Kidney Disease Symptoms and Diagnosis

What are the signs and symptoms of kidney disease?

It can be hard to spot the early symptoms of kidney disease. Chronic kidney disease doesn’t cause symptoms right away in about 90% of people who have it. However, even if your symptoms are mild and you feel OK, the condition could be causing damage. You might notice:

• Feeling unusually tired or weak (fatigue)
• Swelling in the face, hands, legs, ankles or feet due to fluid buildup
• Changes in urination such as not passing as much urine as usual, blood in the urine, changes in how often you urinate or urine that looks foamy
• Nausea or vomiting
• Little or no appetite, or food may taste metallic
• Easy bruising
• Cramps
• Dry, itchy skin
• Feeling cold when others do not

As kidney function gets worse, you may have more severe symptoms such as:

• Difficulty concentrating or confusion
• Notable swelling and discomfort from fluid buildup
• Chest pain, since fluid could build up around the heart
• Shortness of breath from fluid buildup in the lungs
• Internal bleeding
• Weak muscles
• Seizures

If you notice any of these symptoms, it is important to seek medical attention promptly. Your health care provider may refer you to a nephrologist, which is a doctor who specializes in kidney care.

Kidney disease diagnosis

When you see a provider for possible kidney disease, they will ask you about your symptoms and perform a physical exam. They may also recommend blood and urine tests to check your kidney function.

• Blood tests check your creatinine levels. High levels can be a sign of kidney problems. Blood tests also measure estimated glomerular filtration rate (eGFR), which shows how well your kidneys are filtering out substances.
• Urine tests look for protein or blood, which could mean that your kidneys are damaged. 
• Urine output measures the amount of urine you pass in 24 hours.

If your provider suspects advanced kidney disease after these tests, they may recommend:

• Imaging tests like ultrasound or CT scans to check the kidney’s structure.
• Biopsy to figure out what is causing kidney damage.

Stages of kidney disease

There are five kidney disease stages, based on your eGFR:

• Stage 1: 90 to 120. Your kidneys have mild damage but can work normally.
• Stage 2: 60 to 89. There’s more damage to your kidneys than in stage 1, but they still function well.
• Stage 3: 30 to 59. Mild to moderate loss of kidney function or filtering capacity.
• Stage 4: 15 to 29. Moderate to severe loss of kidney function or filtering capacity.
• Stage 5: Below 15. Your kidneys are failing or close to failing. Replacement therapy with transplant or dialysis may be needed.

Complications of kidney disease and failure

If not treated, kidney disease can lead to serious complications, including:

• Cardiovascular problems, such as an increased risk of heart disease or hypertension
• Bone and mineral disorders (kidney failure affects calcium and phosphorus balance)
• Malnutrition
• Acid buildup in the blood (metabolic acidosis)
• Anemia
• Trouble with thinking (cognitive impairment)
• Depression
• Nerve damage
• Gout
• Skin infections

How to manage complications

You can manage complications of kidney disease by working closely with your health care team. They can monitor your kidney function and overall health and recommend treatment plans. 

If you’re diagnosed with kidney disease, you’ll want to understand your treatment options so you can make the choices that are right for you. Learn about treatment options and living with kidney disease.