Early symptoms of kidney disease Recognize the warning sign

• Kidney disease is a condition where the kidneys malfunction or their ability to function is reduced, resulting in their inability to filter waste and toxins and maintain the balance of water, minerals, and hormones in the body normally. It is divided into acute and chronic kidney disease, and its symptoms vary.
• Kidney disease has 5 stages Stage 1 Kidney dysfunction begins, but they still filter waste well; often asymptomatic. Stage 2 Slightly reduced kidney function; still no clear symptoms. Stage 3 Moderate kidney function; symptoms include fatigue, swelling, and high blood pressure. Stage 4 Severe kidney function; preparation for renal replacement therapy. Stage 5 End-stage renal failure; requires dialysis or kidney transplantation.
• Causes of kidney disease include diabetes, high blood pressure, long-term use of pain relievers or certain medications, urinary tract infections, kidney inflammation, genetics, urinary tract obstruction, autoimmune diseases, smoking, insufficient water intake, and a high-sodium diet.
• Common symptoms of kidney disease include back pain, excessive foaming in urination, swelling, easy fatigue, weakness, loss of appetite, nausea or vomiting, a bitter taste in the mouth, itchy skin, and cramps.

Early symptoms of kidney disease are often subtle, leaving many unaware that their kidney function is gradually deteriorating. These include fatigue, swelling of the face and feet, abnormal urination (frequent or infrequent urination, foamy urine, dark urine color), high blood pressure, itchy skin, or nausea. If left untreated, it can progress to chronic kidney disease.

Recognizing these early warning signs is crucial for timely detection, diagnosis, and treatment. This article explores the early symptoms of kidney disease, common causes, treatment approaches, and prevention methods to help you take proper care of your kidney health starting today.

What is kidney disease?

Kidney disease is a condition where the kidneys malfunction or their ability to function is reduced, making them unable to effectively filter waste and toxins, and maintain the balance of water, minerals, and hormones in the body. When both kidneys cannot perform their normal functions, it affects various systems and leads to various illnesses. Common kidney diseases include kidney failure, glomerulonephritis, pyelonephritis, and kidney stones.

What are the important functions of the kidneys?

1. Filtering waste from the blood Eliminating metabolic waste products such as urea, creatinine, uric acid, and various medications through urine.
2. Controlling water and electrolyte balance Regulating the amount of water and electrolytes in the body to maintain balance.
3. Controlling blood pressure Producing important substances like renin to regulate blood pressure.
4. Self-producing essential hormones, such as erythropoietin (EPO), to stimulate the bone marrow to produce red blood cells.

When the kidneys malfunction or deteriorate, waste and fluids accumulate in the body, resulting in symptoms such as swelling, fatigue, weakness, anemia, high blood pressure, and potential abnormalities in the heart, bones, and nervous system. If severe or chronic, dialysis or kidney transplantation may be necessary to replace kidney function.

How many types of kidney disease are there?

1. Acute Kidney Injury (AKI) The kidneys rapidly lose function in a short period of time due to shock, severe infection, significant blood loss, or certain medications. This type of kidney disease is curable if treated promptly.
2. Chronic Kidney Disease (CKD) Kidney function deteriorates slowly and continuously over more than 3 months. It is not curable, but its progression can be slowed. CKD can be divided into 5 stages.

What causes kidney disease?

Kidney disease can be caused by many factors, including underlying medical conditions, genetics, and lifestyle habits. Common causes include

• Diabetes High blood sugar levels over a long period damage the capillaries in the kidneys, reducing their ability to filter waste.
• High blood pressure Continuously high blood pressure accelerates the deterioration of blood vessels in the kidneys, leading to kidney dysfunction.
• Long-term use of pain relievers or certain medications, especially NSAIDs, can unknowingly damage kidney tissue.
• Urinary tract infections or kidney inflammation If recurring or untreated, these infections can lead to permanent kidney damage.
• Genetic diseases or a family history of kidney disease, such as polycystic kidney disease.
• Urinary tract obstruction Obstruction of the urinary tract from kidney stones or mineral buildup can cause urinary reflux and damage the kidneys.
• Autoimmune diseases Such as lupus, which causes inflammation of the kidney tissue.
• Lifestyle habits Smoking, insufficient water intake, and a high-sodium diet can overwork the kidneys and accelerate their deterioration.

What are the early warning signs of kidney disease?

Early-stage kidney disease often has no clear symptoms, making many people unaware that their kidneys are malfunctioning. Observing these warning signs early allows for timely detection and treatment, reducing the risk of future kidney damage or failure.

