10 Signs of Chronic Kidney Disease

When you think about it, your kidneys are kind of the rock stars of your internal organs. They make hormones, balance electrolytes, remove waste and recycle nearly 200 quarts of fluid in your body every 24 hours. But if you have chronic kidney disease (CKD), a condition that affects 45 million Americans or about 15% of the adult population, all those heroic feats grind to a halt as your kidneys gradually lose their ability to function. Early treatment for the disease can help, but 90% of people with CKD don’t even know they have it. Impossible, right?

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“There are no symptoms of early CKD,” says Stephen Pastan, M.D., a professor of medicine at the Emory Transplant Center and National Kidney Foundation board member. “Most symptoms don’t occur until kidney disease is fairly advanced.” Sometimes referred to as a silent killer, CKD is more likely to be discovered if you have regular checkups, bloodwork, and urine tests, especially if you have high blood pressure, diabetes, heart disease, or a family history of kidney disease. Other times, you just feel like something isn’t right. See your doctor if you notice any of these 10 signs.

You're Short of Breath

When your kidneys lose their ability to remove excess fluid from your body, it can accumulate and cause pain and pressure in your chest. “Kidney failure is sometimes confused with asthma or heart failure, because fluid can build up in the lungs,” says Francesca Tentori, M.D., medical director of outcomes research and patient empowerment at DaVita and an adjunct instructor in medicine at Vanderbilt University.

There's Swelling in Your Legs, Hands, or Face

In addition to struggling to remove fluid, failing kidneys lose their ability to remove sodium from your blood. That means the salt you eat stays in your body—and that’s a problem because sodium makes fluid retention problems even worse, leading to swelling, especially in your feet, ankles, hands, face, and around your eyes. Swelling can also indicate serious conditions such as heart failure, liver failure, diabetes, and damage to leg veins, and it can be a side-effect from certain medications. Be safe and have it checked.

Your Muscles Ache

Another task on your kidneys’ to-do list: Maintaining a balance of minerals in your blood. Known as electrolytes, minerals like potassium, calcium, and sodium play a key role in muscle function. “One of potassium’s main jobs is to control how your muscles react and contract,” says Michael Spigler, vice president of kidney disease education at the American Kidney Fund. “If potassium levels are too high or out of whack because your kidneys are not working properly, it can cause muscle aches and heart palpitations.” High potassium levels can also be life threatening.

Your Pee Looks Different

Is your pee a different color than normal? Any blood in your urine? If you’re feeling pressure when you urinate, peeing more or less than usual, or you’re getting up more often at night to go, those could be signs of CKD. Believe it or not, bubbly urine is a red flag, too. When kidneys begin to fail, they allow protein to leak from your blood into your urine, creating a frothy effect. “Protein in urine will cause it to get really foamy, similar to what occurs when you whip egg whites,” says Pastan.

You're Fatigued or Feel Weak

Tired and don’t know why? Low iron, a CKD symptom, could be the culprit. “One of your kidneys’ jobs is to create red blood cells,” says Spigler. “When your kidneys aren’t working well, they may not produce enough red blood cells, leading you to develop anemia.” Red blood cells carry oxygen to various parts of your body, so when you’re running low on supply, oxygen isn’t getting to key organs and muscles, causing fatigue. Another possible reason for feeling tired: A build-up of extra fluid, toxins, and impurities in your blood—which happens when kidneys can’t filter them out properly.

Your Breath Stinks

We’re not talking about I-forgot-to-brush-my-teeth breath here. A distinct ammonia-like, metallic taste in your mouth can occur when your kidneys don’t adequately remove waste and toxins from your blood, leaving these substances to act like poisons that affect various parts of your body. “Waste build-up in the body can cause bad breath, changes in taste, or an aversion to protein-containing foods like meat,” says Tentori. In addition, toxins from CKD can affect your brain in a way that causes nausea or vomiting. “Typically, it causes morning nausea that gets better during the day,” says Pastan.

You Have Itchy, Dry Skin

Like many of the other signs of kidney disease, itchy, dry skin may be an indication of excess toxins in your body. “Waste build-up can cause severe itching, especially of the legs,” Tentori says. Itching is a reaction that can be triggered when urea, a substance created from the breakdown of protein, collects in your body. It can also happen as the result of an imbalance of minerals in your blood. High levels of phosphorus, which is normally excreted by healthy kidneys, may also accumulate in soft tissues and cause itching.

You're Feeling Confused

People with kidney disease sometimes describe themselves as feeling like they have “brain fog”—a nice-ish way of saying they are muddled in their thinking, have trouble concentrating, and keep forgetting things. These symptoms can have several kidney disease-related causes. For one, “low iron levels can lead to cognitive problems or dizziness because you have fewer red blood cells transporting oxygen to your brain,” Spigler says. Confusion may also be a result of high toxin levels in your brain. Elevated protein levels, a hallmark of CKD, can affect brain function as well.

You're Having Trouble Sleeping

Difficulty falling asleep, staying asleep at night, and staying awake during the day are all possible signs of CKD. The disease can cause more serious sleep issues as well. “Kidney toxins in your brain can cause sleep disorders such as sleep apnea, even in patients who are not overweight,” Pastan says. And anemia from kidney disease can raise your risk of developing restless leg syndrome, a condition in which spastic leg movements at night interrupt sleep. Sleep problems can have many other causes (hello, stress!), so check in with your doctor to get a better picture of what’s going on.

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Your Blood Pressure Is High

Your kidneys make hormones that help control blood pressure, so if your blood pressure starts to rise gradually or suddenly, it could be a sign of kidney trouble. Keep this in mind, too: Just as kidney disease can cause high blood pressure, high blood pressure can cause kidney disease by damaging blood vessels in your kidneys. “High blood pressure is the number two cause of kidney failure,” Spigler says. Whether it’s the chicken or the egg, anytime you have elevated BP, it’s good to have a doctor check it out.

Alice Lesch Kelly
Meet Our Writer
Alice Lesch Kelly

Alice Lesch Kelly is a Boston-based freelance writer specializing in health, nutrition, and disease prevention. Her work has appeared in many consumer outlets, including Health After 50, the Boston Globe, Prevention, Yoga Journal, Woman’s Day, WebMD, WeightWatchers.com, and EverydayHealth.com.