Medical History and Physical Exam

Reviewed by: HU Medical Review Board | Last reviewed: December 2022

Chronic kidney disease (CKD) is a long-term disease that gets worse over time. The first step in getting CKD diagnosed is to visit your doctor for a full medical history and physical exam.1

What to expect

During this visit, your primary care provider (PCP) will perform a physical exam and ask about any symptoms you are having. They will check your vital signs, including your:1

  • Blood pressure
  • Heart rate
  • Temperature

Your doctor will also go over your personal medical history, which might include asking about:1

  • Previous or current health conditions, like diabetes or heart disease
  • History of high blood pressure
  • Previous injuries or surgeries
  • Medicines you are currently taking
  • Changes in your peeing (urinary) habits
  • Your family history of diseases

If you have a family history of kidney disease, tell your doctor. If any family members have had kidney disease, you may be at higher risk of developing CKD. Your doctor may want to perform tests more often to check how well your kidneys are working and to monitor for changes that could arise.2

Diagnostic tests

In addition to a full medical history and physical exam, several other tests are needed to confirm a CKD diagnosis. These include blood and urine tests, imaging tests, and more.1

If you have kidney disease, these diagnostic tests can pinpoint how advanced the disease is. This is called staging.3

The stages of chronic kidney disease

There are 5 stages of chronic kidney disease. Each stage is defined by the amount of kidney function you have. As you move from early stages to later stages, your kidney function slowly worsens.3

With each stage of kidney disease, the goal is to slow down the damage to your kidneys with the right treatment so that they continue to work as long as possible.3

Symptoms of stages 1 and 2 CKD

In the early stages of CKD, you may not feel any physical symptoms. In stages 1 and 2, there is mild damage to the kidneys. But they are still working almost like normal.3,4

You may start to have protein in your pee at this point. This is an early sign that you could have kidney damage. But you will not know this unless you have diagnostic tests like blood and urine tests to confirm your diagnosis.3,4

Symptoms of stage 3

In stage 3, there is mild to severe kidney damage. Your kidneys are not able to filter the excess water and waste from your blood. This buildup of waste in your body may lead to symptoms such as:3,4

  • Feeling weak or tired
  • Swelling in the hands and feet
  • High blood pressure

Symptoms of stages 4 and 5

In stages 4 and 5, kidney damage is severe. Your kidneys are close to not working at all. You are much more likely to experience symptoms that make you feel physically ill, including:3-6

  • Weakness and tiredness
  • Swelling in the arms, legs, hands, or feet
  • Peeing more or less than normal
  • Lower back pain
  • Muscle cramps
  • Nausea or vomiting
  • Loss of appetite
  • Trouble breathing
  • Changes in skin color

There are also other symptoms that you might not feel but are just as important. These may include:3-6

  • High blood pressure
  • Low red blood cell count (anemia)
  • Weak bones
  • Protein in your urine
  • High potassium and phosphorus levels in your blood
  • Buildup of acid in your body (metabolic acidosis)

Treatment options

The earlier your kidney disease is diagnosed, the better. You can then make lifestyle changes to help preserve your kidney function, such as:1,4,7,8

  • Avoid medicines that could damage your kidneys
  • Change to a low-protein, low-salt diet
  • Take medicines to control blood pressure, lower cholesterol, and relieve swelling, among other things
  • Lose weight if your doctor recommends it

Kidney failure occurs when your kidneys are no longer working. If you reach this point, you will need dialysis or a kidney transplant.1

Talk with your doctor

If you have a family history of kidney failure or if you are having any of the above symptoms, make an appointment with your doctor as soon as possible. Remember, early signs of CKD often go unnoticed until kidney damage is in the later stages. Stay on top of your health by getting your blood work done and blood pressure checked regularly.4

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