Identifying and Dealing with Kidney Diseases

In recognition of World Kidney Day, it’s worth spotlighting what your kidneys do—and why routine screening matters.

Your kidneys are two bean-shaped organs located below your ribs. They:

• Filter waste and extra fluid from your blood

• Help regulate electrolytes and acid–base balance

• Help control blood pressure through hormone signaling

• Support red blood cell production (via erythropoietin) and bone/mineral health

Kidney disease is common and frequently undiagnosed:

• More than 1 in 7 U.S. adults (~35.5 million; ~14%) are estimated to have CKD

• As many as 9 in 10 adults with CKD don’t know they have it

Many CKD symptoms show up later, which is why testing is so important. When symptoms do appear, they can include:

• Swelling in ankles/feet or around the eyes

• Fatigue or low energy

• Changes in urination (foamy urine, urinating more at night, decreased output)

• Nausea, reduced appetite

• Trouble sleeping or trouble concentrating

• Muscle cramps

• Itchy skin

• Shortness of breath

• High blood pressure that’s new or harder to control

These symptoms are not specific to kidney disease and can overlap with other conditions (including anemia, thyroid disorders, heart disease, and dehydration). If symptoms persist or worsen, testing is the safest next step.

Seek urgent care now if you have:

• Severe shortness of breath, chest pain, confusion

• New severe swelling, fainting, or very high blood pressure symptoms

• Fever with flank/back pain, vomiting (possible kidney infection)

• Very little urine output or signs of dehydration with worsening symptoms

A menudo años. La ERC puede avanzar lentamente y muchas personas se sienten bien hasta que la función renal ya está muy reducida. Con frecuencia se detecta mediante análisis de rutina, no por síntomas.

Dos problemas renales que suelen notarse antes por dolor o síntomas agudos son:

• Cálculos renales (dolor intenso en el costado)

• Infección renal (fiebre, dolor en costado/espalda y síntomas urinarios)

En la ERC, las señales tempranas suelen ser resultados de pruebas, no sensaciones físicas. Indicadores clave:

• Presión arterial alta o peor controlada

• Albúmina/proteína en la orina (uACR)

• Disminución de eGFR en sangre

Las etapas de ERC se clasifican según el eGFR, y en etapas 1–2 puede haber filtración “normal” pero evidencia de daño (por ejemplo, albúmina elevada en orina).

El color de la orina puede dar pistas, pero por sí solo no diagnostica.

Cambios que ameritan evaluación:

• Orina espumosa persistente puede indicar proteína en orina

• Orina rosada/roja o color “cola” puede sugerir sangre en orina (por infección, piedras u otras causas)

La hidratación, alimentos, suplementos y medicamentos también cambian el color, por lo que las pruebas son la mejor manera de confirmarlo.

Las causas más frecuentes de ERC incluyen:

1. Diabetes – se recomienda tamizaje regular con eGFR y albúmina en orina

2. Hipertensión – puede causar y empeorar ERC

3. Riesgo cardiovascular/metabólico – la obesidad y otras condiciones metabólicas aumentan el riesgo

La ERC por lo general no se “cura”, pero suele ser manejable y puede ralentizarse cuando se detecta temprano.

Treatment depends on the stage and the cause, but modern standards focus on:

• Controlling blood pressure

• Managing blood sugar (if diabetic)

• Reducing urine albumin/protein leakage

• Avoiding kidney-toxic exposures (like frequent NSAID use, dehydration)

• Diet and lifestyle adjustments guided by your clinician

For advanced disease, dialysis or transplant planning may be needed. The National Kidney Foundation notes kidney failure is typically when 10–15% of kidney function remains (eGFR <15).

Living well with reduced kidney function usually means a “kidney-smart” routine:

• Regular monitoring (blood pressure, eGFR, urine albumin)

• Medication adherence

• Nutrition adjustments as directed (often sodium awareness; protein/phosphorus/potassium guidance depends on stage)

• Staying active and maintaining a healthy weight

• Avoiding dehydration and unnecessary supplements/meds that may stress the kidneys

With the right plan, many people can continue to work, travel, and live full lives.