What are the signs of kidney disease?
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Signs of Kidney Disease
Common Symptoms of Chronic Kidney Disease (CKD)
Chronic kidney disease (CKD) often progresses silently, with many individuals remaining asymptomatic until the disease reaches an advanced stage. Common symptoms that may eventually manifest include tiredness, swollen ankles, feet or hands, shortness of breath, nausea, and blood in the urine. Additionally, many patients experience non-specific symptoms such as lethargy, itchiness, and loss of appetite.
Advanced Stage Symptoms
In the advanced stages of CKD, patients may experience a significant symptom burden. A cross-sectional survey of patients with stage 5 CKD managed conservatively revealed that more than one-third of patients reported symptoms such as lack of energy, pruritus (itchiness), drowsiness, dyspnea (shortness of breath), edema (swelling), pain, dry mouth, muscle cramps, restless legs, lack of appetite, poor concentration, dry skin, sleep disturbance, and constipation. These symptoms are often severe and can significantly impact the quality of life.
Specific Indicators and Diagnostic Signs
Glomerular Filtration Rate (GFR) and Proteinuria
The best indicator of overall kidney function is the glomerular filtration rate (GFR), which can be measured or estimated using specific equations. A GFR of less than 60 mL/min per 1.73 m² for at least three months is indicative of CKD. Proteinuria, or the presence of excess protein in the urine, is another critical marker associated with an increased risk of CKD progression and mortality.
Albuminuria in Diabetic Kidney Disease
In diabetic kidney disease, persistent albuminuria (exceeding 300 mg/24 h) is a hallmark sign. This condition often progresses from microalbuminuria to clinical proteinuria over several years, eventually leading to a decline in GFR and end-stage renal failure if untreated. Peripheral edema is usually the first symptom noticed in these patients, occurring at a very late stage.
Cutaneous Manifestations
Patients with end-stage renal disease may exhibit various skin and nail abnormalities, including pruritus, perforating disorders, calcifying disorders, and bullous dermatoses. These cutaneous signs can precede or follow the initiation of dialysis or kidney transplantation.
Other Clinical Presentations
Asymptomatic Detection
Many cases of renal disease are detected incidentally through routine screening tests such as urinalysis and blood tests, which may reveal abnormalities like proteinuria or hematuria (blood in the urine).
Symptomatic Presentations
Symptomatic renal disease can present with a range of features, including anorexia, nausea, vomiting, fatigue, weakness, pruritus, breathlessness, bleeding tendencies, apathy, loss of mental concentration, muscle twitching, and cramps. Acute kidney injury (AKI) and urinary symptoms such as frequency, polyuria, nocturia, oliguria, anuria, and visible hematuria are also common presentations.
Foamy Urine
Persistent foamy urine, characterized by multiple layers of small to medium bubbles, is considered a warning sign of kidney disease and may indicate the presence of protein in the urine.
Conclusion
Kidney disease often progresses silently, with many individuals remaining asymptomatic until the disease reaches an advanced stage. Common symptoms include tiredness, swelling, shortness of breath, nausea, and blood in the urine. Advanced stages of CKD are marked by a significant symptom burden, including lack of energy, pruritus, and dyspnea. Diagnostic indicators such as GFR, proteinuria, and albuminuria are critical for early detection and management. Awareness of these signs and symptoms is essential for timely diagnosis and intervention, potentially improving outcomes for individuals with kidney disease.
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