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As we all know that every person has two kidneys in the body, which are mainly responsible for filtering nitrogenous waste materials like urea, cretonne, acid, etc. from the blood. (All of which are products of metabolism in the body) and thus produce urine.

Millions of people are living with different types of kidney diseases and most of them are not even aware of it. This is the reason why kidney disease is often referred to as a ‘silent killer’ because most people do not get diagnosed with the disease until it becomes severe. While people get their blood pressure, blood sugar and cholesterol levels checked regularly, they don’t even get a simple creatinine test in their blood to detect any problems with their kidneys. According to the 2015 Global Burden Diseases (GBD) study, chronic kidney disease (CKD) is ranked as one of the eighth leading causes of mortality in India.

There are many warning signs of kidney disorder, however, most of the time they are ignored or misunderstood as some other type of problem. Therefore, everyone should be very cautious and have confirmatory tests (including blood, urine and imaging) as soon as possible if any signs of kidney disorder are observed. Such a person should visit a nephrologist and get his doubts clarified. But if you have high blood pressure, diabetes, obesity, metabolic syndrome, or a family history of coronary artery disease, and/or kidney failure, or if you are over 60, you should get regular kidney checkups. Should keep doing it.

While the only sure way to diagnose kidney disease is to perform confirmatory tests, here are some early warning signs of kidney disease –

One of the early signs is the appearance of swelling near the ankles, feet, or heels. Edema will appear in places that pit when pressure is applied, and this is called pitting edema. As the kidneys start to disturb their work, salt starts accumulating in the body, causing swelling in your shins and ankles. In short, if a person shows these symptoms, he should see a nephrologist and get his kidney function evaluated immediately.

Per orbital edema: In this, swelling appears around the eyes due to the accumulation of fluid in the cells or tissues. This is one of the early symptoms of kidney disease. This is particularly the case in individuals who have a large amount of protein leaking through the kidneys. The destruction of proteins from the body lowers the intravascular oncotic pressure and leads to additional accumulation of fluid in various places around the eyes.

Weakness : A common symptom of kidney disease is early fatigue. These symptoms become more pronounced as kidney failure progresses. Compared to normal days, the person may feel more tired and unable to do more activities, and need frequent rest. This is largely due to the accumulation of toxins and impurities in the blood, resulting in kidney failure. Being a non-specific symptom, it is often overlooked by most of the people and is not fully investigated.

Loss of appetite : The accumulation of toxins such as urea, creatinine, and acid leads to loss of appetite. In addition, as the kidney disease progresses, there is a change in the patient’s taste, which is often described by patients as dhatu. If someone feels full even without eating anything during the day, then alarm bells should ring in the brain and his kidney should be checked.

Morning Nausea and Vomiting : One of the early signs of kidney failure is early morning nausea and vomiting, and it is detected when the patient brushes his teeth in the bathroom in the morning. This also reduces the appetite of the person. In the late stage of kidney failure, the patient has frequent vomiting and loss of appetite.

Anemia: Hemoglobin levels begin to drop, and the person may appear pale, without blood being expelled from the body. It is one of the common complications of kidney disease. It can also cause weakness and fatigue. This anemia occurs due to a number of reasons, including low levels of erythropoietin (erythropoietin being synthesized in the kidneys), low iron levels, suppression of bone marrow due to toxin accumulation, etc.

Change in the frequency of urination : One has to keep a very careful watch on one’s urine output. For example, the patient may have a decrease in urine output or may feel the need to urinate more often, especially at night (called nocturnal). This can be a warning sign and may indicate that the filtering units of the kidneys have been damaged or are in the process of becoming damaged. Sometimes it can also be a sign of some urinary tract infection or enlarged prostate in men. Thus, a change (increase or decrease) in urine output should be reported to your nephrologists immediately.

Foam or blood in the urine : Excessive foaming of urine indicates the presence of protein in the urine (which should be negligible under normal circumstances). When the filtering system of the kidney is damaged or being damaged, proteins, blood cells, leak out of the urine. In addition to indicating kidney disease, blood in the urine can indicate tumors, kidney stones, or any number of infections. Also, pus coming out of urine with fever or chills can be serious and again a sign of a serious urinary tract infection. Thus any change in the colour, consistency or nature of urine should be reported to the renal specialist at the earliest.

