Kidney failure is a condition in which kidney function declines to the point where it is unable to adequately perform its vital functions, including removing metabolic waste and excess fluid from the body. This condition can cause various waste products to accumulate in the blood and, in advanced stages, affect the function of other organs.
Meanwhile, chronic kidney disease (CKD) can progress slowly and often causes no symptoms in the early stages. Therefore, many cases are only diagnosed after kidney function has significantly declined. Recognizing risk factors and warning signs, as well as undergoing regular checkups, is crucial to slowing disease progression and preventing complications.
Why Do Kidney Disease Symptoms Often Go Unnoticed?
In the early stages of chronic kidney disease, the kidneys still have a fairly high level of compensatory capacity. This means that even if some kidney function begins to decline, the sufferer may still experience no significant symptoms.
As kidney function declines, various symptoms can appear. However, these symptoms are often nonspecific and can resemble everyday conditions, such as fatigue from activity, lack of sleep, or dehydration. This makes kidney problems easy to overlook.
Therefore, regular health check-ups are very important, especially for individuals who have risk factors for kidney disease.
Symptoms to Watch Out For
Here are some complaints that can arise in kidney disease, especially when kidney function has experienced a significant decline:
1. Easily tired and body feels weak
Chronic kidney disease can cause anemia, partly due to decreased production of erythropoietin, a hormone that plays a role in red blood cell formation. As a result, the body can feel weak, fatigued, and lack energy. Anemia in kidney disease can also be influenced by other factors, so a thorough evaluation is necessary.
2. Swelling in the Feet, Hands, or Face
When kidney function declines, the body's ability to regulate sodium and fluids can be impaired, leading to fluid buildup in the tissues. This condition can lead to edema, particularly in the legs and ankles. In some cases, swelling can also be seen in the hands or face.
3. Changes in Urine Frequency and Characteristics
Changes in urine can be a sign of kidney or urinary tract problems. Some changes to watch for include:
- The frequency of urination becomes more frequent or even decreases.
- Urine appears foamy, which may be related to the presence of albumin or protein in the urine.
- Urine is darker in color or appears to be mixed with blood.
- Pain when urinating in certain conditions, although this complaint is more often related to urinary tract infections or disorders than chronic kidney disease.
If these changes persist or are accompanied by other complaints, a medical examination should be carried out to determine the cause.
4. Nausea, vomiting, and decreased appetite
In advanced kidney disease, the buildup of metabolic waste products in the blood can cause symptoms of uremia. Symptoms may include nausea, vomiting, changes in taste, and decreased appetite. If prolonged, this condition can contribute to weight loss.
5. Itchy Skin and Difficulty Concentrating
In advanced chronic kidney disease, metabolic disorders and changes in mineral balance can contribute to persistent itching. Metabolic disorders and uremia can also affect brain function, leading to difficulty concentrating, drowsiness, or decreased thinking ability.
Who is at Higher Risk of Kidney Disease?
Some groups have a higher risk of developing chronic kidney disease, including:
- People with diabetes, especially if their blood sugar levels are not controlled.
- People with high blood pressure can damage the blood vessels in the kidneys.
- Individuals with obesity.
- People with heart disease.
- Active smoker.
- People who have a family history of kidney disease.
- People of advanced age.
- People who have experienced acute kidney injury (AKI).
For at-risk groups, regular health checks are still recommended even if they are not yet experiencing symptoms.
Early Screening is Important for People at Risk
Tests can help detect kidney disease before severe symptoms appear. Key tests to assess chronic kidney disease include:
1. Blood Creatinine Examination
Blood creatinine levels are used in conjunction with estimating equations to calculate eGFR, which is one of the main parameters of kidney filtration function.
2. Estimated Glomerular Filtration Rate (eGFR)
eGFR is estimated based on creatinine levels, age, gender, and other variables according to a specific equation. This test helps estimate the kidneys' ability to filter blood.
3. Urine Test (Urinalysis)
Urinalysis can help detect blood, protein, signs of infection, and other abnormalities in the urine.
4. Urine Albumin-Creatinine Ratio (UACR)
UACR is used to detect albumin in the urine (albuminuria), which can be an early sign of kidney damage. Albuminuria and eGFR testing are important components in the evaluation of chronic kidney disease.
5. Kidney Ultrasonography (USG)
An ultrasound can help assess the structure and size of the kidneys and detect abnormalities such as stones, cysts, or urinary tract dilation. This test is performed as indicated and is not the primary screening test for chronic kidney disease.
6. Check Blood Pressure and Blood Sugar Levels
High blood pressure and diabetes are major risk factors for chronic kidney disease. Therefore, both need to be regularly checked and controlled as part of preventative measures.
When Should You See a Doctor?
Consult a doctor immediately if you experience:
- Swelling in the feet, hands, or face that does not improve.
- Persistent changes in the amount, color, or characteristics of urine.
- Prolonged fatigue without an obvious cause.
- Nausea, vomiting, or loss of appetite that does not improve.
- Persistent itching, especially if accompanied by other complaints that point to kidney problems.
The doctor will conduct an evaluation through blood and urine tests, as well as a kidney function assessment, to determine the cause of the symptoms and determine appropriate treatment. The earlier kidney disease is detected, the greater the chance of slowing its progression and preventing or delaying more serious complications.
The article was written by Dr. Dirga Sakti Rambe, M.Sc, Sp.PD (Internal Medicine Specialist, EMC Pulomas Hospital).