high blood pressure, cardiovascular disease, nerve damage, metabolic acidosis, hyperkalemia (high potassium), hyperphosphatemia (high phosphorus), edema (swelling) due to fluid buildup, and a weakened immune system.

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What Causes Chronic Kidney Disease (CKD)?

As noted, chronic kidney disease is a gradually progressive condition in which kidney function slowly worsens over a period of months to years. This is in contrast to acute kidney failure which occurs in a matter of days. 

Some of the health conditions that can lead to kidney disease include: 

• Type 1 or type 2 diabetes

• High blood pressure

• Inflammation in the kidneys (glomerulonephritis or interstitial nephritis)

• Polycystic kidney disease (multiple cysts in the kidney)

• Recurrent kidney infections (pyelonephritis)

• Vesicoureteral reflux (backflow of urine into the kidneys)

• Prolonged obstruction of the urinary tract from stones, enlarged prostate, or certain cancers

What Is The Most Common Cause of Chronic Kidney Disease?

Diabetes is the most common cause of chronic kidney disease, accounting for 44% of new cases. High blood pressure is the second leading cause.

Who Is At Increased Risk For CKD?

Non-modifiable risk factors are risk factors for a disease that are out of human control. It is a characteristic that increases the likelihood of an individual developing a disease that can not be controlled by lifestyle or behavior modification. A few non-modifiable risk factors for CKD are listed below:

Age

Kidney disease can develop at any age, but older individuals (age 60 and above) are at greater risk. Researchers estimate that 1 in 2 seniors over the age of 75 in the U.S. has kidney disease due to a gradual loss of kidney function with age. Many people don’t realize they are at increased risk until chronic kidney disease is at an advanced stage.

Race and ethnicity

African Americans are 4 times more likely to develop kidney disease than Caucasians. Other races at risk of CKD include Hispanics or Latinos, Asian Americans, Pacific Islanders, and American Indians or Alaska Natives. 

Family history of kidney disease

Kidney disease affects some families more than others. People who have risk factors for chronic kidney disease, such as diabetes and high blood pressure, as well as kidney disease in close relatives, are high-risk and should be screened and tested for kidney problems.

Lifestyle Factors Affecting Kidney Health

Smoking

Smoking slows blood flow to important organs like the kidneys. It can also affect the efficacy of blood pressure medications. As noted, poorly controlled high blood pressure is a leading cause of CKD.

Obesity

In people who are obese, the kidneys have to work extra hard to meet the demands of the increased body weight. This can damage the kidneys in the long term and increase the risk of CKD.

Diabetes

Diabetes is the leading cause of CKD. It accounts for 44% of new cases of kidney disease. Strict control of blood sugar levels is necessary to prevent kidney damage in diabetics.

High blood pressure and cardiovascular disease

High blood pressure is the second leading cause of chronic kidney disease after diabetes. High blood pressure narrows and weakens the blood vessels throughout the body, including the kidneys. This leads to a reduced blood flow in the kidneys leading to decreased function of the kidneys. Almost 1 in 2 adults in the U.S. has high blood pressure. 

Progression Of Kidney Disease

What Is Stage 1 Kidney Disease?

Stage 1 chronic kidney disease (CKD) means you have a normal glomerular filtration rate (GFR) of 90 or higher. The glomerular filtration rate is a measure of how the kidneys are functioning. The higher the GFR, the better the kidneys are filtering. The lower the number, the worse the kidneys are functioning. In stage 1 of CKD, there is mild damage to your kidneys, but you may not have any symptoms. Other signs of kidney damage may be present, such as the presence of protein in your urine. Here is a quick overview of CKD stages:

When To Seek Medical Advice

You should seek medical advice for any unexplained or unusual symptoms such as weight loss, fatigue, swollen ankles, shortness of breath, or changes in urination.

According to the National Kidney Foundation, people at high risk of chronic kidney disease should be screened for the condition with a urine test to detect albuminuria (protein in urine) and serum creatinine with estimated glomerular filtration rate (eGFR).

Managing CKD To Slow Progression

Your doctor will implement a treatment plan based on your CKD classification. This will include lifestyle changes and medications to manage underlying health conditions that can worsen kidney function, such as high blood pressure and diabetes. People with eGFR below 15 require dialysis or kidney transplantation.

