Kidney (Renal) Disease Signs & Symptoms

In this article, we’ll cover the signs and symptoms of kidney disease, also known as renal disease. We’ll look at a range of symptoms, starting from early-stage kidney disease up to kidney failure. Let’s begin with one of the most common symptoms: changes in urination patterns.

Urinary changes are often one of the earliest signs. For example, some kidney conditions may cause an increase in urine volume, leading to more frequent urination. Conversely, in more advanced stages of kidney disease, urine output may decrease. Additionally, conditions affecting the kidneys can lead to foamy urine, indicating the presence of protein, or even blood in the urine, a condition known as hematuria.

Another notable sign of kidney disease is peripheral edema, which appears as swelling, often in the lower limbs. This happens because fluid builds up in tissue spaces due to volume overload, often associated with advanced kidney disease. When the kidneys aren’t removing enough fluid, it can accumulate in tissues. Peripheral edema is also common in nephrotic syndrome, where the loss of albumin - a protein that helps regulate fluid - leads to fluid retention in tissues.

Kidney disease can also cause hypertension, or high blood pressure, due to increased blood volume from inadequate fluid removal. This excess fluid may also lead to shortness of breath, known as dyspnea, if it accumulates in the chest cavity and around the lungs. Additionally, some patients may experience chest pain, often related to fluid overload.

Other symptoms of kidney disease include sleep issues, often caused by increased toxins in the bloodstream. Individuals may struggle to fall asleep, wake frequently, or feel fatigued during the day. This fatigue, partly due to accumulated toxins, is also linked to anemia, which we’ll discuss shortly. Anemia in kidney disease is due to the kidney’s decreased ability to produce erythropoietin (EPO), a hormone that stimulates red blood cell production. With less EPO, fewer red blood cells are produced, leading to fatigue.

Muscle twitching and spasms can also occur, resulting from electrolyte imbalances since the kidneys play a key role in maintaining electrolyte balance. Low calcium and high phosphate levels, common in kidney disease, can contribute to these spasms.

As kidney function declines, urea - a byproduct of protein metabolism accumulates in the blood, causing uremia. This elevated urea can lead to complications, such as uremic pericarditis (inflammation of the pericardium) and uremic encephalopathy (brain dysfunction that can cause delirium or confusion). Uremic encephalopathy may present with asterixis, a tremor or "flapping" of the wrists due to postural instability.

Pruritus, or severe itching, is another symptom, often resulting from high urea levels. Patients may develop scratch marks, also known as uremic pruritus. Uremia can also cause nausea, vomiting, and a loss of appetite, which may lead to weight loss.

Finally, kidney disease can lead to platelet dysfunction due to uremia, increasing the risk of bleeding. Despite normal platelet counts, the platelets may not function properly, leading to symptoms such as bleeding gums, easy bruising, and nosebleeds. Superficial bleeding may appear as petechiae (small red spots) or purpura (larger purple spots) on the skin.

I hope you found this article informative.