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Symptoms of Kidney Disease

Many people experience no symptoms of kidney disease until it has progressed to Stage 2 or 3, and for those who do, their symptoms vary greatly, partly because the kidneys affect so many body systems that pinpointing the cause can be difficult.

According to the National Health and Nutrition Examination Survey (NHANES) 1996–2006 survey participants, less than 5% of persons having symptoms of kidney disease in stages 1 or 2 (mild disease) reported being aware of having chronic kidney disease (CKD); of those with CKD stage 3 (moderate disease), awareness was only about 7.5%; for stage 4 (severe disease), awareness was still only less than half (about 40%). This data is derived from the United States Renal Data Entry System (USRDS).

There may be no decrease in urine output, even with advanced CKD. General symptoms of CKD include:

• fatigue, weakness, lack of energy and pale skin die to anemia
• loss of appetite, nausea and vomiting
• frequent urination, especially at night
• fluid retention, swelling around legs and eyes
• itching • headaches
• numbness in feet or hands due to peripheral neuropathy
• disturbed sleep
• altered mental status
• restless legs syndrome
• chest pain due to inflammation around the heart
• shortness of breath from fluid in the lungs
• easy bruising, bleeding and poor blood clotting
• bone pain and fractures
• decreased sexual interest and erectile dysfunction
• change in energy level or strength
• lightheadedness
• high blood pressure—(not a symptom, but a sign: high blood pressure itself is not a symptom, but can lead to symptoms)

Clearly these symptoms could indicate a wide range of other diseases and physical conditions. This is why your doctor is likely to order a BUN, serum-creatinine, a 24-hour urinary collection (for assessing e-GFR values) to determine if your symptoms are related to CKD. These tests are periodically performed, especially if you have diabetes, high blood pressure or metabolic syndrome. CKD is a multi-system disease causing chemical disturbances that can affect various body systems causing, for example:

• Anemia with general fatigue as a result of falling erythropoietin levels. Uremic platelet disorders can cause bleeding.
• Cardiovascular ailments from congestive heart failure and coronary artery disease to pericarditis and occlusive vascular disease.
• Neurologic ailments ranging from encephalopathy with dizziness and mental change to peripheral neuropathies (restless leg or burning feet syndromes) and muscle weakness.
• Gastrointestinal upset (nausea, vomiting, constipation or diarrhea) and at times GI bleeding
• Endocrine disturbance from sexual dysfunction to menstrual disturbances and thyroid dysfunction
• Bone disease or renal osteodystrophy
• Skin disorders with uremic pruritus or itching.