The kidneys do not usually make a fuss when something starts to go wrong. That is the problem.

Unlike a chest pain that sends someone to the emergency department, or a swollen joint that forces a hospital visit, the early signs of kidney disease arrive quietly. A little more tiredness than usual. Ankles that feel slightly puffy by evening. Urine that looks foamy but only sometimes.

Easy to dismiss. Easy to attribute to something else. By the time kidney disease symptoms become hard to ignore, significant damage has often already occurred. That is why early kidney care and timely testing matter far more than most people realise.

What is kidney disease?

Kidney disease happens when the kidneys can no longer filter waste products and excess fluid from the blood effectively.

The kidneys do more than most people realise:

Remove waste and toxins from the blood.
Balance fluid levels in the body.
Control blood pressure.
Support red blood cell production.
Maintain mineral and electrolyte balance.

Early signs of kidney disease

These are the symptoms that most often get dismissed and should not be.

Swelling in the feet, ankles, face, or around the eyes: swelling due to kidney disease occurs because the kidneys can no longer remove excess fluid; it is often worse in the morning around the eyes and in the evening around the ankles.

Foamy urine: frothy or bubbly urine that persists suggests protein in urine, one of the earliest detectable signs of kidney damage.

Frequent urination: especially waking at night to pass urine more often than usual

Fatigue and weakness: reduced kidney function leads to anaemia and toxin buildup, both of which cause persistent tiredness.

Loss of appetite and nausea: waste products accumulating in the blood affect digestion.

High blood pressure that is difficult to control: kidneys regulate blood pressure; damaged kidneys raise it.

None of these alone confirms kidney disease. Together with or alongside known risk factors, they warrant a kidney function test without delay.

Kidney disease symptoms as damage progresses

Worsening swelling in the legs and face.
Shortness of breath from fluid accumulating around the lungs.
Persistent itching, waste products depositing in the skin.
Muscle cramps, particularly at night.
Poor sleep.
Confusion or difficulty concentrating in advanced cases.
Reduced urine output in late-stage kidney failure.

Symptoms that need immediate medical attention:

Blood in urine.
Sudden drop in urine output.
Severe breathlessness.
Confusion or drowsiness.
Severe swelling that develops rapidly.

These are kidney failure symptoms; do not wait and see if they pass.

What is your urine telling you?

Urine changes are among the most informative early kidney disease warning signs, and among the most ignored.

Watch for:

Foamy or frothy urine: protein in urine entering the urine from damaged kidney filters.
Blood in urine: pink, red, or brown discolouration.
Frequent urination: passing urine more often, particularly at night.
Reduced urine output: less urine than usual over several days.
Dark or unusual urine colour that is not explained by food or medicines.

High creatinine levels: what they mean

Creatinine is a waste product produced by muscle activity. Healthy kidneys clear it efficiently. When kidneys are damaged, creatinine accumulates in the blood.

High creatinine levels on a blood test suggest reduced kidney function. But creatinine alone does not tell the full story; it is interpreted alongside eGFR (estimated glomerular filtration rate), which gives a clearer picture of how much kidney function remains.

Persistent high creatinine on two or more tests, weeks apart, needs nephrology review. A single elevated reading can sometimes be explained by dehydration or exercise, but it still deserves follow-up.

Kidney disease causes: who is most at risk

Diabetes and kidney disease:

Diabetes is the single largest cause of kidney failure globally. High blood sugar damages the tiny blood vessels in the kidney filters over time. Protein in urine is often the first detectable sign. Tight blood sugar control, combined with regular kidney function monitoring, is the most effective prevention.

High blood pressure and kidney disease:

Uncontrolled high blood pressure damages kidney blood vessels directly. And damaged kidneys raise blood pressure further, creating a cycle that accelerates kidney decline. Controlling blood pressure is one of the most important kidney protections measures available.

Other kidney disease causes:

Recurrent kidney infections.
Autoimmune conditions affecting the kidneys.
Family history of kidney disease.
Long-term use of painkillers or certain medicines without medical supervision.
Kidney stones causing recurrent obstruction.

