If you notice this in the toilet see your doctor immediately
Sometimes, you may experience issues with urination and wonder if it’s just a simple infection or something more serious. If you have persistent issues with your waterworks, it might be a sign of chronic kidney disease (CKD), a long-term condition where the kidneys do not work as well as they should.
CKD can range from a mild condition with no or few symptoms to a very serious condition where the kidneys stop working, sometimes called kidney failure. Most people with CKD will be able to control their condition with medicine and regular check-ups. CKD only progresses to kidney failure in around 2 in 100 people with the condition.
In its early stages, CKD is ‘silent’ and doesn’t usually cause symptoms, but as it gets more advanced, there are some signs you may notice.
Here are 10 signs you may notice if your kidneys have sustained significant damage. However, it’s essential to note that they can all be symptoms of other underlying conditions.
- Expert warns about the change in your eyes you should never ignore
- Check before you flush. What your poo says about your liver, gut and even your mood
Blood in your urine
GP Alice Whittle says, ‘When your kidneys are working properly, they keep the blood cells in your body when they’re filtering waste out of your blood. If the kidneys’ filters are damaged, though, some blood cells can leak into your wee. If you see blood in your pee (haematuria), you should always see your doctor urgently so they can rule out infections, plus more serious things such as cancer of the bladder and kidneys.’
A urinary infection (cystitis) is by far the most common cause of haematuria, particularly in young women. If blood in the urine coincides with symptoms of cystitis and disappears a few days after the infection is treated, no further tests are usually required. The other symptoms of cystitis are:
- Burning feeling on passing water
- Feeling the need to pass urine more often
- Feeling that the bladder has not been emptied
- Sometimes a fever and feeling unwell
Puffy eyes, ankles and feet
Have you noticed puffiness around your eyes, ankles and feet? It may be a sign your kidneys aren’t working as well as they should.
Whittle says, ‘When your kidneys are not removing excess water and waste from your body, it can build up in your tissues. This leads to swelling, usually in your lower body, although it can affect other areas, including around your eyes and sometimes your hands. If untreated, it may progress to excess water in the lungs causing shortness of breath.’
Other reasons you may have puffy eyes include sleep deprivation, a high-salt diet, allergies, and the natural ageing process.
Swollen feet and ankles may be caused by prolonged periods of sitting/standing, a high-sodium diet, and being overweight.
Foamy urine
Occasional instances of foamy pee are common. However, sometimes, those extra bubbles in the toilet water can be a sign of a more serious condition, such as diabetes or CKD.
Dr Hussain Ahmad says, ‘Froth in your pee may be a sign there are high levels of protein in it, especially if you have to flush a few times to clear the bubbles. It may look like the foam you see on the surface when you’re scrambling eggs, because the type of protein that ends up in urine is the same as the albumin found in eggs.’
Foamy urine is pretty common. Sometimes, when you really have to go, the speed and force of your urine stream cause lots of bubbles to appear. Or, if you use a toilet cleaner, your urine may be foamy until you flush away all the chemicals. Foamy urine can also be a sign of dehydration.
But if you regularly have foamy urine, or if your pee looks very foamy it might be a sign that something is wrong, and you should reach out to a medical professional.
Fatigue
Everyone feels tired occasionally. Extreme, ongoing tiredness, together with a lack of energy, may be a sign of something more serious. According to Whittle, there are lots of reasons why you may experience fatigue with CKD.
‘If your kidneys are not working well, toxins build up in your blood and this can make you feel tired and weak. You may feel more tired as your CKD gets worse and your kidney function drops. Fatigue is a very common symptom for people living with kidney disease, with approximately 70% of people reporting fatigue and up to 25% reporting severe symptoms,’ says Whittle.
Poor appetite
When your kidneys are not functioning properly, it can lead to a loss of appetite and feelings of nausea. It can also affect the way food tastes.
