Early Warning Signs of Kidney Failure: 11 Things Your Body Is Telling You!


I'm Dr. Frita, and today we're talking about the early warning signs of kidney failure, 11 things your body is telling you. I am a board-certified high blood pressure and kidney doctor, and one of the most frustrating things about my job is when I meet a patient for the first time who already has kidney failure. Then I realized after having the conversation that that patient's body was giving them warning signs of kidney disease way before the patient ever even stepped into my office. This is frustrating and it happens more times than you could imagine, and this is why.

According to the CDC, over 35 million adults in the United States have kidney disease yet nine out of 10 don't know it, why? Because oftentimes the early symptoms of kidney disease are silent and very subtle. So you can be walking around here with kidney failure and literally not even know it.

But here's the good news, if you consult with your doctor on a regular basis, plus if you yourself become familiar with the early warning signs of kidney disease, then you can potentially slow down the progression and even prevent kidney failure altogether in some cases. Now, doesn't that sound good? I thought so. So let's talk about it.


Would you like my undivided attention as we discuss your specific medical journey? If so, you are in luck because I offer a concierge telehealth service where you can get my direct input on your health concerns. Be sure to click here to learn more.


11 Early Warning Signs of Kidney Failure

Remember, signs are what you see, symptoms are what you feel.

1. Unexpected Changes in Urination Patterns

Unexpected changes in urine patterns could be a subtle early sign of kidney failure. And this could be making less urine than you expect or more urine. If your kidney failure is advanced, then yes, your kidneys will likely make less urine than normal. But guess what? One of the early symptoms of kidney failure could be making more urine than you expect having polyuria, and this is because you might be having trouble concentrating the urine.

Another change in urination patterns could be foamy urine, not just a couple of little bubbles in the toilet when you urinate. I mean a lot of foam kind of like those beer commercials when you have that thick white foam on the top of the glass of beer.  If you have excess foam in the urine, that could mean that you have protein in your urine, which is not normal.

early warning signs of kidney failure

Certainly, if you have bloody urine, that could be a sign of kidney failure, or if it's Coca-Cola colored or if it looks like a dark tea, and if your urine is just dark or if it has a foul smell, that could be a problem also.

2. Unexplained or Persistent Swelling

Unexplained or persistent swelling, also called edema. If you notice that you're getting some puffiness in your feet and your ankles, like if your shoes are getting tighter or if you're noticing the indentation of your socks, then you could have swelling, which could be a warning symptom of kidney disease. And this can happen for a few reasons. One, your kidneys are responsible for the way that you regulate salt in your fluid balance. If that's off due to kidney disease, it can certainly cause swelling.

swelling sign of kidney failure

And then with some even more potentially serious forms of kidney disease, you can get a lot of swelling, meaning not just in your feet and your ankles and not just in your hands, but all over your body. You can get swelling around your eyes, face, neck, and in your stomach. This is called anasarca and it often means that your kidneys are leaking out excessive amounts of protein, which could really be a problem. Be sure to watch my video on what is nephrotic syndrome after you finish reading this article.

3. Restless Legs Syndrome

Do you ever have legs that just seem like they have to move, like all night long? You can't resist the urge to move them and they even disrupt your sleep? Or better yet, do you have a partner or a spouse who complains that you won't stop moving your legs under the covers or even your arm sometimes?

early warning signs of kidney problems restless legs syndrome

Well, if this is happening, you could have restless legs syndrome and it could be your body trying to tell you something. Perhaps you have some type of electrolyte imbalance or perhaps a disruption in your nerves, a neurological disruption related to kidney disease. And so if you have restless legs syndrome run, don't walk to your doctor, and get checked out because this could be an early warning sign of kidney failure.

4. Ammonia-like Breath or A Metallic Taste In The Mouth

Now if this has happened to you, it definitely could be a warning sign of failing kidneys. And I can tell you firsthand, that my patients can't stand this one. It's what they describe as the breath, literally smelling like urine. And yes, as a physician I have had patients who are in kidney failure and their breath can smell like urine or smell like ammonia and it leaves a really bad taste in the mouth. They describe it as a metallic-like taste and it can cause you to have a poor appetite and even weight loss.

If you are experiencing this symptom, then it really could mean that you have some form of advanced kidney disease, and this metallic taste occurs when the blood urea nitrogen (BUN) level is high. And it could mean that you are uremic, which is a very serious sign of kidney failure. If you or a loved one has this ammonia-like breath, take it very seriously and consult your doctor as soon as possible.

flank pain kidney disease

5. Flank Pain or Discomfort

If you have any type of pain in the lower back or flanks, this could be a symptom of kidney disease and you want to let your doctor know as soon as possible. It could mean that you have a kidney mass, kidney stones, or a kidney infection. Make sure you don't ignore it and be sure to watch my video on the painful truth about kidney stones after you finish reading this article.