Kidney disease diagnosis: what to expect

If kidney disease is suspected, the workup typically includes:

Kidney function test: creatinine and eGFR from a blood sample.
Urine routine test: checking for protein, blood, and infection.
Urine protein test: quantifying the degree of protein leakage.
Blood pressure assessment.
Blood sugar testing: particularly in patients with diabetes risk.
Ultrasound kidney scan: assessing kidney size, structure, and any blockage.
Additional tests based on suspected cause, autoimmune markers, biopsy in selected cases.

Chronic kidney disease: understanding the stages

Chronic kidney disease is classified into five stages based on eGFR. Early stages (1–3) may cause no symptoms at all. The only way to detect them is through testing. Later stages (4–5) cause progressive symptoms and may require dialysis or kidney transplant in kidney failure.

The reason early detection matters: treatment in stages 1–3 can slow or halt progression. By stage 5, the options are significantly narrower.

Kidney disease treatment

Treatment focuses on protecting remaining kidney function and managing the underlying cause:

Control blood sugar in diabetes, HbA1c monitoring and appropriate medicines
Control blood pressure, target levels are often lower for kidney disease patients than for the general population
Reduce protein leakage, ACE inhibitors and ARBs are used for kidney protection as well as blood pressure
Avoid unnecessary painkillers, NSAIDs are directly toxic to damaged kidneys
Follow kidney-safe dietary advice, reducing salt, controlling protein intake, and managing potassium and phosphate as disease progresses
Regular kidney function monitoring, frequency increases as disease advances

Advanced kidney disease treatment:

Specialist nephrology care for complex disease management.
Dialysis, haemodialysis or peritoneal dialysis, in kidney failure.
Kidney transplant in selected patients.

Kidney disease prevention: practical steps

Many cases of kidney disease are preventable or significantly delayable.

Control diabetes and high blood pressure consistently, not just during flare-ups.
Maintain a healthy weight.
Drink adequate water, dehydration strains the kidneys, particularly in hot climates.
Avoid smoking, it accelerates vascular damage including in kidney vessels.
Do not take painkillers, herbal remedies, or supplements without medical advice.
Get a kidney function test at least once a year if you have diabetes, high blood pressure, a family history of kidney disease, or recurrent infections.

When to see a nephrologist

Do not wait for symptoms to become severe. See a nephrologist if:

Creatinine is elevated on a blood test.
eGFR is below 60.
Protein is found in urine.
There is persistent swelling in the feet or face.
Blood pressure is difficult to control despite medicines.
Diabetes has been present for several years without kidney monitoring.
Are any kidney disease warning signs present?

Nephrology care at Narayana Health

Narayana Health provides comprehensive nephrology care from early kidney function testing and chronic kidney disease monitoring to dialysis and transplant support.

Experienced nephrologists specialising in chronic kidney disease, diabetes-related kidney damage, and complex nephrology.
Advanced kidney disease diagnosis, including urine protein testing, eGFR monitoring, and kidney imaging.
Integrated care with endocrinology and cardiology for patients with diabetes and high blood pressure-related kidney disease.
Dialysis and kidney transplant programmes for advanced kidney failure.
Long-term kidney care planning focused on protecting remaining function.

Conclusion

Kidney disease does not wait for the right moment to announce itself. The early signs are subtle: foamy urine, mild swelling, a little more tiredness than expected. Most people live with them for months before connecting them to kidney health.

A kidney function test takes minutes. It can detect damage that would otherwise stay invisible for years. If you have diabetes, high blood pressure, a family history of kidney disease, or symptoms that have been quietly building, that test is worth doing today.

Call the nephrology team at Narayana Health at 08068617735.

FAQs for Kidney Care

What are common kidney disease symptoms?

Symptoms can include swelling, weakness, appetite loss, urine changes, breathlessness, and nausea.

What causes kidney disease?

Common causes include diabetes, high blood pressure, infections, autoimmune disorders, and inherited conditions.

What is a kidney function test?

It is a group of tests, including creatinine and eGFR, used to assess how well the kidneys are working.