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Spotting the Early Warning Signs of CKD

Oct 6, 2023

Chronic kidney disease (CKD) is growing at an increased rate and currently affects 15% of American adults. There are a number of physical signs of CKD. However, many people associate them with other conditions or do not present with any physical signs.

This can make spotting early warning signs of CKD very challenging for both the person and healthcare providers. Getting tested is the only way to be certain if CKD is present.

Key Points

The Kidneys

The kidneys are part of the urinary tract, along with the bladder and ureters. The kidneys are two kidney bean-shaped organs located on each side of the spine, below the rib cage.

Each kidney is made up of about a million nephrons. Nephrons are filtering units that contain a glomerulus (filter) and a tubule. The nephrons in a two-step process: (i) the glomerulus filters the blood, and (ii) the tubule returns essential nutrients and substances back into the bloodstream, removing all waste products.

Kidneys that are healthy filter approximately half a cup of blood every minute. Waste products and excess water are removed, producing urine. The urine flows from the kidneys to the bladder through the ureters. The urine is then stored in the bladder until it is passed out of the body.

The kidneys perform other essential functions in the body, such as:

  • Controlling the production of red blood cells
  • Releasing hormones that regulate blood pressure
  • Removing toxins such as drugs from the body
  • Producing an active form of vitamin D
  • Regulating certain electrolytes (sodium, potassium, and calcium) in the body

Chronic Kidney Disease Overview

Chronic kidney disease (CKD) is a progressive and irreversible condition that damages the kidneys, reducing their ability to function correctly. If the damage to the kidneys is severe, they may stop working entirely (kidney failure or ESRD).

CKD occurs when the kidneys sustain enough damage that they lose their ability to filter waste and excess water out of the blood effectively. This may lead to waste products building up and causing further damage to the kidneys and other parts of the body.

Two of the most common causes of CKD are hypertension (high blood pressure) and diabetes. Other causes of CKD may include:

  • Kidney cancer
  • Glomerulonephritis
  • Lupus nephritis
  • Polycystic kidney disease

While anyone can develop CKD, certain populations of people have increased risk factors, such as those who:

  • Are over the age of 60
  • Are Asian American, African American, or Native American
  • Have a family history of kidney disease
  • Have cardiovascular disease (heart disease), hypertension, or diabetes

Other health problems that can cause CKD

The kidneys play an essential role in the proper functioning of the whole body. As kidney function decreases, other health problems can arise, such as:

  • Hypertension (High blood pressure)
  • Cardiovascular disease (Heart disease)
  • Anemia (reduced amount of red blood cells in the body)
  • Edema (fluid build-up in parts of the body)
  • High potassium, which may harm the heart
  • High phosphorus and calcium, which may cause bone disease

Any damage to the kidneys cannot be reversed. Thus, there is an emphasis placed on early detection and appropriate treatment to try to slow disease progression and reduce or prevent the risk of developing other health problems.

Signs of CKD

Signs and symptoms of CKD are often nonspecific as they are similar or the same as other conditions. The kidneys are able to make up for reduced function until irreversible damage has occurred; therefore, many people may not have any early warning signs of CKD.

Signs of CKD may develop over time if the disease progresses, as waste products and fluid build up in the body.

CKD is separated into five stages based on the severity of damage to the kidneys and how well they are still able to work properly.

Stage 1 CKD

In Stage 1 CKD, the damage to the kidneys is mild, with the kidneys still functioning well. In this Stage, most people do not experience any symptoms that affect their health. Some signs that may present or that doctors may notice when running tests for other conditions include:

  • Hypertension
  • Kidney damage that shows in an ultrasound, kidney biopsy, MRI, or CT scan
  • Hematuria (blood in the urine)
  • Protein in the urine
  • Swelling in the feet or hands
  • Urinary tract infections

Stage 2 CKD

In Stage 2 CKD, the kidney damage is still mild, and they are able to function well enough not to create any symptoms. While most symptoms of CKD may not start until Stage 3, some signs that may be noticed in Stage 2 may include:

  • Protein in the urine
  • Hypertension
  • Urinary tract infections
  • Hematuria (blood in the urine)
  • Swelling in feet or hands
  • Kidney damage that shows up on imaging

Stage 3 CKD

In Stage 3 CKD, the kidneys present with mild to moderate damage. Their reduced function limits their ability to clear waste and fluid out of the blood effectively. This build-up of waste (uremia) and fluids may begin to cause other conditions, such as hypertension, anemia, and bone issues. Stage 3 CKD is split into two sub-categories, Stage 3a and Stage 3b. This is based on the estimated glomerular filtration rate (eGFR).

For many people with CKD, Stage 3 is typically when the disease begins to affect their health noticeably and when symptoms start to present. Signs of Stage 3 CKD may include:

  • Feeling tired and weak
  • Trouble sleeping
  • Swelling in the feet or hands
  • Muscle cramps
  • Skin that is itchy or dry
  • Pain in the lower back
  • Restless leg syndrome
  • Increased or decreased frequency of urinating
  • Urine that is darker in color or more foamy than normal

Stage 4 CKD

In Stage 4 CKD, the kidneys are moderately to severely damaged and no longer functioning well. Uremia may be present and cause other health conditions such as:

  • Cardiovascular disease
  • Hypertension
  • Anemia
  • High phosphorus
  • Metabolic acidosis
  • Bone disease
  • High potassium

Signs of Stage 4 CKD may include:

  • Loss of appetite
  • Pain in the lower back
  • Swelling in the arms and legs
  • Muscle cramps
  • Increased or decreased frequency of urinating
  • Nausea and vomiting

Stage 5 CKD

In Stage 5 CKD, the kidneys are severely damaged and have stopped functioning. They are very close to failure or have already failed. If the kidneys have failed, renal replacement therapy will need to begin.

Early symptoms of kidney failure may include:

  • Swelling in the feet, legs, arms, and hands
  • Producing little to no urine
  • Loss of appetite
  • Trouble breathing
  • Muscle cramps
  • Nausea or vomiting
  • Headaches
  • Feeling tired and weak
  • Changes in skin color
  • Pain in the lower back

As symptoms of CKD may not present until the kidneys are moderately or severely damaged, the only way to determine how well the kidneys are functioning is to get tested. Talk to your healthcare provider about regular screenings for your kidneys.

Panoramic Health

Panoramic Health is the only integrated value-based kidney care platform led by physicians, which uniquely qualifies us to care for patients holistically. We partner with providers, practices, and healthcare systems to advance the use of cutting-edge data analytics and clinically validated best practices across the continuum of value-based kidney care.

Our providers are focused on delivering compassionate and personalized care via holistic interventions for all patients across the CDK spectrum.