Dry and itchy skin : Dry and itchy skin can be a sign of advanced kidney disease. As kidney function declines, toxins build up in the body, causing itching, dryness, and foul-smelling skin.

Back pain or lower abdominal pain: Pain in the back, side or under the ribs can be an early symptom of a kidney disorder such as kidney stones or pyelonephritis. Similarly, lower abdominal pain can be associated with a bladder infection or a stone in a urethra (the tube connecting the kidneys and bladder). Such symptoms should not be ignored and should be further investigated by routine imaging studies such as X-ray KUB or ultrasound abdominal.

High blood pressure : High blood pressure can be a symptom of kidney disease. Anyone diagnosed with hypertension should have a detailed description of kidney function and kidney imaging to ascertain the renal etiology of hypertension. As kidney function deteriorates, sodium and water accumulate in the body leading to high blood pressure. Symptoms of high blood pressure include headache, abdominal pain, cloudiness, and perhaps early signs of kidney disease.

Kidney failure or kidney failure can be avoided if there is awareness of the recognition of the warning signs and timely treatment, otherwise the patient has to undergo dialysis or kidney transplant and in case of excessive negligence, he can even die.

Tips to keep kidneys healthy –

There are many ways to prevent kidney disease. So, why wait until your kidney is diseased? The following are some tips to take care of your kidney health –
Drink plenty of water. This is the most common and easiest way to keep your kidneys healthy. Consuming plenty of water, especially warm water, helps the kidneys clear sodium, urea and toxins from the body.

Low sodium/salt diet : Keep sodium or salt intake under control in your ear. This means you have to avoid packaged/restaurant foods as well. Also, don’t add extra salt to your food. A low salt diet reduces the load on the kidneys and prevents the development of disorders related to hypertension, hypertension and also prevents the progression of kidney disease.

Maintain proper body weight : Eat healthy food and keep your weight under control. Have your body’s cholesterol levels checked regularly to prevent cholesterol deposits in your kidney arteries. Also, keep saturated fat/fatty fried foods away from the diet and insist on eating lots of fruits and vegetables daily. As a person gains weight, the load on the kidneys increases. Try to aim for a BMI of 24 or less, especially in the Indian scenario.

Regularly check blood sugar levels and keep them under optimum levels: Kidney failure is very common in diabetic patients and can be prevented if detected early. Therefore, it is advised to keep a regular check on your blood sugar level, avoid sugary food products and see a doctor if you have high blood sugar (fasting or postprandial) level or HbA1c. Keep the HbA1c level below 6.0.

Monitor blood pressure regularly and keep it under control : If you have high blood pressure, take antihypertensives as advised by your doctor, and maintain a healthy lifestyle and make necessary dietary changes. A normal blood pressure level is <120/80. In addition to kidney problems, high blood pressure can also lead to stroke or heart attack.

Get a kidney function test with regular urine analysis as a part of your annual checkup: As I mentioned earlier if you have diabetes, high blood pressure, obesity or if you are over 60 years old Kidney function tests, renal imaging, and urine analysis should be done regularly. If even the slightest protein in the urine is detected, visit your nephrologist. Diabetic patients should especially keep an eye on it.

Quit smoking : Smoking is one of the very risk factors in the progression of kidney disease. Even smoking 1 cigarette can further damage an already weakened kidney. Smoking is also a risk factor for diabetes, high blood pressure, and CAD. So one must stop smoking immediately, which is important not only for the kidneys but also for the overall health of the body.

Play sports like jogging, cycling, swimming, racquet games for at least 5 days out of 7 days a week, if not daily, for about 45 minutes daily and thus maintain a healthy healthy lifestyle by doing light exercises. Change your sedentary lifestyle, walk around the office or take a walk after lunch or exercise in the morning and evening.

Balance your lifestyle properly by getting at least 8 hours of restful sleep in a day. Getting a good night’s sleep is essential for staying healthy.