• Abnormal urination, frequent urination, excessive foaming of urine.
• Swelling of the body, face, hands, feet, or ankles that leaves pitting edema that doesn't return to its original state.
• Easy fatigue, weakness, and lack of energy.
• Loss of appetite, nausea, or vomiting; a bitter taste in the mouth.
• Itchy or unusually dry skin; easy bruising.
• Frequent muscle cramps or spasms.
• Difficult-to-control high blood pressure, especially in younger people.
• Lower back or flank pain; may be dull or severe.

Symptoms of kidney disease that require immediate medical attention:

• Blood in the urine or unusually dark urine.
• Significantly decreased urination or no urination at all.
• Sudden swelling, especially in the face, around the eyes, or both legs.
• Fatigue, shortness of breath, chest tightness, or difficulty breathing.
• Severe nausea and vomiting, severe loss of appetite, or lethargy.
• Severe lower back or flank pain accompanied by fever and chills.
• Very high, uncontrolled blood pressure, or severe headache, blurred vision.
• Confusion, seizures, or loss of consciousness.

How many stages are there in chronic kidney disease?

Chronic kidney disease can be divided into 5 stages based on eGFR, from the initial stage to end-stage renal failure. The symptoms of kidney disease at each stage are as follows:

1. Stage 1-2: Mild kidney deterioration; kidney function is still relatively good. Often there are no obvious symptoms, but abnormal signs may begin to appear, such as protein leakage in the urine.
2. Stage 3: Kidney function decreases further. Symptoms begin to appear, such as fatigue, swelling, high blood pressure, or abnormal urination.
3. Stage 4: Kidney function is drastically reduced. Symptoms become more pronounced. Kidney replacement therapy is necessary, such as preparing for dialysis or evaluating kidney transplantation.
4. Stage 5: End-stage renal failure. The kidneys can no longer function adequately. Patients require dialysis or kidney transplantation to maintain life.

Kidney Disease Diagnosis

1. Blood tests: Measure levels of metabolic waste products from muscle and protein in the blood, and calculate the glomerular filtration rate (GFR).
2. Urine tests: Check for albumin in the urine and other abnormalities such as blood in the urine.
3. Kidney ultrasound: Examine the size, structure, and overall appearance of the kidneys.
4. Kidney biopsy (in some cases) to determine the specific cause.

Kidney Disease Treatment Guidelines

Kidney disease can be treated in its early stages to improve symptoms. Treatment guidelines include:

1. Controlling the Underlying Disease

Controlling the underlying cause is the first and most important step in treating chronic kidney disease. It helps slow disease progression by focusing on treating underlying conditions that damage the kidneys, such as diabetes, high blood pressure, gout, or kidney inflammation.

2. Lifestyle and Dietary Modifications

Lifestyle and dietary modifications help control weight, lower blood pressure, and reduce blood sugar levels, which are crucial factors in improving kidney function. Limit protein, sodium, potassium, and phosphorus to reduce waste products that the kidneys must filter. Choose low-potassium fruits and vegetables such as cucumbers, cabbage, apples, and pineapples; boil and rinse to reduce potassium. Avoid bananas, ripe mangoes, spinach, and fresh milk. Control weight through light exercise, quit smoking, and limit alcohol for overall kidney health.

3. Medication

The main medications commonly used are antihypertensive drugs such as ACE inhibitors (Enalapril) and ARBs (Losartan), which reduce protein in the urine and directly protect the kidneys, especially in patients with diabetes or high blood pressure. 1. Blood Sugar Control Medications, such as SGLT2 inhibitors (Dapagliflozin), help reduce the risk of kidney failure. Diuretics (Furosemide) reduce edema and fluid retention. Avoid medications that are toxic to the kidneys, such as NSAIDs (Ibuprofen, Diclofenac), certain antibiotics (Gentamicin), and adjust the dosage of other medications based on GFR to prevent kidney deterioration.

4. Dialysis

There are two main methods of dialysis: hemodialysis and peritoneal dialysis, chosen based on the patient's condition and lifestyle.

• Hemodialysis uses an external hemodialysis machine to filter blood, performed three times a week for 4-5 hours each time. It requires the creation of artificial blood vessels in the arm and is performed in a hospital. Suitable for patients requiring care from a medical team.
• Peritoneal dialysis uses dialysis fluid passed through a catheter implanted in the abdomen. It can be done at home 4-5 times a day or continuously overnight. Suitable for patients with easy mobility but with a higher risk of infection.

Both methods help control electrolyte balance. It reduces swelling and fatigue, but it's not a permanent cure. It requires lifelong care or until a kidney transplant is performed.

