My name is Dr. Sudeep Singh Sachdev and I am currently working as a consultant nephrology in Narayana Super Specialty Hospital, Gurugram, Sec-24. Today I will be talking about the early warning signs of kidney diseases. Now millions of people on this earth are suffering from kidney diseases but most of them do not even have the idea about it. Why? Because most of the kidney diseases present with non-specific symptoms and are only prevalent when the patient prevents in advance stages of the disease. While the only way to confirm the presence of kidney diseases is to get confirmatory investigations done which include blood test, urine test and various form of image investigation.
However, the following are the few early signs of kidney diseases. One of the earliest sign is the appearance of swelling over the feet, ankle or legs. One will start to notice edema which pits on applying pressure and often termed as pitting edema. This is usually due to the fact, that when renal dysfunction advances, there is salt retention and accumulation of fluid in the extra vascular spaces of the body. Now another common and early sign is the presence of periorbital puffiness which is the appearance of edema on the upper and lower eyelid. It especially occurs in people who have protein leakage from their kidneys. And in often termed as nephrotic syndrome.
Another one of the early signs is the presence of early morning nausea. Now the patient would classically present to the bathroom at the time of brushing his teeth with the sensation of early morning nausea which leads to a separation of his appetite and decreases in taking of food during the day. This in turn can also be expedited if the patient also complaints during the later stages of disease with the sensation of metallic taste because of which he starts to deny even the most favourite products which he had loved to eat beforehand. Now another one of the early sign is anemia. By anemia I mean there is a fall in hemoglobin without any apparent blood loss from the body. There is no visible site of blood loss but the hemoglobin of the person starts to fall.
The reason for this is that kidney is a site where there is production of erythropoietin in the body. And erythropoietin is required for hemoglobin production. As renal dysfunction advances there is decrease in erythropoietin levels which present as low hemoglobin levels thus leading to anemia. Now another one of the early signs is the change in the frequency of urination of the person. One might start to urinate more often and it is often described as increase in the frequency of maturation during the night termed as notaria. This can also happen during prostate disorder in man and also urinary tract infection or could be the early sign of kidney disease.
Now one should also be very careful about any changes that occur in the nature, consistency or color of urination. As the filtering mechanism of the kidney fails, there is leakage of both protein or blood cells from the kidney. Thus the presence of blood could indicate the presence of prostate disorder, urinary tract infection or even presence of tumors of the kidney, presence of pus in the urine along with fever which indicates the serious infection of kidneys like pyelonephritis or excessive frothiness of the urine would indicate presence of great amount of protein leakage which needs to be evaluated in further detail. Another non-specific sign would be the presence of dry skin or psoriasis. As the renal dysfunction would advance there would be also associated itching and one can notice itch marks on the skin of the person. Now a non-specific early sign could also be either a backache which would present as pain along the side or below the rib or even lower abdominal pain which could be in pubic region.
This will either indicate the presence of stone, maybe in the kidney or in the bladder itself or the respective infections. Last but not the least, another presenting sign of kidney disease could be the high blood pressure. Often when high blood pressure detected it’s not evaluated for kidney etiologies. Thus, it is very important for any person who presents with hypertension to get his kidney function test done along with imaging of the kidney to rule out renal etiology of hypertension. Lastly, I would like to mention that recognition and awareness along with timely intervention would lead to early detection and treatment of a kidney disorder which otherwise, could end up with dialysis, transplant or even an unfortunate circumstance as death.