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Chronic kidney disease tends to be a silent disease, meaning there are usually no signs or symptoms in the early stages. As the disease progresses, however, symptoms start to appear. These may include a loss of appetite, fatigue and weakness, tiredness and drowsiness, sleep problems, swelling of the ankles and feet, frequent or infrequent urination, muscle cramps and twitches, hypertension, trouble concentrating, nausea and vomiting, shortness of breath, numbness, persistent itching, dry skin, weight loss, and chest pain. Additionally, it is not uncommon for people with chronic kidney disease to develop anemia, bone disease, malnutrition, and other health problems.

Since most signs and symptoms of chronic kidney disease are nonspecific, it’s sometimes difficult to tell if they are caused by CKD or another illness. Many signs and symptoms of chronic kidney disease can be observed due to changes in urination. For one, making more or less urine than usual, resulting in frequent or infrequent urination, respectively. Two, making urine that is foamy or bubbly. Three, feeling excess pressure when urinating. Four, finding blood in the urine, which is usually only detected through a microscope. Five, observing any other changes in the overall appearance or color of the urine.

As the kidney loses its ability to make urine, fluid buildup can occur in the body. Symptoms of fluid buildup are often confused with those of asthma or heart failure. When the kidneys can’t get rid of extra fluid and salt, a condition known as edema may occur. Edema refers to swelling in the ankles, feet, legs, hands, or face. Other signs and symptoms of chronic kidney disease may be the result of a buildup of waste. These include a metallic taste in the mouth, ammonia breath, nausea and vomiting, loss of appetite, not wanting to eat meat or other strong flavors, difficulty concentrating, and feeling itchy or fatigued.

Oftentimes, fatigue is due to anemia, or occurs as the result of being anemic. Since damaged kidneys are unable to make the hormone that’s involved in making red blood cells, enough oxygen doesn’t get to all the cells in the body and thereby leads to anemia. People with chronic kidney disease can also develop bone disease and malnutrition. Mineral and bone disorder in CKD is caused by unbalanced calcium and phosphorus levels in a person’s blood, where as malnutrition develops due to inadequate intake of vitamins, minerals, and other essential nutrients.

The kidneys are highly adaptable and can compensate for lost function quite well, so it’s not uncommon for CKD to be diagnosed only after irreversible damage has already occurred. As such, kidney disease can lead to a multitude of health problems, from stroke to heart attack to heart disease. Stroke is caused by a blockage or the bursting of a blood vessel, which cuts off the blood supply to the brain. Heart attack occurs when the blood vessels leading to the heart become blocked by plaques, or fatty deposits. Heart disease refers to any problem that involves the heart not pumping blood as well as it should. This is the most common cause of death among people with kidney disease.