The liver is a vital organ that is essential to the human vitality and health. It helps to digest food, rid toxic substances and absorb essential nutrients that the body needs for survival.
Some people are born with liver problems while others damage their liver by being exposed to harmful chemicals, alcoholism or the after-effects of a virus.
Early signs of liver problems should not be ignored, and medical help should be sought to assure proper treatment.
At any stage of kidney disease, knowledge is power. Knowing the symptoms of kidney disease can help you get the treatment you need to feel your best.
If you or someone you know has one or more of the following symptoms of CKD (Chronic Kidney Disease), or you worry about kidney problems, see a doctor for blood and urine tests.
Remember, other health concerns can cause many of the symptoms. The only way to know the cause of YOUR symptoms is to see your doctor.
① Symptom 1: Changes in Urination
Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- You may have to get up at night to urinate.
- Urine may be foamy or bubbly.
- You may urinate more often, or in greater amounts than usual, with pale urine.
- You may urinate less often, or in smaller amounts than usual, with dark-colored urine.
- Your urine may contain blood.
- You may feel pressure or have difficulty urinating.
What patients said:
- “When you go to use the restroom, you couldn’t get it all out. And it would still feel just like tightness down there, and there was so much pressure.”
- “My urine is what I had started noticing. Then I was frequently going to the bathroom, and when I got there, nothing’s happening. You think, ‘Hey, I’ve got to go to the John,’ and you get there: 2, 3 drops.”
- “I was passing blood in my urine. It was so dark it looked like grape Kool-Aid. And when I went to the hospital they thought I was lying about what color it was.”
② Symptom 2: Swelling
Failing kidneys don’t remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, face, and/or hands.
What patients said:
- “I remember a lot of swelling in my ankles. My ankles were so big I couldn’t get my shoes on.”
- “My sister, her hair started to fall out, she was losing weight, but her face was really puffy, you know, and everything like that, before she found out what was going on with her.”
- “Going to work one morning, my left ankle was swollen, real swollen, and I was very exhausted just walking to the bus stop. And I knew then that I had to see a doctor.”
③ Symptom 3: Fatigue
Healthy kidneys make a hormone called erythropoietin (a-rith’-ro-po’-uh-tin), or EPO that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less EPO.
With fewer red blood cells to carry oxygen, your muscles, and brain tire very quickly. This is anemia, and it can be treated.
What patients said:
- “I was constantly exhausted and didn’t have any pep or anything.”
- “I would sleep a lot. I’d come home from work and get right in that bed.”
- “It’s just like when you’re extremely tired all the time. Fatigued, and you’re just drained, even if you didn’t do anything, just totally drained.”
④ Symptom 4: Skin Rash/Itching
Kidneys remove wastes from the bloodstream. When the kidneys fail, the build-up of wastes in your blood can cause severe itching.
What patients said:
- “It’s not a skin itch or anything, it’s just right down to the bone. I had to get a brush and dig. My back was just bloody from scratching it so much.”
- “My skin had broken out, I was itching and scratching a lot.”
⑤ Symptom 5: Metallic Taste in Mouth/Ammonia Breath
A build-up of wastes in the blood (called uremia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don’t feel like eating.
What patients said:
- “Foul taste in your mouth. Almost like you’re drinking iron.”
- “You don’t have the appetite you used to have.”
- “Before I started dialysis, I must have lost around about 10 pounds.”
⑥ Symptom 6: Nausea and Vomiting
A severe build-up of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
What patients said:
- “I had a lot of itching, and I was nauseated, throwing up all the time. I couldn’t keep anything down in my stomach.”
- “When I got nausea, I couldn’t eat, and I had a hard time taking my blood pressure pills.”
⑦ Symptom 7: Shortness of Breath
Trouble catching your breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath.
What patients said:
- “At the times when I get the shortness of breath, it’s alarming to me. It just fears me. I think maybe I might fall or something, so I usually go sit down for awhile.”
- “I couldn’t sleep at night. I couldn’t catch my breath like I was drowning or something. And, the bloating, can’t breathe, can’t walk anywhere. It was bad.”
- “You go up a set of stairs, and you’re out of breath, or you do work, and you get tired, and you have to stop.”
⑧ Symptom 8: Feeling Cold
Anemia can make you feel cold all the time, even in a warm room.
