The Kidney TRUST

Symptoms of CKD

Most people with early CKD don’t have symptoms — or don’t know that they have them. Knowing what to watch for can help you to alert your doctor. And, getting early treatment can help you feel your best and protect your kidneys.


Red blood cells carry oxygen to all of the cells in your body. Anemia is a shortage of red blood cells that can start early in CKD. What do kidneys have to do with blood cells? Healthy kidneys make a hormone called erythropoietin (EPO) that tells your bone marrow to make red blood cells. As kidneys fail, they make less of the hormone.

With fewer red blood cells, you get tired much faster, even when you are doing routine tasks like climbing a flight of stairs or walking to the mailbox. Feeling very, very tired can be a symptom of anemia.

Other symptoms of anemia are:

  • Muscle weakness
  • Shortness of breath
  • Pale skin, gums, and fingernail beds
  • Feeling dizzy or lightheaded
  • Feeling cold all the time (when other people are not)
  • Fuzzy thinking (memory problems or trouble focusing)
  • Erectile dysfunction in men
  • Changed periods in women
  • Pica (a desire to eat ice or non-food items, like ice, dirt, laundry starch, or clay)

Tell your doctor right away if you have any of these symptoms. Anemia can be treated with iron and injections of EPO. In just a few weeks, you can have your energy back — and getting your anemia treated can also protect your heart.

Sometimes people with CKD give up their jobs and go on disability because they are so tired. But disability pays much less than most jobs, and there is a 6-month wait for checks to start. Once you leave a job, it can be hard to find a new one after you feel better. Don’t let this happen to you! If you think you have anemia, ask for a blood count and get treatment.

Edema (Swelling)

Failing kidneys remove less water. The extra water can build up in the legs, ankles feet, face, and/or hands (edema). Some people have trouble catching their breath due to extra fluid in the lungs. (This may be mistaken for asthma). If you have high blood pressure, you may find that it is harder to control, even when you take your pills.

In early CKD, your doctor may suggest that you eat less salt in your diet and take drugs to help your kidneys remove more water (diuretics). These steps may help slow the rate of CKD and help your edema.

Changes in Urination

Kidneys make urine, and when the kidneys are failing the urine may change. Some changes in that may notice include:

  • Urinating more often
  • Not urinating as much
  • Making more — or much less — urine than usual
  • Getting up at night to urinate
  • Foamy or bubbly urine
  • Blood in the urine or very dark urine that looks like tea or cola
  • Pressure when urinating or trouble getting a flow started

Uremia (Buildup of Toxins in the Body)

Kidneys remove wastes from the blood. When the kidneys fail, wastes build up in the body (uremia). Symptoms of uremia include:

  • Skin rash
  • Itching
  • Nausea and vomiting
  • Loss of appetite for meats (protein)
  • Metallic taste in the mouth
  • Bad “ammonia” breath
  • Weight loss (from loss of appetite)

Phosphorus is a mineral that is found in many foods (especially meats, dairy, beans, nuts, and whole grains). When it builds up in the body, it can cause itching. Your doctor may prescribe drugs called phosphate binders and ask you to eat less phosphorus in your diet to help relieve your itching.

Back or Flank (Side) Pain

Some people with kidney problems have pain in the back or flank on the side of the affected kidney. Polycystic kidney disease can also cause this type of pain.

Poor Growth (Children Only)

One of the early signs of CKD in children is poor growth.


To sum things up, most of these symptoms are not only found in CKD — they can occur with other health problems, too. A doctor is the best person to check out all of your symptoms and order tests to find out if CKD is the cause. If you are at high risk for CKD due to high blood pressure, diabetes, or a family history of CKD, the sooner you find out if you have a problem, the sooner you can take steps to treat it.