6. Skin Changes or Darkened Skin Patches

Abnormal kidney function can lead to a change in your skin pigmentation, and it could be for a few reasons. One, when the kidneys aren't filtering out toxins the way that they should, you can get a buildup of toxins or even a buildup of certain electrolytes in your blood, and this can cause a change in the way that your skin is colored. You can also have a buildup of phosphorus in particular.

skin changes or darkened skin patches kidney failure

Phosphorus is something that your kidneys typically filter out. If you get a buildup of this, it can cause you to have really itchy, itchy skin and you can even start to get some patches when you scratch. You can get some hyperpigmentation or some darkening of the skin.

There's also a condition called calciphylaxis, which can lead to skin patches when you have advanced kidney failure especially.

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7. Unusual Fatigue or Sleep Apnea

Many of my kidney patients complain of fatigue, and being extremely sleepy. Fatigue is a tricky symptom because a lot of things can explain it. You can say, oh, maybe I didn't get enough sleep, or maybe it's my thyroid or a million other reasons. But one reason that you don't want to miss is kidney failure. You see, your kidneys are responsible for making a hormone called erythropoietin. Erythropoietin is largely responsible for your red blood cell production, which helps to keep you from being anemic.

unusual fatigue or sleep apnea

Well, if you have kidney failure, then one of the warning signs could be a decrease in erythropoietin, which can lead to anemia, which can lead to unusual fatigue. The other thing that can happen with kidney failure is that if you start to accumulate excess fluid in the body, if you start to get edema, well you could get edema around your throat or in your neck area. This type of swelling could cause an obstruction or a blockage while you sleep, causing you to have snoring and sleep apnea. Sleep apnea can lead to daytime somnolence or being very, very sleepy in the daytime, even when you've been in bed for what you feel is an adequate amount of time.

8. Skin Rash or Itching

Ugh, my patients can't stand this symptom, and it's definitely a warning symptom of kidney disease in many cases. What happens is that the kidneys are not filtering out excess toxins properly or filtering out excess electrolytes and keeping them in balance. The buildup can cause rashes, it can cause itching, and even worse, it can cause patients to scratch, and scratch, and scratch until they break the skin and get hyperpigmentation or darkening.

9. Hiccups That Won't Stop

Now, this is a warning that surprises most people when it comes to kidney failure, but absolutely, this excessive elevation in toxins due to kidneys that are failing can lead to uncontrollable hiccups. So here's a fun fact about how hiccups are related to kidney disease in case you're interested.

When you have kidney failure or kidney disease, then it can irritate the nerve that innervates or controls the diaphragm. When this happens, it can cause a diaphragm to be stimulated, which can lead to hiccups. So if you're having these hiccups that don't seem to stop or last for days, make sure you talk to your doctor and get those kidney numbers checked out.

10. Always Feeling Cold

If this is you, or if you're someone who's in the room and you always want somebody to turn the heat up or to get you a heating blanket, when everybody else is feeling hot or comfortable, well, it really could be a warning that you have kidney disease.

always feeling cold

Remember, kidney disease can lead to anemia, and if you're very anemic, then you could present with being very cold all the time. Also, in some cases, when patients have kidney disease, they get that buildup of toxins, that causes that metallic taste in the mouth we talked about, which can cause them to have unintentional weight loss. Well, if you lose a significant amount of weight, or a significant amount of fat, that can cause you to be colder than you used to be, it can cause cold intolerance. So make sure you consult with your doctor and find out if it's your kidneys.

11. Uncontrollable or Elevated High Blood Pressure

Oh my gosh, this is what I see so often in my kidney disease practice because the kidneys are responsible for helping to regulate blood pressure. They make all types of hormones and enzymes. They help with water balance and salt balance. When you have kidney disease, then one of those early warning signs could be elevated blood pressure. So instead of just staying at home and coming up with excuses for why your blood pressure is high, don't just say, "Oh, I must be stressed out." Or, "Maybe this blood pressure cuff doesn't work." Or, "Ah, maybe I just need to lose a little weight." Okay, all those things could possibly be true, but what you don't want to do is miss a warning sign of kidney problems.

high blood pressure and ckd


So these are 11 of the warning signs of kidney failure and what you need to pay attention to in case your body is trying to tell you something. Of course, this list is not exhaustive and you definitely want to consult with your physician. As you probably noticed, all of these signs and symptoms are not obvious. It's not obvious that they could be connected to the kidneys, but it's important that you are your own advocate. Stay proactive and pay attention to your body. Also, work in conjunction with the physician you trust in order to have your healthiest, happiest life.

Again, I am a board-certified kidney doctor and nephrologist. If you want to have a one-on-one conversation with me where you talk more about what you think might be going on with your kidneys, I do offer a telehealth concierge medical service where we can go into detail and I can give you personalized medical information about you. As always, I appreciate your support and I want you to do your best to live your healthiest, happiest life!

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

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