What patients said:
- “I notice sometimes I get really cold, I get chills.”
- “Sometimes I get really, really cold. It could be hot, and I’d be cold.”
⑨ Symptom 9: Dizziness and Trouble Concentrating
Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems, trouble with concentration, and dizziness.
What patients said:
- “I know I mentioned to my wife that my memory—I couldn’t remember what I did last week, or maybe what I had 2 days ago. I couldn’t concentrate because I like to work crossword puzzles and read a lot.”
- “I was always tired and dizzy.”
- “It got to the point, like, I used to be at work and all of the sudden I’d start getting dizzy. So I thought maybe it was my blood pressure or else diabetes was going bad. That’s what was on my mind.”
⑩ Symptom 10: Leg/Flank Pain
The most common causes of CKD (Chronic Kidney disease) do not cause any pain. And, much of the pain that is near the kidneys is not caused by a kidney problem. But some people who have CKD do have pain.
Some people with kidney problems may have pain in the upper back (where the kidneys are) or on the same side as the affected kidney.
- Polycystic kidney disease (PKD), which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause pain.
- Kidney infections and kidney stones can cause severe pain, often in spasms.
- Bladder infections can cause burning when you urinate.
- People who have medullary sponge kidney say it is painful.
What patients said:
- “About two years ago, I was constantly going to the bathroom all the time, my back was always hurting, and I was wondering why…and they diagnosed that kidney problem.”
- “And then you have to get up all time through the night, and then you have the side ache, a backache, and you can’t move.”
- “At night, I would get a pain in my side. It was worse than labor pain. And I’d be crying, and my husband would get up, everybody, rubbing my legs.”
What You Can Do
“The more informed I was, the better I felt about it. I felt I had some control.” – CKD patient
Most chronic kidney disease (CKD) can’t be cured. The good news is that if your doctor finds out that you have a kidney problem, there may be many ways to help slow down the disease. To help you feel better, and help you make better medical decisions. What can you do?
1.) Know Your Lab Tests
Learn the names of the lab tests your doctor orders and what the results mean. Kidney disease is often diagnosed, and always monitored, by measuring levels of substances in the blood or urine. Typical lab test values can be found here.
- Measures of kidney function
- Measures of anemia
- Measures of diabetes control
- Measures of nutrition
- Control Your Blood Pressure
2.) Keep your blood pressure at the target level your doctor sets with:
- Weight loss
- Exercise
- A low-sodium diet
- Reducing stress
- Taking your blood pressure medication the right way
3.) Ask Your Doctor About Certain Medications That May Help Treat Kidney Disease
There may be drugs that treat the kidney problem YOU have. Fish oil has been found to help some types of kidney problem. Medications that suppress the immune system may help some auto-immune causes of CKD.
4.) Ask Your Doctor About Anemia
A shortage of red blood cells can start early in CKD. Anemia can cause you to feel tired and worn out. Ask your doctor about medications such as epoetin (EPO) and iron to treat anemia.
5.) Eat a Healthy Diet
We are what we eat — we build our cells out of our food. So, if you eat mostly fast food and drink sugary sodas, you may be able to improve your kidney health by eating better foods.
6.) Ask Your Doctor About a Lower-Protein Diet
A dietitian can help you learn how to keep your kidneys healthy longer by eating the right foods. Don’t limit your protein until you have talked about it with your doctor or dietitian.
7.) Control Your Blood Sugar Levels
If you have diabetes, stay at a healthy weight, exercise, and take medications as prescribed to keep your blood glucose in the “normal” range. Tight control of blood sugar can help slow the progression of kidney disease.
8.) Quit Smoking
In people with CKD, smoking is linked to an increase of protein spilled in the urine. In smokers with diabetes, CKD may progress twice as fast.
9.) Avoid Certain Pain Medications
Some over-the-counter pain pills containing ibuprofen or naproxen, and even acetaminophen (e.g., Motrin®, Advil®, Aleve®, Tylenol®) can affect kidney function.
This is especially true if you have kidney, heart, or liver disease or you take diuretics (water pills). Avoid using combinations of these pain pills and caffeine — both at once can further damage your kidneys.
10.) Exercise
With your doctor’s okay, start an exercise program to control weight and keep your heart and blood vessels healthy and your muscles and joints in good working order.