There may be several other reasons why you have lost your appetite. Changes to your body and mood can affect your ability to feel hunger. These could include:
- Pain
- Dehydration
- Dental problems or tooth pain
- An injury
- A loss or reduction of taste or smell
- An emotional reaction, such as grief, fear, sadness, or shock.
- A common cold
- An infection
Confusion
Ahmad says people with severe kidney disease may develop confusion. ‘Your kidneys act as a filter for your blood. They remove waste and help keep levels of water and minerals at their proper levels. People with severe kidney disease can develop cognitive symptoms like confusion or problems concentrating. These cognitive changes can develop for different reasons, such as damage to the small blood vessels in your brain or due to the build-up of waste products in your blood.’
Needing to wee more often
Healthy kidneys filter your blood and remove waste through your urine. But when the kidneys are damaged, they may make urine that contains mostly water, with few waste products. That means you may need to go to the bathroom more often, especially at night.
According to Whittle, most people pee on average about seven to eight times per day. ‘If you feel the need to pee more than that, or if you have to get up to pee every 30 minutes to an hour, we’d class this as frequent urination. But context matters. This may still be ‘normal’ if you’re drinking lots of fluids or taking certain medications. What matters most is what’s typical for you.’
Many conditions and other factors can cause frequent urination, including:
- Urinary tract, bladder and pelvic conditions
- Pregnancy
- Diabetes
- Enlarged prostate
Dry, itchy skin
You may find that you become itchier as your kidney function worsens.
According to Ahmad, itching is very common, affecting around half of people with advanced kidney disease. ‘Experts don’t know exactly why kidney disease leads to very dry, itchy skin. But it may be connected to a few different factors including toxins in the blood and an imbalance in levels of minerals in your body.’
If you have an itch, it’s probably nothing to worry about. A number of factors can cause itching, including allergies, eczema, certain toiletries and cleaning products, and some medications, such as morphine-based painkillers.
If the itching is persistent, and accompanied by other symptoms related to your kidneys, it’s worth making an appointment with your GP.
Muscle cramps
Whittle says, ‘Impaired kidney function can cause an electrolyte imbalance, which can cause neuromuscular problems, including muscle cramping, twitching, or weakness. Some people may also feel pins and needles or lose sensation in certain areas of the body.’
A muscle cramp is often nothing to worry about and can occur after working a muscle too hard or straining it, losing body fluids through sweat, or simply holding a position for an extended period.
Sleep problems
When the kidneys are not functioning properly, toxins and waste products can build up in the bloodstream.
According to Ahmad, ‘This accumulation of waste can cause a range of issues, including sleep disruptions. For example, high levels of toxins in the body may lead to discomfort, muscle cramps, or restless leg syndrome, which can interfere with the ability to fall or stay asleep.’
Moreover, kidneys balance electrolytes such as calcium, sodium, and potassium. An imbalance in these electrolytes can cause symptoms such as muscle spasms, leg cramps, and disruptions to the body’s natural sleep-wake cycle, leading to insomnia or fragmented sleep.
Who is at risk of chronic kidney disease?
Anyone can develop CKD, at any age. However, some people are at a higher risk than others. The most common CKD risk factors are:
- Diabetes
- High blood pressure
- Heart disease and/or heart failure
- Obesity
- Age – it is more common in over 60s
- Family history of CKD or kidney failure
- Smoking and/or use of tobacco products
For many people, CKD is not caused by just one thing. Instead, it is a result of many physical, environmental, and social factors.
Knowing the risk factors can help you determine your level of risk and whether you should be checked for CKD.
When to see a doctor
Make an appointment with your doctor if you experience signs or symptoms of kidney disease. Early detection might help prevent kidney disease from progressing to kidney failure.
If you have a medical condition that increases your risk of kidney disease, your doctor may monitor your blood pressure and kidney function with urine and blood tests.
Kidney Care UK has a free kidney health checker tool where you can answer a few simple questions to find out if you are at risk of kidney disease and understand more about keeping your kidneys healthy. Find out more here.
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