Symptoms of Diseased Kidneys
Most patients with chronic kidney disease remain asymptomatic until advanced stages, making early detection through screening rather than symptom recognition the cornerstone of diagnosis. 1, 2, 3
Early Stage Disease (Stages 1-3)
- Patients are typically asymptomatic in early chronic kidney disease, which is why less than 5% of patients with early CKD report awareness of their disease 4, 3
- CKD typically evolves over a long time and can be detected by laboratory tests before the onset of symptomatic kidney failure 1
- The disease is usually discovered incidentally through screening tests (urinary dipstick or blood tests) rather than through symptoms 3
Advanced Stage Symptoms (Stages 4-5)
When symptoms do appear in more advanced stages, they include:
Constitutional Symptoms
- Lack of energy and fatigue are among the most frequently mentioned CKD-associated symptoms 1
- Lethargy and loss of appetite occur as kidney function deteriorates 3
Dermatologic Manifestations
- Itching and skin problems are common complaints in advanced CKD 1
Sleep and Pain
- Sleep-related problems are frequently reported 1
- Pain and discomfort affect quality of life in CKD patients 1
Non-Specific Presentations
- Many patients present with non-specific symptoms that only become apparent in more advanced stages when complications of renal dysfunction develop 2
Critical Clinical Context
The absence of symptoms should never be interpreted as absence of disease. The key clinical pitfall is waiting for symptoms to develop before screening high-risk patients, as this delays diagnosis until significant kidney damage has occurred 1, 4.
- Symptoms generally vary but are more commonly noted with advanced stages of chronic kidney disease 5
- Patients with CKD remain asymptomatic most of the time, presenting complications typical of renal dysfunction only in more advanced stages 2
Screening Over Symptom-Based Detection
Annual screening with urine albumin-to-creatinine ratio and serum creatinine for eGFR estimation is essential for high-risk patients, including those with diabetes, hypertension, family history of CKD, or age over 60 years 1, 6. This proactive approach is far more effective than waiting for symptoms to manifest 1.