Symptoms of Chronic Kidney Disease

Chronic kidney disease is a progressive organ damage that may initially present with mild symptoms or no obvious discomfort. However, as the condition worsens, multiple systemic functions gradually become abnormal. The kidneys are responsible for waste elimination, regulating fluid balance, and maintaining electrolyte stability. When their function is impaired, all organs in the body may be affected. Recognizing early symptom changes helps in early diagnosis and treatment, thereby slowing disease progression.

The symptoms of this disease are closely related to the degree of renal function decline. Early-stage patients may only experience mild fatigue or changes in urination patterns, but in later stages, symptoms such as edema and abnormal blood pressure may appear. Patients with end-stage renal failure may face severe metabolic disturbances and systemic symptoms. Understanding the characteristic symptoms of each stage is essential for self-monitoring and medical follow-up.

Early Symptoms and Signs

In the early stages (Stage 1 and 2) of chronic kidney disease, symptoms are often extremely subtle. Patients may notice only minor changes such as:

• Mild fatigue after activity due to decreased erythropoietin production by the kidneys
• Increased nighttime urination or frequent urination, with darker urine
• Mild swelling of the lower limbs, especially around the ankles and eyelids

These signs are often mistaken for overwork or aging, leading to delayed medical consultation.

Some patients may have abnormal urine test results but no obvious discomfort. Regular urine and blood tests are key for early detection, especially monitoring urine protein and serum creatinine levels. When glomerular filtration rate (GFR) continues to decline, even if symptoms are not prominent, vigilance is necessary.

Common Symptoms

Fluid Balance Disorder Symptoms

As the kidneys lose their ability to excrete water, patients will gradually experience:

• Generalized edema, mainly in the lower limbs, abdomen, and face
• Persistent high blood pressure, accompanied by dizziness, headache, and other hypertensive complications
• Shortness of breath due to pulmonary edema or metabolic acidosis

This reflects severe impairment of the kidney's ability to regulate fluid and electrolytes.

Metabolic Waste Accumulation Symptoms

When the kidneys cannot effectively eliminate metabolic waste, patients will gradually develop:

• Persistent nausea and loss of appetite, possibly with bad breath
• Itching or intolerable skin pruritus, especially at night
• Difficulty concentrating and memory decline due to uremic toxin accumulation affecting the nervous system

These symptoms are directly related to the decline in glomerular filtration rate (GFR), which can be assessed through serum creatinine and blood urea nitrogen changes in blood tests.

Disease Progression and Symptom Changes

As kidney function gradually deteriorates, symptoms will show stage-specific changes. After Stage 3, symptoms may include:

• Bony abnormalities such as osteoporosis or bone pain caused by hyperparathyroidism
• Cardiovascular symptoms like palpitations and chest tightness due to potassium accumulation or fluid overload
• Decreased immune function, leading to recurrent infections or slow wound healing

In Stages 4 and 5, severe complications such as uremic syndrome may occur, requiring immediate medical attention.

The rate of symptom worsening is closely related to individual metabolic status and control of underlying diseases. Patients with diabetes and hypertension may experience accelerated symptom deterioration due to metabolic disturbances. Regular monitoring of estimated glomerular filtration rate (eGFR) and urinary protein excretion helps predict symptom development trends.

When to Seek Medical Attention

Seek immediate medical attention if you experience the following warning signs:

• Sudden decrease in 24-hour urine output accompanied by worsening edema
• Blood pressure exceeding 140/90 mmHg for three consecutive days despite medication
• Vomiting or altered consciousness, which may indicate a uremic crisis

Symptoms of chronic kidney disease can be confused with other illnesses; professional examinations such as GFR measurement and urine analysis are crucial for diagnosis.

If unexplained weight gain, persistent muscle cramps, or difficulty breathing occur, it may indicate dangerous levels of potassium or fluid overload. High-risk groups (such as those with hypertension or diabetes) should undergo kidney function screening every six months for early detection of potential issues.

 

Frequently Asked Questions

How can dietary management delay the progression of chronic kidney disease?

Diet control is key. It is recommended to limit intake of high-protein, high-sodium, and high-phosphorus foods to reduce kidney burden. Consult a nutritionist to develop a personalized diet plan, such as choosing high-quality protein sources (like fish and soy products) and avoiding processed foods to reduce salt intake.

Is early-stage chronic kidney disease often mistaken for other illnesses?

Yes, early symptoms such as mild fatigue and increased urination are often overlooked or misdiagnosed as overwork or urinary tract infections. If experiencing persistent weakness or lower limb edema, blood and urine tests should be performed to confirm kidney function indicators like serum creatinine and urine protein excretion.

Which medications may worsen kidney function during treatment?

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and certain antibiotics can damage the kidneys. Always inform your doctor of your medical history before use. The doctor will adjust medication doses based on GFR and regularly monitor drug metabolism to avoid nephrotoxic drugs.

How can daily exercise habits be adjusted to protect the kidneys?

Moderate aerobic exercise (such as jogging and swimming) can improve blood flow and metabolism, but high-intensity training that overexerts should be avoided. It is recommended to exercise 3-5 times a week at moderate to low intensity, and to stay hydrated in hot weather to prevent dehydration and further kidney burden.

When should dialysis or kidney transplantation be considered?

When kidney function severely declines (GFR below 15 mL/min) or severe complications such as hyperkalemia or uremic symptoms occur, replacement therapy should be evaluated. The doctor will provide personalized treatment recommendations based on overall health status and quality of life needs.