5. Kidney Transplantation

A kidney transplant is a surgical procedure to remove a kidney from a donor (relative or deceased) and implant it in a recipient. The new kidney is placed in the pelvic area and connected to major blood vessels and the bladder. One kidney is usually sufficient. The process begins with blood and tissue compatibility testing (HLA matching and Crossmatch Test) to reduce the risk of kidney rejection. Before surgery, the recipient must undergo dialysis to purify the blood, fast from food and water, and have their electrolyte balance adjusted.

The donor undergoes open or endoscopic surgery to remove the less vital kidney (usually the left kidney). After surgery, the recipient must take immunosuppressant drugs for life, and kidney function is monitored, with biopsies performed if problems arise. The average lifespan of a kidney is 15-20 years.

What are some complications of kidney disease?

1. Anemia
2. Osteoporosis
3. Cardiovascular abnormalities
4. Pulmonary edema
5. Infection susceptibility

Self-care for people with kidney disease:

• Have regular health checkups.
• Control your diet: reduce salt, phosphorus, sugar, and fat.
• Exercise regularly.
• Avoid medications that are toxic to the kidneys, such as NSAIDs, certain herbs, and supplements.
• Avoid smoking and alcohol.
• Choose fresh fruits, vegetables, whole grains, and fish.
• Avoid processed foods, fermented foods, and foods high in potassium/phosphorus, such as dried beans, raisins, durian, tamarind, pumpkin, egg yolks, and oysters.
• Maintain a healthy weight.

What foods should people with kidney disease avoid?

People with kidney disease should eat bland, low-sodium foods with adequate protein. They should choose fruits and vegetables low in potassium and avoid processed foods. They should also control their food and fluid intake according to their doctor's recommendations to slow kidney deterioration and maintain quality of life.

1. Foods that are very salty and high in sodium.
2. Foods high in potassium (in some stages of the disease).
3. Foods high in phosphorus.
4. Excessive protein (especially in early to mid-stages).
5. Processed and ready-to-eat foods.
6. Alcoholic beverages and sugary drinks.
7. Certain herbs and supplements.
8. Broths and concentrated soups.

What should people with kidney disease eat?

1. Rice, flour, and other energy-giving carbohydrates.
2. Adequate amounts of good quality protein.
3. Low to moderate potassium vegetables.
4. Low potassium fruits.
5. Heart-healthy fats.
6. Low-sodium seasonings.
7. Drink water as directed by your doctor.

Do all kidney disease patients need dialysis?

Kidney disease doesn't always require dialysis. Doctors will only consider dialysis in the end-stage (eGFR below 15) or when there are serious complications such as pulmonary edema, acidosis, or dangerously high levels of waste products. If detected early and lifestyle changes are made appropriately, it can effectively slow down kidney deterioration and may even prevent the need for dialysis for life.

How to Prevent Kidney Disease

Taking care of your kidney health starts with daily habits. Important ways to prevent kidney disease include:

• Controlling blood sugar and blood pressure to reduce damage to blood vessels in the kidneys.
• Drinking enough water, at least 6-8 glasses a day, helps the kidneys excrete waste more efficiently.
• Not holding your urine reduces the risk of urinary tract infections and kidney inflammation.
• Avoiding the overuse or continuous use of medications, especially pain relievers. Always consult a doctor or pharmacist before using any medication.
• Having annual health checkups to detect kidney abnormalities in their early stages.
• Avoiding sweets and processed foods, which are often high in sodium and additives.
• Exercising regularly helps control weight, blood sugar, and blood pressure.
• Avoiding very salty or sweet foods to reduce the long-term burden on the kidneys.

Kidney Screening and Treatment at Vibhavadi Hospital

Kidney disease is a health problem that should not be overlooked. Early detection and treatment are crucial. Regular kidney health screening is available at Vibhavadi Hospital, where expert physicians provide accurate diagnosis and treatment to improve kidney health and promote a happy and healthy life.

Summary

Kidney disease is a condition where the kidneys lose their function of filtering waste and maintaining bodily balance. It often doesn't show clear symptoms in the early stages, but can be observed through swelling, abnormal urination, or fatigue. The main causes are diabetes, high blood pressure, and a high-salt diet. Kidney disease is divided into acute (curable) and chronic (5 stages) requiring ongoing care. Treatment focuses on controlling the underlying cause, adjusting diet, and using medication to slow progression. Dialysis or kidney transplantation is only performed in the end-stage.

The best prevention is regular health checkups, drinking clean water, and avoiding medications that are toxic to the kidneys. If you notice any symptoms that suggest you may be at risk of kidney disease or that your kidneys are beginning to have problems, you can get screened at Vibhavadi Hospital. We are equipped with modern equipment for accurate diagnosis and treatment to help you achieve better health.