Kidney disease, which affects one in seven Americans, is more than twice as common as coronary heart disease, which affects one in 20 American adults. And yet, kidney disease is very easy to miss. That’s why we asked doctors for the subtle kidney disease symptoms you should watch for, especially if you have an increased risk of developing the condition.
“Symptoms of kidney damage are typically very subtle, and by the time you notice them, there is usually already serious harm done,” said Jeremy Allen, D.O., a family medicine physician with Brookwood Baptist Health Primary Care in Pelham, AL. “It is possible to lose as much as 90% of kidney function without having any overt symptoms.” That’s a problem because your kidneys play the essential role of filtering your blood, regulating blood pressure, maintaining strong bones, and supporting red blood cell production, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Meet the experts: Jeremy Allen, D.O., a family medicine physician with Brookwood Baptist Health Primary Care in Pelham, AL; Mateo Ledezma, M.D., a nephrologist with Kaiser Permanente.
One important way to lower your risk of developing kidney disease is to keep your blood sugar and blood pressure under control. According to the NIDDK, diabetes and high blood pressure are the two most common causes of kidney disease, with one in three people with diabetes and one in five people with hypertension developing the condition.
You can also ask for a full blood workup at your annual checkup—and review any medications you’re currently taking. If your bloodwork shows high levels of the waste product creatinine, your doctor might order additional blood tests, urine tests, or kidney scans. Likewise, Dr. Allen said your doctor can help you pinpoint medications that are toxic to your kidneys—“like some NSAIDs, certain antibiotics, or lithium or iodine-containing medications”—and suggest other treatments.
But if something seems amiss, don’t wait until your annual exam to bring it up. While kidney disease is often silent, there are some warning signs that can help you catch it early—as long as you know what to look for.
Common kidney disease symptoms
Swollen ankles
Your kidneys remove waste and excess fluid from your body by producing urine. “If the kidneys slow down or do not work well, then fluid can be retained,” said Mateo Ledezma, M.D., a nephrologist with Kaiser Permanente. “This can result in persistent swelling in tissue.” Swelling caused by excess fluid in the body is called edema and happens most often in the feet, ankles, and legs, per the Cleveland Clinic.
Infrequent urination
When more fluid is stuck in your tissues, less is being flushed out—meaning you may be peeing less than usual. If you notice you’re drinking the same amount you normally do, but urinating less frequently, it may be worth bringing up with your doctor. According to the Cleveland Clinic, low urine output is most common in people with certain types of kidney disease that can cause acute kidney injury.
Fatigue
“Part of the function of the kidneys is to help regulate a person’s hemoglobin level,” explained Dr. Ledezma. Hemoglobin is a protein in your red blood cells that helps circulate oxygen throughout the body. When something goes wrong with your kidneys, your hemoglobin levels can drop and you can become anemic—making you feel tired and weak.
Nausea or loss of appetite
When waste builds up in your system because your kidneys aren’t filtering it out, it can start to mess with other parts of your body. Per the Mayo Clinic, this can lead to nausea, vomiting, and loss of appetite and just generally make you feel sick.
High blood pressure
Once your kidneys are damaged, they can’t effectively regulate your blood pressure. At the same time, the force of your blood pounding against your vessels stretches them, causing further damage by scarring and weakening the blood vessels in your kidneys. According to the NIDDK, high blood pressure is the second leading cause of kidney failure in the U.S., while kidney disease may also exacerbate or cause high blood pressure or make it more difficult to control.
Heart palpitations
“If your kidney damage is causing a build-up of potassium, you might notice an abnormal heartbeat,” said Dr. Allen. Your heartbeat might seem fast or irregular, or you may feel like your heart is fluttering.
Brain fog
Waste build-up can also affect your brain, according to the Mayo Clinic, causing you to feel like you can’t think clearly. Pay attention to symptoms like forgetfulness, trouble concentrating, confusion, and brain fog, especially if they’re out of character for you.
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