How will someone know they have kidney problem?

Being a Nephrologist I am asked one common question in most patient Interactions : “Doctor how will someone know they have Kidney problem ?”

So, I will tell you what are common and some uncommon signs & symptoms of Kidney diseases. As you know kidneys are responsible for formation of urine and removal of Toxins from the body hence many symptoms are related to your urinating habits

1. 1. Frequent urination may be related to uncontrolled Blood sugars in a Diabetic patient, or it may be due to infection in urine (UTI or Urinary Tract Infection), or weakening Kidney Functions (as in Chronic Kidney Failure). This may lead to getting up 3-4 times in the night after sleep.
   2. Blood in Urine (Hematuria) in young people is mostly due to Kidney Stones, infection, or injury to kidneys; but in old people it may be a marker of Cancers of Kidney.
   3. Pus in urine is due to UTI which is usually associated with Fever and Burning in urine
   4. Reduced urine output- commonly a healthy person produces 1.5-2 litres of urine per day. However, either due to poor oral intake of fluids or due to dehydration the urine output is reduced, and when urine output is even less than 500 ml per day the kidney starts to fail.
   5. Swollen feet and facial puffiness: once the kidney functions are compromised various toxins, salt and water start getting accumulated and edema happens.
   6. Poor appetite and a tendency to vomit occurs when various toxins accumulate due to failing kidneys
   7. Shortness of breath and inability to walk or even lie down comfortably is due to accumulation of fluid in chest.
   8. Uncontrolled Blood Pressure in spite of using 2-3 anti-hypertensive drugs.
   9. Fall in Haemoglobin due to lack of a hormone (Erythropoetin) in blood which is formed in Kidneys
   10. Bony pains and weakness of muscles due to lack of Calcium, Vitamin D and malnutrition
   11. Some patients present to us as bleeding disorders like nasal bleed or irregularities with menstrual cycles.
   12. In addition to all these many patients are diagnosed when we do some screening tests or screening camps for Diabetic patients and Nephropathy is diagnosed when we detect albumin in Urine or elevated Blood Urea or Creatinine in very early phase of illness when many patients are asymptomatic.

Diagnosing Kidneys diseases in early stages gives us, the Nephrologists, the opportunity to reverse or retard the progression of Kidney disease.

Author : Dr. L. K. Jha, Director & Senior Consultant – Nephrology & Kidney Transplant, Dharamshila Narayana Superspeciality Hospital, Delhi