Chronic kidney disease (CKD) can take years to develop and in most cases it progresses slowly. In its early stages, the patient may not even realize there is a problem. The symptoms of early kidney disease can be subtle and may mimic other conditions. Having regular laboratory testing of your blood and urine done at your doctor’s office is the surest way to monitor the efficiency of your kidneys.
Early signs and symptoms
- Changes in urine habits (having to go more often, but producing little or no urine) or changes in the urine (frothy, bubbly, dark in color or with blood) or feelings of pressure in the lower pelvic area.
- Swelling or inflammation in the legs, feet, hands or face. If this is caused by the kidneys not removing all the fluid they should.
- General and persistent fatigue, dizziness or feeling cold. Commonly called anemia, these symptoms are a result of your kidneys failing to produce a hormone called erythropoietin, which regulates the production of red blood cells. With fewer red blood cells, less oxygen is transported to your muscles and to your brain. This causes you to feel tired, dizzy, cold or short of breath.
- Skin rash or itching. This is a result of the buildup of toxins, which the kidney is failing to remove efficiently. The itch can feel deep in the tissues.
- Nausea, vomiting, loss of appetite or a metal taste in your mouth. This is a result of uremia, which is a build up of wastes in the blood. Your food may taste different, and you may lose weight.
- Muscle cramps or jerking.
Blood and urine tests for kidney disease
Routine blood and urine testing performed by your doctor will uncover early signs of kidney disease. Regular testing is especially advised if you have risk factors like high blood pressure, diabetes, kidney cancer or family history of kidney disease. When your kidney functioning starts to drop, your doctor can advise lifestyle changes and medicines to slow the progression of disease.
Many people do not visit doctors regularly and are diagnosed with kidney disease after it has become serious. These blood and urine tests become important measures of how the disease is progressing.
Measuring your glomerular filtration rate (GFR)
Your physician will measure your glomerular filtration rate (GFR). This is a measure that indicates how well your kidneys are filtering wastes. Blood and urine tests are needed to measure your GFR. As your kidney disease worsens, your GFR goes down.
Five stages of chronic kidney disease (based on GFR)
| Stages of chronic kidney disease | Description | GFR |
| Stage one | Kidney damage (i.e., protein in the urine) | >90 |
| Stage two | Kidney damage with mild decrease in GFR | 60-90 |
| Stage three | Moderate decrease in GFR | 30-59 |
| Stage four | Severe reduction in GFR | 15-29 |
| Stage five | Kidney failure (dialysis or kidney transplant needed) | <15 |