10 Chronic Kidney Disease Symptoms You Should Refuse To Ignore!

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As a board-certified kidney doctor, one of the most painful parts of my career is when I see patients with kidney failure that could have been prevented, had only they recognized the early symptoms. The mind-blowing thing is that the top two causes of kidney failure and the top two reasons that people end up in my dialysis units are largely preventable or at least manageable. The good news is that there are ways to detect kidney disease early and prevent, or at least slow down the progression of kidney disease. So today we're going to be proactive problem solvers because I'm giving you 10 chronic kidney disease symptoms you should refuse to ignore.

chronic kidney disease ckd

What Is Chronic Kidney Disease or CKD?

Chronic Kidney Disease or CKD occurs when you have damage or a decrease in your kidney function for three months or more. At that three-month mark, that's when we call it chronic kidney disease. Now, there are multiple causes of CKD. The top two are diabetes and high blood pressure, and we're able to determine if you have CKD based on your blood work.

When you get a BMP or a basic metabolic panel, it has your creatinine there and it also has your EGFR (estimated glomerular filtration rate). Depending on what that GFR is, that's how we stage your kidneys and determine whether or not you have CKD. Be sure to watch my video on the stages of chronic kidney disease after you finish reading this article.


What Are Kidneys and Their Functions?

Your kidneys are your two organs located in your lower back or your flanks, where the love handles are. Quite honestly, they are really underrated. They don't get enough press. Yes, I am biased because I'm a kidney doctor, but the kidneys are super important. Not only do they filter out excess fluid from your body, but they also help to maintain the balance of your electrolytes and maintain your blood pressure. They also help to keep you from being anemic, and they help to promote good bone health. And here's the real kicker. If both your kidneys fail, then you cannot live, unless you have another form of kidney replacement therapy like dialysis or a transplant.

But honestly, if you can, wouldn't you want to prevent getting to the point of needing dialysis or a transplant? The wonderful thing is that if you recognize the symptoms of kidney disease, in many cases, you can and that's what we will discuss in this article.

10 Chronic Kidney Disease Symptoms and Signs

It's really important that you recognize the signs and symptoms of CKD because if you're not careful, it's easy to be in denial or to dismiss them and say, "Oh, I just slept wrong," or, "Oh, I've just been working too hard lately." You can always come up with a reason, but you want to pay careful attention because if you or a loved one is experiencing these signs or symptoms of kidney disease, then it's possible that if you catch them early and seek medical attention, you could literally prevent going into kidney failure.

high blood pressure and ckd

1. High Blood Pressure or Hypertension

This is interesting because in this case, it's like what came first, the chicken or the egg? High blood pressure can definitely cause kidney disease, but having kidney disease in and of itself can also cause high blood pressure. Remember, by definition, you have high blood pressure if that top number or systolic blood pressure is greater than or equal to 130, or if that bottom number, the diastolic blood pressure is greater than or equal to 80. If you have high blood pressure, you want to make sure that your doctor does further tests to find out if kidney disease is the cause of the high blood pressure. I have an entire book on how to properly manage high blood pressure titled Under Pressure: A Guide To Controlling High Blood Pressure.

2. Swollen Feet and Ankles

Having swollen feet and ankles is another common sign of chronic kidney disease. You can have swelling or edema of the feet, ankles, or legs, even of the entire body. It's commonly referred to as generalized edema or anasarca. This is due to the kidneys being unable to filter out excess fluids in your body, leading to fluid retention and swelling in different parts of the body.  A lot of people may get swollen feet or ankles and they may say, "Oh, it's 'because I had a little bit too much salt, or I was on my feet too much." You can come up with a million reasons, but guess what? You don't want to miss the fact that chronic kidney disease could be the reason for your swollen feet and ankles.

chronic kidney disease and swollen feet

You can also get puffiness in the eyes. When your salt balance is not properly regulated, you could be holding onto the salt, which makes you hold onto more fluid in your tissues, causing puffiness or swelling. The swelling can also happen in CKD if you've gotten to the point where you're not making enough urine or if you have a form of CKD that causes protein leakage, which can also cause swelling in your body.

3. Foamy or Dark Urine

If your urine is dark or foamy, that could mean that you have excess protein in your urine. It is considered normal for urine to contain either no protein at all or only very small amounts. If you have excess protein in your urine, it can cause foaminess when the urine hits the toilet. And I don't mean just a couple of little bubbles here and there. I mean really foamy like in those beer commercials when you see that white foam after the beer has been poured into a glass.

Also, if you have dark, Coca-Cola colored urine or something that looks like it could be blood in the urine, this could mean that your kidneys are leaking out red blood cells, and this is NOT normal and could be a sign of kidney damage and another sign of CKD.

4. Fatigue

There are so many things that can cause fatigue and being sleepy all the time. One, it could be because your body is holding onto excess poisons or toxins and those are causing you to have fatigue or be excessively tired. Also, in CKD, you could have anemia. Again, the kidneys are responsible for helping to prevent anemia. So if you have anemia or low blood, this can cause fatigue and it could be one of those warning symptoms of CKD.

