Kidney disease: signs and symptoms


Chronic kidney disease (CKD) is a general term used to describe a chronic disease or condition that causes progressive loss of kidney (kidney) function. The main functions of the kidneys are the elimination of toxins and the regulation of the hydric and acid-base balance of the organism. Without these functions, a person cannot survive. Although there are many different causes of CKD, such as diabetes, hypertension, infections, and autoimmune diseases, the symptoms will often be similar regardless of the underlying condition.

Depending on the stage of your illness, you may have nonspecific symptoms such as fatigue, malaise, nausea, and loss of appetite, along with more common symptoms such as kidney pain , foamy urine, and ammonia-smelling breath.

Over time, the progressive loss of kidney function can cause a cascade of domino-like symptoms that affect the heart, lungs, brain, bones, and other organs.

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Frequent symptoms

Symptoms of CKD are often overlooked in the early stages of the disease and, in many cases, remain completely invisible until significant damage occurs. Unlike acute kidney injury (AKI) , in which symptoms appear suddenly and are often reversible, CKD is characterized by progressive and irreversible damage over months and years.

Symptoms of CKD develop as the kidneys are less able to filter water and waste products from the blood. The accumulation of these and other excretory substances (such as uric acid, calcium and albumin) can disrupt the normal balance of acids and electrolytes in the body and alter circulation, blood pressure, digestion, respiration and even brain activity.

What's more, when the kidneys begin to fail, they stop producing the hormone erythropoietin, which tells the body how to make red blood cells (red blood cells). The depletion of these oxygen-carrying cells is called anemia .

Kidney dysfunction can cause characteristic symptoms such as :

  • Cold intolerance (constant feeling of cold)
  • Difficulty urinating
  • Dizziness and lightheadedness
  • Dysgeusia (metallic taste)
  • Difficulty breathing (shortness of breath)
  • Slight bruising
  • Facial edema (facial edema)
  • Fatigue
  • Foamy urine (due to excess protein in the urine)
  • Loss of concentration
  • Nausea and vomiting
  • Nocturia (frequent urination at night)
  • Pain in the legs and upper back.
  • Peripheral edema (swelling of the extremities, especially of the hands, ankles, and feet)
  • Itching (itching)
  • Uremia stink (ammonia breath)


As CKD progresses and kidney function falls below 25% of normal, the spectrum of symptoms becomes severe.

As part of an interconnected system, loss of kidney function invariably affects all other organ systems. Without blood filtration and waste treatment, even beneficial substances can accumulate to toxic levels, leading to metabolic complications such as hypercalcemia (excess calcium), hyperkalemia ( excess potassium ), hyperphosphataemia (excess phosphate), and uremic toxicity ( excess uric acid). ..

The relationship between the kidneys and other organs causes health problems that often lead to other health problems.

For example, high blood pressure, a common cause of CKD , can put constant pressure on the kidneys, causing damage and the development of renal hypertension (high blood pressure in the kidneys). This , in turn, can further increase blood pressure. and contribute to the development of atherosclerosis (hardening of the arteries) and coronary artery disease .

The consequences of this metabolic imbalance can be serious and far-reaching. From them:

  • Hypercalcemia can cause excessive urination, kidney stones, lethargy, loss of appetite, confusion, nocturia, weakness, fainting, and coma.
  • Hyperkalemia can cause chest pain, shortness of breath, malaise, muscle weakness, nausea, numbness, palpitations, slow heart rate, weak pulse, and sudden cardiac death.
  • Hyperphosphatemia can cause bone pain, muscle cramps, joint pain, and itching.
  • Renal hypertension can cause blurred vision, confusion, double vision, shortness of breath, headaches, nausea, nosebleeds, vomiting, wheezing, and pulmonary edema (fluid build-up in the lungs).
  • Uremic toxicity can cause abdominal pain, bone demineralization, chest pain, erectile dysfunction, hematuria (blood in urine), insomnia, irregular periods, loss of libido, memory loss / confusion, peripheral neuropathy (needles), pericarditis . (inflammation of the heart), personality changes, seizures, and coronary artery disease .

End-stage kidney disease

Your greatest concern occurs when your kidneys begin to fail, a condition called kidney failure or end-stage renal disease (ESRD). ESRD requires a patient to undergo dialysis or a kidney transplant to survive.

Without life-sustaining interventions, toxins can build up quickly and cause a condition called uremia.

Death usually occurs in a few days or weeks. If the decision is made not to undergo dialysis , palliative care is needed to keep the patient as comfortable as possible in his last days.

End-stage symptoms generally include:

  • Loss of appetite
  • Anxiety
  • Sleeps most of the day.
  • Disorientation and confusion.
  • Hallucinations
  • Accumulation of fluid in the lungs.
  • Respiratory changes
  • Changes in skin color and temperature.

Cardiac arrest is the most common cause of death in people with ESRD. Other possible causes include infection, sepsis, stroke, and bleeding.

When to see a doctor

The symptoms of CKD are often nonspecific and general in nature, meaning that they can be confused with many other conditions. Because your kidneys are adaptive and can make up for lost function, signs and symptoms may not appear until irreversible damage occurs.

To this end, it is important to identify your personal risk factors and consult your doctor if you have any symptoms that suggest CKD.

Frequently asked questions

  • In stage 1, your kidneys are working, but you may have some mild symptoms, and in stage 2, your kidneys are still working, but you have additional symptoms. In stage 3, your kidney function has decreased and you may have more noticeable symptoms, and in stage 4, your kidney function is very poor. Stage 5 is near or close to kidney failure and you may need dialysis or transplantation.

  • No, there is no cure for chronic kidney disease, but there are treatment options that can delay the decline in kidney function.

Chronic Kidney Disease Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

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