An estimated 35.5 million adults in the U.S. suffer from kidney disease, and most are unaware of it.

“There are various physical symptoms of kidney disease, but many people mistakenly attribute them to other health issues,” explained Dr. Joseph Vassalotti, Chief Medical Officer at the NKF. “Often, kidney disease doesn't show symptoms until it’s in the advanced stages, when the kidneys are failing or there’s a significant amount of protein in the urine. This is why only 10% of people with chronic kidney disease are aware they have it.”

While the only way to confirm kidney disease is through testing, there are some key signs to look for.

Kidney Disease Risk Factors

If you are at risk for kidney disease—due to high blood pressure, diabetes, a family history of kidney failure, or if you're over 60—it's important to get tested for kidney disease annually.

Are you at risk for kidney disease? Take this quick one-minute quiz to find out.

Kidney Disease Testing

Two straightforward tests help determine if you have kidney disease:

• Estimated Glomerular Filtration Rate (eGFR): A blood test that estimates how well your kidneys are working.

• Urine Albumin-Creatinine Ratio (uACR): A urine test that measures albumin (a protein) and creatinine (a waste product).

Learn more about kidney disease testing.

10 Signs of Kidney Disease

1. Fatigue or Difficulty Concentrating
   As kidney function decreases, toxins and impurities can build up in the bloodstream, making you feel exhausted and making it harder to concentrate. Anemia, a common complication of kidney disease, can also contribute to fatigue.

2. Sleep Problems
   When kidneys fail to filter properly, toxins stay in the blood, which can make it harder to sleep. There's also a link between obesity and chronic kidney disease, and sleep apnea is more prevalent in people with kidney disease than in the general population.

3. Dry and Itchy Skin
   Healthy kidneys perform essential tasks, like removing waste, producing red blood cells, and maintaining the right balance of minerals. Dry, itchy skin can signal mineral and bone diseases that occur when the kidneys can no longer regulate minerals and nutrients properly.

4. Frequent Urination
   If you feel the need to urinate more often, especially during the night, it may indicate kidney disease. Damaged kidney filters can increase the urge to urinate, though it can also point to urinary infections or an enlarged prostate in men.

5. Blood in Urine
   Healthy kidneys keep blood cells in the body when filtering out waste. However, damaged filters can cause blood cells to leak into the urine. Blood in the urine can also indicate tumors, kidney stones, or infections.

6. Foamy Urine
   Excessive foam in the urine—especially foam that persists despite flushing—could mean protein is present in the urine. This foam resembles the bubbles formed when scrambling eggs, as albumin (the protein in urine) is the same protein found in eggs.

7. Persistent Puffiness Around the Eyes
   Protein in the urine is an early sign of kidney filter damage. The puffiness around the eyes occurs because the kidneys are leaking protein into the urine instead of retaining it in the body.

8. Swollen Ankles and Feet
   When kidney function declines, sodium retention can cause swelling in the ankles and feet. Swelling in the lower body can also be a sign of heart disease, liver problems, or chronic vein issues in the legs.

9. Loss of Appetite
   This general symptom could result from a buildup of toxins due to impaired kidney function.

10. Muscle Cramps
    Electrolyte imbalances caused by poor kidney function—such as low calcium or poorly controlled phosphorus levels—can lead to muscle cramping.