Do any of these signs and symptoms of CKD sound familiar? Do you think that you or a loved one may be experiencing CKD? Do you want to talk to me about it? Guess what? Now you can, because I have a telehealth concierge service. We can arrange a one-on-one virtual appointment. We can talk about your history, your physical, your signs, your symptoms, and your concerns. I will give you my undivided attention. Please click here to schedule a concierge appointment with me today.

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5. Shortness of Breath

You can get shortness of breath when you have CKD, one, just because you're fatigued and just trying to move or walk can make you tired. But also, if you have CKD and you're not making enough urine, you can have a backup of fluid in your body, and you can get fluid in the lungs or pulmonary edema. This can certainly make you short of breath. Another thing is the anemia. When you have anemia or low blood, then your tissues are not getting all of the oxygen they should get. You see, your red blood cells act like cars, which carry your oxygen to your tissues. If you have anemia associated with CKD and you're not getting enough oxygen, this can lead to fatigue, which can lead to shortness of breath.

6. Loss of Appetite or Weight Loss

Loss of appetite or even weight loss is something that I see quite often in my Atlanta Nephrology practice, and it's one that's easily masked. I'll have patients who come in to see me and they will have CKD, but they'll tell me, "Oh yeah, I lost weight. You know, I've been trying to lose weight for years, and I guess now I have portion control. I'm just not eating as much." And they may tell themselves or think that they're losing the weight on purpose.

If you have CKD, this can cause a buildup of excess toxins in your body, which can cause you to have a poor appetite, nausea or vomiting, or unintentional weight loss. If this is happening to you, it could be a sign of chronic kidney disease.

7. Changes in Urination

You can have a change in urination by not putting out enough urine. If you have chronic kidney disease, the kidneys aren't filtering well and you can make less urine than you should and get a buildup of fluid in your body. Or you can have a change in urination, meaning that you're making too much urine or you have polyuria, and this is how that happens. Your kidneys are responsible for concentrating your urine, ensuring that toxins and necessary substances are appropriately filtered out. This process allows for the elimination of excess waste and maintains a healthy balance of electrolytes. If you have CKD, then sometimes you lose the ability to concentrate the urine, and then you get very diluted or watery urine. So often one of the symptoms of chronic kidney disease could be:

  • Making more urine than you're used to making
  • Having frequent urination
  • Getting up oftentimes at nighttime or having nocturia

So changes in urination definitely could be a symptom and you'll want to talk to your doctor about it.

itchy skin ckd

8. Itchy Skin or Pruritus

Many things can cause you to have itchy skin. It could be that you're having an allergic reaction to your detergent, a soap, a new lotion, or a perfume. These things can all cause itchy skin, but CKD can do it as well and for many reasons.

1. You have a buildup of toxins in your body, and this can cause your skin to have an itchiness or you can get very dry skin.

2.  There is something called phosphorus. Phosphorus is a substance that your kidneys are responsible for filtering out, and you find phosphorus in all kinds of things. You find it in prepackaged foods, processed foods, in nuts, and you can find it in milk. If you have CKD and you're not getting rid of phosphorus the way that you should, then you can cause a buildup of phosphorus in your body or your blood also known as hyperphosphatemia. When this happens, one of the very common reactions is pruritus or itchy, itchy skin.

9. Bad Breath or A Metallic Taste In Your Mouth

When you have chronic kidney disease some of these toxins start to build up and you have uremia or a high BUN (blood urea nitrogen). This could cause you to have a metallic taste in your mouth. And this is actually one of the later symptoms of CKD. And when you get this metallic taste in your mouth, it makes you just not want to eat food because it just doesn't taste the same. You can also get an unpleasant odor on your breath. Literally, your breath can smell like urine. And so if you're having a really strong odor on your breath and all the brushing in the world doesn't help, or if you have a metallic taste in your mouth, then you may have CKD.

10. Difficulty Concentrating or Other Neurological Signs

So when you have CKD, particularly the late stages like CKD stage five, the buildup of toxins or the buildup of the BUN, having the uremia can agitate your nervous system, It can affect your brain, it can affect your nerves, and it can cause you to have brain fog or difficulty focusing or concentrating. It can also affect the way that you walk. You can get an ataxia or an abnormal gait and the way that you walk can be off. You can also get a tremor. So if you're having a fine tremor or finding that you're not able to hold a fork properly or hold a cup of coffee without spilling it, this could definitely be a sign that you have CKD. And certainly, if you're having some memory loss, talk to your doctor and make sure that your kidneys are functioning well.

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When To See A Doctor or Nephrologist For Kidney Disease?

