Chronic kidney conditions tend to develop slowly over time, often being vague or silent until the very last stages of the affliction. In the early stages of silent kidney damage, you may not feel sick or have any symptoms until your kidneys have become damaged and unable to function as they should.
Chronic kidney disease (CKD) is a common condition that is often associated with aging, but can affect individuals of any age. It is a long-term condition with little initial symptoms where the kidneys gradually lose their ability to properly function.
Many people with chronic kidney disease are unaware they have the disease, which is why it is often referred to as a “silent” condition.
Many patients ask ‘what does early kidney disease feel like’. In the early stages of kidney disease, symptoms are often mild and easy to overlook. However, they may include:
Needing to urinate more often, especially at night
Feeling tired, weak, or having low energy
Loss of appetite
Foamy or bubbly urine
Puffiness around the eyes
Dry or itchy skin
Trouble concentrating
Difficulty sleeping
These symptoms may reflect early kidney disease or the beginning of kidney function decline.
As kidney damage progresses, symptoms often become more severe and may include:
Swelling of the hands, feet, ankles, or face
Shortness of breath
Nausea or vomiting
Muscle cramps
Numbness or tingling
High blood pressure that is difficult to control
Darkening of the skin
These are important kidney failure warning signs and suggest more advanced chronic kidney disease (CKD).
The leading cause of kidney disease is diabetes followed by high blood pressure, both conditions damage your kidneys over time. If you have heart disease, your risk of developing CKD is also increased. These conditions strain the kidneys, leading to kidney damage:
Diabetes
High blood pressure
High cholesterol
Kidney infections
Kidney stones and urine blockages
Enlarged prostate
Glomerulonephritis or kidney inflammation
Older age (over the age of 60)
Being overweight
Long term regular use of non-steroidal anti-inflammatory drugs (NSAIDs) that can damage kidneys
If you notice signs of early kidney disease or have ongoing health conditions that raise your risk of kidney disease there are some steps that you can take to help manage your condition.
Monitor kidney health: Regular checkups to monitor how well your kidneys are working.
Regular screening: Regular blood tests every 6 to 12 months to check for kidney problems.
Schedule a visit with a nephrologist: Visit a specialist if you suspect you have persistent or worrying symptoms.
Lifestyle changes: Make healthy lifestyle changes to control underlying conditions
Diagnosing chronic kidney disease requires a nephrologist (kidney specialist) to assess your risk and health of your kidneys, especially if you already have symptoms of kidney disease.
Here are some tests that are used to diagnose your kidney condition or to determine if you are at risk of your kidneys failing.
Blood tests: These check how well your kidneys are working by measuring waste products in your blood, such as creatinine and urea.
Urine tests: A urine sample can show early signs of kidney disease and may help identify the cause. The presence of protein (called albumin) or blood in the urine can be a sign that the kidneys are not working properly.
Imaging tests: An ultrasound may be used to look at the size and structure of your kidneys. In some cases, other imaging tests may also be needed.
Kidney biopsy: In certain situations, your doctor may recommend removing a small sample of kidney tissue for testing. This is done using a thin needle and helps determine the cause of kidney disease. A biopsy is usually recommended when the cause is unclear, kidney function is worsening quickly, or there is a large amount of protein in the urine.
Many patients ask ‘when should you test kidney function’. Blood and urine tests remain the most reliable way to detect silent kidney damage and assess overall kidney health, helping to prevent chronic kidney disease and related complications.
Anyone with diabetes, high blood pressure, a family history of kidney disease, or persistent symptoms should undergo regular screening.
Two key markers used in kidney function screening are the estimated glomerular filtration rate (eGFR) and the urine albumin-to-creatinine ratio (UACR), which help identify and monitor progressive kidney damage and identify kidney failure warning signs.
The estimated glomerular filtration rate (eGFR) is a blood test that shows how well your kidneys are filtering waste, excess fluid, and toxins from your blood. It is calculated using your blood creatinine level, along with factors such as age and gender.
eGFR ≥ 90: Kidney function is considered normal if urine albumin levels are also normal and there is no other evidence of kidney damage.
eGFR 60-89: Kidney function is mildly reduced and may still be normal for some individuals. It is not diagnosed as chronic kidney disease unless other signs of kidney damage (such as abnormal urine albumin) are present for more than 3 months.
eGFR 30-59: This indicates moderate chronic kidney disease and requires medical monitoring and treatment.
eGFR 15-29: This indicates severe chronic kidney disease.
eGFR < 15: This indicates kidney failure and requires immediate specialist care and preparation for renal replacement therapy (dialysis or transplant).
One of the earliest signs of kidney disease is the presence of excess protein in the urine. One of the most reliable screening tests for this is the urine albumin-to-creatinine ratio (UACR) test.
The UACR measures the amount of albumin (a type of protein) compared to creatinine in a single urine sample. This ratio allows doctors to accurately estimate how much protein is being lost in the urine, even without collecting urine for 24 hours.
A UACR result of 30 mg/g or higher may indicate early kidney damage and warrants further evaluation.
Once the albumin level is determined, your nephrologist can recommend the most appropriate treatment and monitoring plan.
Many patients ask ‘is kidney disease reversible if caught early’. While chronic kidney disease is not usually reversible, early detection allows intervention that may slow kidney disease progression.
Prevention is always better than cure. There are several ways in which you can strive to protect your kidneys in the long term and prevent kidney function decline.
To lower the risk of developing kidney disease or slow its progression:
Maintain a healthy weight
Manage existing medical conditions
Regular health screening for early prevention
Avoid or stop smoking
Follow doctor’s instructions with medications. Overuse of certain painkillers for long term can lead to kidney damage.
If you are experiencing ongoing fatigue, swelling, changes in urination, or foamy urine, you may be wondering ‘how do I know if my kidneys are failing’. Seek prompt immediate medical evaluation when in doubt. The sooner kidney damage is detected, the better the potential outcomes.
At Prince Court Medical Centre, our kidney specialists (nephrologists) offer screening and early detection services to diagnose and manage kidney or other nephrology-related conditions.
Book an appointment today to protect your kidney health.
Reviewed by Dr Wan Mohd Rasis Wan Ahmad Kamil
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