Signs and Symptoms of Kidney Disease
The signs and symptoms of kidney disease are varied and depend on the type of problem and the extent of kidney impairment. Frequently however, patients may not experience any symptoms until kidney disease is advanced. Early signs that the kidneys may be diseased include blood or protein in the urine or elevated blood pressure readings. Blood and urine testing more accurately define the degree and nature of the problem. The National Kidney Foundation is running a screening program for the early detection of kidney disease. The KEEP (Kidney Early Evaluation Program) initiative is ongoing throughout the United States. Here in Maine, the NKF has run many such programs which have identified many individuals at risk for the development of hypertension and kidney failure (NKFM-KEEP). There are, however, some common symptoms of kidney disease. They appear as one or more of the five basic functions of the kidney begin to fail:
Fluid Retention: As the kidney loses its ability to regulate the amount of fluid and salt in the body, you may notice swelling in the feet and legs, fingers, or around the eyes. Initially treatment usually involves restricting fluid and limiting salt intake. You may also begin taking fluid pills (diuretics).
Hypertension: High blood pressure can be a cause of kidney disease, and kidney disease can cause high blood pressure. Treatment is with salt restriction, weight reduction if necessary, and sometimes a combination of fluid pills and high blood pressure medications.
Fatigue: As the kidney loses its ability to remove toxins from the body, they will accumulate and cause symptoms including fatigue, itching, insomnia, irritability, loss of appetite, nausea, and vomiting. Usually more of these symptoms appear as kidney failure worsens, with people experiencing only mild or moderate kidney impairment having few or none of these symptoms. Initially, treatment will be with diet changes, specific medications to treat specific symptoms, and eventually dialysis and kidney transplantation.
Anemia: Anemia is common in patients with kidney disease and generally is caused by the inability of the failing kidneys to make the hormone erythropoietin, which stimulates the bone marrow to make red blood cells. Symptoms of anemia include weakness and lack of stamina. Erythropoietin has now been genetically engineered, and is now available in drug form to combat the anemia caused by chronic kidney disease.
Bone Disease: Failure of the kidney to produce vitamin D an lead to bone softening, and eventually bone pain and muscle weakness. Oral and IV forms of vitamin D are available and can be given to slow the development of such problems.
Should an individual have any of these problems, a detailed evaluation should be performed in order to make a diagnosis thus guiding therapy and also defining the likely outcome. In general, the earlier kidney conditions are diagnosed and treated, the better the outcome is likely to be.