How do you know when you need to talk to your doctor about kidney disease or when you need to see a nephrologist? Well, spoiler alert, you need to talk to your doctor right now. Not because you have kidney disease, but because you definitely want to prevent it. When you do your routine histories and physicals, which you should be doing at least every year, they do a panel of blood work. And in that panel, they do screen for kidney disease. But you need to be proactive and you need to be your own advocate. So when your doctor gives you your results and they say, "Oh, everything looks fine, the kidneys look fine," you need to back up and say, "What does fine mean? What is my EGFR?" If your EGFR is less than 60, then everything is not fine. I don't care if you have no symptoms, everything is not fine. If the EGFR is less than 60, then it is recommended that you be referred to a nephrologist or a kidney doctor.

Now if your doctor tells you your kidney function, you'll want to ask specifically what it is. And if it's less than 60, you will want to see a kidney doctor. The other thing is, if you're experiencing any of these signs and symptoms that I mentioned, pick up the phone, call your doctor's office, and ask for an appointment.  When you can go in for that appointment, they can check your blood work and urine work, they can also examine you, and they can find out if you're someone to watch closely for kidney disease. They can also find out about your family history and screen you for diabetes, high blood pressure, and risk factors for kidney disease.

kidney disease ckd doctor

Some symptoms are urgent or even emergent. If you're having some of these neurological symptoms such as having an abnormal gait or the way that you walk, if you're having a tremor, then that's an emergency. You want to contact your doctor immediately or even call 9-1-1, depending on how severe the symptoms are.

Also, if you can't eat, if you're having nausea, vomiting, a bad taste in your mouth to the point where you're not eating, not drinking, or you can't keep anything down and you're dehydrated, that's urgent, you need to call your doctor right away. There's also certain blood work that could signal an emergent situation. For example, when you go in to check out your kidney function, if you find out that you have hyperkalemia or a very high level of potassium in your blood, this could be something that is an indication for emergency dialysis.  It's important that when you have certain signs and symptoms, you seek medical attention right away.

Important Questions To Ask Your Doctor About Chronic Kidney Disease

So now let's talk about some important questions you should ask your doctor concerning your kidney disease to make sure that you're heard. Oftentimes, the squeaky wheel gets the oil. So the more interest you show in your own kidney health, the more attention you'll oftentimes get from your doctor. I'm not saying that's the way it should be. Because everybody should get equal attention, but this is oftentimes the way that it is. The more you know, the more interest your doctor will sometimes show. So even if you think you know the answers to some of these questions, these are some of the things that can really perk your doctor's ears up.

  • Ask your doctor what signs and symptoms you should be looking out for for CKD.
  •  Ask how often you should be checked. And just so you know, if you have an EGFR of less than 60, then it's recommended that you see your kidney doctor at least once every three months. If your EGFR is less than 30, you should be seeing your doctor by recommendation every month.
  • Ask your doctor what tests can be done to pick up kidney damage early. And again, even if you think you know the answer, ask the question. And then you can compare what the doctor says to your notes. And just so you know, the BMP should be checked to pick up kidney disease. Your creatinine, your EGFR, also, your urine protein should be checked. For your urine protein to creatinine ratio, a urinalysis will help.
  • Ask what they will do to monitor your CKD.
  • Ask if there are any medications out there that can help to slow down the progression of CKD.
  • Ask what you can do at home in your daily life to help prevent or slow down the progression of kidney disease.

Things You Can Do In Your Daily Life To Help Prevent CKD Or To Slow Down The Progression

I already mentioned that the top two causes of chronic kidney disease are diabetes and high blood pressure, so you want to make sure that you are properly screened for diabetes. How can you do this? Ask your doctor what your blood sugar levels are, specifically your fasting blood sugar levels, and also your hemoglobin A1C.

You want to make sure that you have a diet that is high in protein, high in vegetables, and that is low in carbs. You don't want to have a lot of starchy foods, or added sugar. Be sure to watch my video on what added sugar does to your body after you finish reading this article.


The other thing, you want to maintain a normal blood pressure. High blood pressure is the number two cause of kidney failure. So you want to eat foods that are low in salt. You want to make sure that you get your blood pressure checked regularly. If you do have high blood pressure, you want to manage it not only with lifestyle changes like diet, exercise, and eating the proper foods but also if necessary, you may have to take medications.

Another thing you can do is drink water. One cause of kidney failure is dehydration. Can you believe it? Not drinking enough water can cause kidney failure. So make sure you consult with your doctor and you find out what the proper amount of hydration is for you, and be sure to watch my video on the importance of drinking water for kidney health. You want to eat foods that help your kidneys to filter better like cruciferous vegetables such as kale, broccoli, and brussels sprouts. You want foods that are loaded with antioxidants like raspberries, blueberries, and blackberries. Be sure to also watch my video on the truth about kidney detox.

Prevention is key. So recognizing the signs and chronic kidney disease symptoms and doing something about it early on, that's the key to having good kidney health. If you found this article to be helpful and informative, please be sure to share it with the people you care about. As always, I appreciate your support and I want you to do your best to live your healthiest, happiest life.

Dr. Frita - Frita McRae Fisher, M.D.
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