Methods For Diagnosing Kidney Disease

Doctors use both blood tests and urine tests to check kidney function. These tests are used to diagnose chronic kidney disease. In people who have already received a diagnosis of CKD, healthcare providers use these tests to see if the treatment is working and how the disease is progressing. 

Glomerular Filtration Rate

A blood test called GFR (glomerular filtration rate) checks how well the kidneys are filtering blood. A GFR of 60 or more is normal. A GFR below 60 may indicate kidney disease. There are various stages of kidney disease based on GFR as mentioned above. A GFR of 15 or below indicates kidney failure. People with this level of GFR need dialysis or a kidney transplant.

Serum Creatinine

Creatinine is a waste product from the breakdown of muscles in the body, which the kidneys remove. Doctors measure blood creatinine levels to estimate GFR and how well the kidneys are working. As the kidney disease gets worse, the blood creatinine level goes up as less creatinine is being filtered out.

Urine Albumin

Albumin is a protein that healthy kidneys do not allow to pass into the urine. However, albumin leaks into the urine when the kidneys are damaged. A urine albumin test measures how much albumin is passing into the urine. A high urine albumin would be concerning for kidney disease.

What Is The Biggest Indicator of Kidney Disease?

The biggest indicator of kidney disease is a decreased glomerular filtration rate (GFR) below 60. The GFR is measured through a blood test and indicates how well the kidneys are filtering waste products from the blood. A low GFR signifies impaired kidney function. Along with GFR, blood creatinine levels are used to diagnose and monitor kidney health.

What Happens After You Are Diagnosed With Kidney Disease?

Your doctor will recommend lifestyle changes and medications after you are diagnosed with kidney disease. These may include dietary modifications to limit the amount of protein you eat and medications to treat underlying health conditions such as high blood pressure and diabetes. Regular testing to monitor kidney function will also be done. If CKD is advanced, you will need to follow up regularly with a nephrologist (kidney specialist) who will monitor your kidney health and prescribe treatments to slow the progression of the disease.

Understanding Test Results

Your doctor can screen for chronic kidney disease with the following tests:

• Albumin-to-creatinine ratio (ACR) spot urine test to detect albuminuria (protein in urine)

• Serum creatinine to estimate glomerular filtration rate (GFR) to check kidney function

Your primary care provider may refer you to a nephrology clinic that specializes in treating kidney problems if your GFR is less than 30 mL/minute/1.73m2 or the albumin-creatinine ratio is more than 300 mg/g.

Prevention and Management

Strategies For Preventing CKD

Here are some ways to lower your risk of chronic kidney disease:

• See your healthcare provider regularly and get recommended health screenings.

• Manage high blood pressure with lifestyle changes or medications.

• Manage blood sugar levels if you have diabetes.

• Avoid overusing nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen (non-prescription pain relievers). Taking more than the recommended doses of these medications can cause kidney damage. 

Lifestyle Changes To Support Kidney Health

• Eat a healthy, well-balanced diet.

• Get regular exercise. Aim for at least 30 minutes of physical activity at least five days a week.

• Maintain a healthy body weight.

• Limit alcohol use.

• Avoid smoking.

Can Damaged Kidneys Be Repaired?

No, there is no way to repair or reverse kidney damage. However, there are ways to treat damaged kidneys and slow the progression of the disease.

What Is The Life Expectancy of a Person With Kidney Disease?

The life expectancy of a person with chronic kidney disease depends on the stage of kidney disease, age, gender, and other health conditions. 

For example, for a 30-year-old male with an estimated glomerular filtration rate (eGFR) above 60, the life expectancy is about 40 years. For a 30-year-old female with a similar eGFR above 60, the life expectancy is slightly higher at 43 years. For an 85-year-old male or female with an eGFR above 60, the life expectancy is significantly lower at about 3 years. 

Frequently Asked Questions

What Happens If You Have Kidney Disease?

If you have kidney disease, your doctor will recommend treatment based on the stage of chronic kidney disease (CKD). Treatment options include lifestyle changes, medications, dialysis, and kidney transplants. 

What Happens If Your Kidney Function Is Low?

Low kidney function can lead to a range of health complications due to the buildup of waste and fluids in the body. A GFR of 15 or below signals kidney failure and requires dialysis or kidney transplantation. Potential complications include fluid retention that can cause swelling in the arms and legs, high blood pressure, and fluid in the lungs. Decreasing kidney function can also cause anemia, heart disease, weaker bones, decreased immune response, pericarditis, and decreased sex drive, amongst other conditions.