Kidney disease: Signs and symptoms you should know

March 14, 2024 Providence Health Team


In this article:

  • Millions of Americans don’t know they are living with kidney disease because there are few early warning signs.
  • Providence nephrologist Katherine Tuttle, M.D. shares early symptoms and warning signs of kidney disease.
  • The nephrology experts at Providence offer care for every stage of kidney disease.

Kidney disease is often called the “silent killer.” According to the Centers for Disease Control and Prevention, as many as 37 million Americans live with kidney disease, but many don’t know they have it because symptoms may not be obvious until it progresses to a serious stage.

The good news is that kidney disease can be treated. Providence nephrologist Katherine Tuttle, M.D. says it’s important to diagnose and treat kidney disease early.

“We have transformative new treatments that save lives, hearts and kidneys,” says Dr. Tuttle.

Understanding kidney disease

You have two kidneys. The bean-shaped organs are located on either side of your spine and under your rib cage. Their main function is to clean and filter your blood. Your kidneys filter toxins and waste from all of your blood every 30 minutes. They also help control your blood pressure and are essential for healthy bones.

Chronic kidney disease (CKD) occurs when your kidneys are damaged and can’t filter blood the way they should. Excess fluid and waste can build up and cause health complications including heart failure and kidney failure. Other health issues associated with kidney disease include serious infections, bone disease and fractures, and anemia or low red blood cell count.

Although CKD is a serious health condition, there are highly effective and safe treatments available. If left untreated, your kidney function progressively decreases and can lead to kidney failure or death.

There are five stages of CKD. Each stage is determined by your level of kidney function. End-stage CKD is stage 5 and is considered kidney failure, which is also known as renal failure.

Early warning signs of kidney disease

You may not have any obvious symptoms during the early stages of kidney disease. However, several conditions, like high blood pressure and diabetes, increase your risk for kidney disease. Dr. Tuttle says proper diagnosis and management of these conditions can aid in the early diagnosis of CKD.  

“Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension, and diabetes, but only a fraction of people are diagnosed with these conditions and even fewer are treated,” she says.

While CKD symptoms may not be severe in the early stages, as the disease progresses there are symptoms you may notice. Some symptoms of kidney disease include:

  • Changes in urination – If your kidneys are not functioning well, you may notice changes in your urine. You may need to urinate more frequently, and your urine may be foamy or bubbly. Blood in your urine can make it appear darker or tea colored.
  • Fatigue or extreme tiredness – Excess waste and toxins in your system can cause you to feel more tired than normal. CKD can also cause anemia, which leads to extreme fatigue.
  • Itchy skin – The buildup of waste products in your skin can cause severe itchiness.
  • Hand, face and feet swelling – Swelling and puffiness may occur in your hands and feet, as well as your face, if your kidneys aren’t removing extra fluid and sodium from your body.
  • Shortness of breath – Fluid can also build up in your lungs and cause shortness of breath when your kidneys aren’t working properly.
  • Back pain – Back pain can occur when your kidneys are blocked or infected. You may notice pain that remains constant or worsens with movement or stretching.
  • High blood pressure – Fluid and sodium buildup caused by decreased kidney function can lead to high blood pressure.

Other symptoms include trouble concentrating, trouble sleeping and loss of appetite.

When to see a doctor

If you have a family history of CKD or have risk factors, like high blood pressure or diabetes, you should be screened for CKD yearly. You should also see your doctor if you have constant, dull pain on one side of your back or experience changes in your urination, fatigue or swelling in your face, hands and feet.

If your doctor suspects kidney problems, they will go over your medical history and may order a blood and urine test. A blood test will show how effectively your kidneys are filtering toxins and waste. A urine test will detect any protein in your urine. Healthy kidneys should not lose protein in the urine.

Your doctor may also order a calcium test since calcium is generally low in those with kidney disease. Low calcium could lead to frequent muscle cramps.

Your doctor may order additional imaging tests such as ultrasound, magnetic resonance imaging (MRI) and computerized tomography (CT) to check for kidney damage.

Treating chronic kidney disease

If you are diagnosed with CKD, your doctor will help you manage the disease. Your treatment depends on the severity of the disease and can include lifestyle modifications, medication or in severe cases dialysis.

“There are now four pillars of therapy for CKD. They are ACE inhibitors or angiotensin receptor blockers, SGTL2 inhibitors, GLP-1 receptor agonists and aldosterone blockers. These treatments have been shown to reduce risks of death, kidney failure and heart failure. When initiated early people with CKD can remain healthy enough to live happy and productive lives,” says Dr. Tuttle.

No matter how severe your kidney disease is, your doctor can work with you to preserve your kidney function for as long as possible. If you do progress to kidney failure, dialysis or kidney transplants are available.

During dialysis, your blood is circulated through a machine that removes toxins and waste. The filtered blood is then returned to your body. The procedure can take up to four hours and is generally done in an outpatient setting several times a week.

“If you have reduced kidney function, we can develop a plan to ensure your lifestyle promotes kidney health. You may need to be careful about certain medications (such as over-the-counter anti-inflammatory pain medications that can worsen your condition), eat a low-sodium, kidney-friendly diet and manage other health conditions such as high blood pressure and diabetes,” Dr. Tuttle says.

Preventing kidney disease

Dr. Tuttle says that since early detection is critical when it comes to treating and managing CKD, it’s important to understand your risk factors and take action before you have severe symptoms.

Dr. Tuttle stresses the importance of prevention through a healthy lifestyle. Some things you can do to prevent CKD include:

  • Be physically active for at least 30 minutes a day
  • Don’t smoke
  • Eat a well-balanced, low-salt diet
  • Maintain a healthy weight
  • Manage high-blood pressure and diabetes

“Kidney disease is a serious condition, but it is treatable when caught early. The most important thing I tell my patients is to prevent health conditions that can lead to kidney damage. Obesity, diabetes and high blood pressure can all be prevented and managed. By managing those conditions, you can effectively decrease your risk for kidney disease,” says Dr. Tuttle.

If you suspect you may have a kidney issue, contact your primary care provider.  

Contributing caregiver

Katherine Tuttle, M.D., is a nephrologist with Providence Spokane Nephrology.

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Related resources

Kidney disease: common, but mostly preventable

Fun facts about your kidneys

A last-minute lifesaver  

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

About the Author

The Providence Health Team brings together caregivers from diverse backgrounds to bring you clinically-sound, data-driven advice to help you live your happiest and healthiest selves.

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