Millions of people are living with various types of kidney diseases and most of them don’t even have the faintest idea about it. This is why Kidney disease is often known as a ‘Silent Killer’ as most people do not feel any different until the disease is advanced.

There are a number of warning signs of a kidney disorder, however, most of the time these are ignored or confused with alternative pathologies because of their non-specific nature. Therefore, one has to be very watchful and should get the confirmatory tests (including blood, urine, and imaging) done at the earliest appearance of any sign of a kidney disorder.

While the only definitive way to diagnose a kidney disease is to get confirmatory tests done, here are some of the early warning signs of a kidney disease:

Swelling over the ankles, feet or legs: One will start to notice edema at these sites which pits on applying pressure and is termed as pitting edema. As the kidney function begins to fall there is sodium retention which causes swelling in your shin and ankles. In short, any person noting new onset pedal edema should get an immediate evaluation of his/her renal function after visiting a nephrologist.
Periorbital Edema: It denotes swelling or puffiness around eyes caused by the accumulation of fluid in the cells or tissues. It is one of the earliest signs of a kidney disorder. It is especially prominent in individuals where there is leakage of a significant amount of protein via the kidney. Loss of protein from the body decreases the intravascular oncotic pressure and leads to extravascular accumulation of fluid in various sites like around the eyes.
Weakness: Early fatigability is almost always a universal symptom of kidney disease. As renal dysfunction progresses this symptom becomes more and more prominent. One may feel more tired or exhausted than on normal days and will be unable to perform more strenuous activities, thus requiring rest more often. This is largely due to an accumulation of toxins and impurities in the blood, resulting from poor kidney function. Being a non-specific symptom it is often ignored by most of the people and not thoroughly investigated.
Decreased appetite: Secondary to an accumulation of toxins like urea, creatinine and acids, the appetite of an individual is suppressed. Also as kidney disease advances, there is a change of taste, often described as metallic by patients. If one gets the feeling of early satiety in spite of barely having anything during the day, it should raise alarm bells in one’s mind and one should get his or her renal function evaluated.
Early morning nausea: Classically described as hitting the person when he or she goes to the bathroom in the morning for brushing his or her teeth. It also contributes to the poor appetite of the individual.
Anaemia: Haemoglobin level starts to fall, one might look pale, without any apparent site of blood loss from the body. This can also cause weakness and fatigue. The cause of anaemia is multifactorial which includes low Erythropoietin levels (Erythropoietin being synthesized in the kidney), low iron levels, toxin accumulation causing bone marrow suppression to name a few.
Changes in urine frequency: One has to keep a very careful watch on his or her urine output. For instance, you may feel the need to urinate more often, especially at night (termed as nocturia). It can be a warning sign and may indicate that the kidney filtering units are damaged or in the process of being damaged. Sometimes this can also be a sign of some urinary tract infection or enlarged prostate in men.
Change in color, consistency or nature of urine: Excessive FROTHYNESS in the urine indicates the presence of protein in the urine (which under normal circumstances should be negligible). When the filtering mechanism of the kidney has been or is being damaged, protein, blood cells start to leak out into the urine. In addition to signaling kidney disease, blood in the urine can indicate tumors, kidney stones or any kind of infection. Also, pus in urine along with fever or chills can be serious and may indicate pyelonephritis (infection of the kidneys).
Dry skin: Dryness of skin or xerosis can be an early sign of a kidney disorder. As the renal function falls, toxins tend to accumulate in the body leading to itchy, dry and foul smelling skin.
Backache or lower abdomen pain: Pain in the back, side or below the ribs can be an early symptom of kidney disorder like renal calculus or pyelonephritis. Similarly, lower abdomen pain can be associated with bladder infection or stone in the ureter or urinary bladder. Such symptoms should not be ignored and investigated further by a routine imaging study like XRAY KUB or ultrasound of abdomen.
High Blood Pressure: A presenting sign of kidney disease may be high blood pressure. Any person being diagnosed with hypertension must have detailed workup of renal functions and kidney imaging to rule out renal etiology of hypertension.

Recognition and awareness of warning signs and timely intervention can mean the difference between early detection and treatment of the kidney disorder or kidney failure which could end up with dialysis, kidney transplant or even death.