What Are The Symptoms of Chronic Kidney Disease?

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

Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and cannot filter waste and extra water properly. The symptoms of CKD can be vague or easily mistaken as a sign of another illness. In the early stages of kidney disease, most people have no symptoms.1-3

In fact, while 37 million adults in the United States live with kidney disease, 9 out of 10 do not know they have it.1,2

Symptoms that overlap with those of other conditions

Even in the later stages of kidney disease, symptoms can be confused with those caused by other health conditions. For example, diabetes, heart disease, and autoimmune conditions can have some of the same symptoms as kidney disease.1,3-5

Later-stage kidney disease can cause:1,3-5

  • Feeling more tired
  • Anemia
  • Trouble concentrating
  • Dry, itchy skin
  • Muscle cramps
  • Bone fractures or brittle bones (osteoporosis)
  • Trouble sleeping
  • Changes in how often you need to pee (urinate) or how your pee looks
  • Swollen or puffy eyes, feet, and ankles
  • Loss of appetite
  • Nausea and vomiting

The vagueness of these symptoms may be why 2 out of 5 people with severe CKD do not know they have serious kidney disease.2

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Feeling tired or having trouble concentrating

As the kidneys work less and less well, toxins and waste build up in the blood. This condition is called uremia. It may cause you to feel weak or tired, or have trouble thinking.3,6

CKD also can lead to anemia, or low red blood cell levels. This common problem can cause weakness and fatigue. Anemia may also cause you to feel dizzy or cold even in a warm room.3,6

Dry, itchy skin and muscle cramps

In people with severe kidney disease, dry, itchy skin and muscle cramps may be a sign of mineral and bone disease. When the kidneys do not filter blood well or control hormones properly, chemicals in the body get out of balance.3,5

For example, high levels of the mineral phosphorus may lead to dry, itchy skin. Low levels of calcium may cause muscle cramps.3,5

Bone disease

Normally, the kidneys make hormones that make vitamin D usable to the body so your bones can stay strong. When the kidneys begin to stop working, hormone imbalances lead to weak, misshapen bones caused by CKD-related mineral and bone disease.3,5

These symptoms may begin when kidney disease is moderate. But almost everyone with kidney failure has mineral and bone problems.3,5

Sleep problems

When the kidneys do not filter well, waste builds up in the blood instead of being passed out of the body in pee. These toxins can make it hard to sleep.3,7

If a person with kidney disease is also overweight, they are more likely to have sleep apnea than other people. Sleep apnea is disorder that causes people to stop breathing for short periods during sleep.7

Changes in your pee

When the kidneys’ filters become damaged, you may need to pee more often, especially at night. You may pee in larger or smaller quantities than before. Some people pee less often or have trouble peeing. Some may begin to see blood in their pee as the damaged filters "leak" blood into the urine.3,6,8

Foamy urine is a sign of protein in your pee. Healthy kidneys do not let protein pass into the urine.3

Puffiness and swelling

Some people with kidney disease may notice puffiness around their eyes. This may happen when protein leaks out of their body in pee rather than being processed by the kidneys. On the other hand, swelling of the hands and feet may mean the kidneys are allowing salt and extra fluid to build up in the body rather than being removed.3,6

Loss of appetite, nausea, or vomiting

Poor appetite, nausea, and vomiting may occur as kidney disease becomes severe. Some people notice a metallic taste in the mouth or that their breath smells like ammonia. It is not uncommon for someone with severe CKD to stop liking to eat meat or to lose weight because they do not want to eat.3,6

These symptoms may be signs that waste is building up to a dangerous level in the body.3,6

Complications of severe kidney disease

Complications are problems related to a certain health condition. The many serious complications that severe kidney disease can cause include:6,9

  • Blood pressure that is hard to control
  • Higher risk of heart attack and stroke
  • Weakened immune system, which makes it easier to catch infections
  • Chest pain or trouble breathing, due to fluid build-up
  • Dangerous levels of potassium in the blood, which can cause abnormal heartbeat
  • High acid levels in the body

The good news is that by taking steps to manage your kidney disease, you can control many of these symptoms. Following a treatment plan may also help slow the development of kidney failure, which will require dialysis or a kidney transplant.6

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