Since many kidney diseases are progressive, a few patients are unaware of the subtle changes that are slowly happening in their bodies until they are close to renal failure. However, many patients experience a vague malaise even before their renal function begins to decline. Since most people are not very familiar with kidney disease, they fail to consider that this might be the cause of their symptoms. Fortunately, a good physical that includes routine urinalysis can reveal whether kidney problems might be present.
Hypertension
Kidney patients and hypertension go together like peanut butter and jelly. When kidney patients become aware of this problem, they often make substantial changes in in their diets and exercise routines--only to no avail. This type of intractable hypertension is a red flag for renal disease.
The kidneys regulate blood pressure in response to the volume of blood that is filtered. When they filter a lot of blood, they keep blood pressure low. However, when the total volume filtered is down, they start secreting a hormone called angiotensin to constrict the blood vessels to raise the blood pressure.
While this mechanism works great in healthy people, it doesn't work for kidney patients because the volume of blood filtered might be lower than normal because the kidneys are scarred or inflamed. Increasing the blood pressure just aggravates the problem because the filters in the kidneys called glomeruli are tiny blood vessels that are destroyed by high blood pressure.
Hematuria
Hematuria is another name for blood in urine. For some patients, hematuria is the first major symptom that something is wrong with their kidneys.
While most kidney patients experience some degree of hematuria, not all are aware of it. If the blood is not immediately obvious, it is called microhematuria. If the blood is obvious, it is called frank hematuria.
Hematuria can be measured by a dipstick test or by counting the number of red blood cells in a microscopic field. While the dipstick test is very useful, it is not always the best measure of hematuria because it does not produce accurate numbers. Actually counting the cells provides far more meaningful results.
Proteinuria
Proteinuria, also called albumenuria, means that there is protein in the urine. Kidneys of healthy people filter out proteins, but diseased or inflamed kidneys have difficulties performing this function. This is often the first symptom that something is wrong. For many patients, proteinuria is discovered when urinalysis is performed during a physical.
The National Institute of Diabetes, Digestive and Kidney Disease reports that "proteinuria has no signs or symptoms in the early stages." Moderate proteinuria may cause a vague, ill-defined malaise. Symptoms are more obvious when proteinuria is severe. Patients that void more than three grams per day of protein in their urine are said to be nephrotic. These patients may suffer from swelling in their feet, hands, groin or under their eyes. A common complaint is that shoes don't fit anymore.
Kidney Early Evaluation Program
The National Kidney Foundation has a special program called Kidney Early Evaluation Program. The NKF "offers free screening for those at risk--anyone 18 years and older with high blood pressure, diabetes or a family history of kidney disease." The organization hopes that this program will raise awareness about kidney disease and its symptoms so that complications such as renal failure can be prevented or delayed.
