Symptoms of Kidney Disease

Symptoms of Kidney Disease


hello welcome to the chronic kidney
disease program at University of California San Diego my name is Danuta
Trzebinska and I’m a nephrologist in our clinic in this module we’ll talk
about symptoms of chronic kidney disease or CKD the symptoms associated with
chronic kidney disease worsen as you progress from the least severe stage
stage one to most severe stage Stage five patients will have chronic kidney
disease stage one usually have no symptoms the only exception is patients
who are spilling a massive amount of protein in the urine because they can
subsequently develop swelling in the legs or other parts of the body now
chronic kidney disease stage two is usually associated with no symptoms
either just like stage one you don’t know the vast majority of patients with
CKD stage one and two are not aware of having kidney disease unless they
undergo specific blood and urine testing so most of the time it’s incidental
finding you are not even looking for it now chronic kidney disease stage three
this is the most common stage of kidney disease this is middle road your GFR is
between 30 and 59 since this stage is associated with moderate reduction in
level of kidney function a proportion of patients might develop some symptoms and
what kind of symptoms some of those symptoms like fatigue or more frequent
urination at night are nonspecific and overlooked by patients or attributed to
some other things going on in their lives think about it there is a very
long list of causes for fatigue and kidney diseases certainly not number one
some patients who are in chronic kidney disease stage three can experience
swelling in the legs now we are moving on to stage 4 stage 4 is associated with
farther reduction in the level of kidney
function is considered severe GFR is between 15 and 29 thus as you can expect
there will be more patients having symptoms in this stage symptoms can be
similar to those with stage 3 but they’re just more obvious there might be
some additional symptoms like decreasing appetite or some patients will
experience shortness of breath now we are moving to stage 5 chronic kidney
disease and this is the most severe stage if you recall in stage 5 GFR is
less than 15 as with other stages various patients
will experience different amounts of symptoms there are certainly many people
in this stage who continue to work full-time and live a pretty much normal
life you look at them and you would never guess that they have chronic
kidney disease stage 5 they ask me doc are you sure I feel just fine
I cannot tell in general however in this stage there are more symptoms than in
any other previous stages on top of previously mentioned symptoms like
fatigue swelling in the legs patients might suffer from some other symptoms
like skin itching metallic or bitter taste in the mouth sometimes I ask
patients do you feel like you swallowed a coin now that I know what it tastes
like but it’s just your taste is off sometimes patients experience nausea or
even vomiting and this naughty and vomiting vomiting might be most more
pronounced in the morning when you are in stage 5 you can expect further
worsening in energy level and some sleep disturbances some patients will require
we require more sleep at night for example instead of your previous six
seven hours which was enough to feel refreshed now you will need nine hours
to feel rested or semi rested or maybe you’re going to have a reverse sleeping
pattern that means that you will stay up at night you’re just not sleepy you
cannot sleep and then you will want to sleep all day long
or some patients they sleep at night just fine but they also required a nap
during the day that will tell me doc I go to work I can get through work but
then when I got come home I really need this nap and they didn’t need it a year
ago many patients when they are in Stage
five chronic kidney disease they are in denial all those changes are very slow
it’s not like one day you have hundred percent of kidney function and the next
day you wake up and your level of kidney functions down to ten percent so you
really have to pay attention to your body how you feel we tend to adapt if I
have less energy all right I’m not going to run I’m going to do less I might
sleep more oh I don’t have an appetite so I will eat less but sometimes people
don’t notice so when you come to see us in clinic especially when you’re in
chronic kidney disease stage five we’ll ask you very pointed questions how much
do you sleep how many hours well how many hours did you sleep a year ago
how much do you eat well is it up or is it down all those questions are helpful
some patients in chronic kidney disease stage five suffer from muscle cramps
even when measured electrolytes in the blood are normal sodium is normal
potassium magnesium so please do not self medicate yourself don’t just start
taking magnesium supplements when you get cramps because you might overdo it
you might notice worse concentration or actually you might not notice but
somebody else around you will notice that you’re not as sharp as you used to
be some patients might feel more cold than usual than previously your urine
volume eyedrop you’ll be peeing less than you did previously and may be
swelling in your legs will get worse sometimes when you are in stage five
chronic kidney disease blood pressure control becomes more difficult we have
to add another agent and blood pressure keeps creeping up patients who have
diabetes might have more episodes with low instead of high sugar that’s one of
the findings of advanced kidney disease to summarize please remember that
chronic kidney disease is a silent disease and some patients will have just
nonspecific symptoms only which are often
north or overlooked till kidney disease is quite advanced let us go through a
couple of questions to check your understanding of this module question
number one which stage of chronic kidney disease is associated with most symptoms the correct answer is chronic kidney
disease stage 5 is associated with most symptoms this is the most advanced stage
of kidney disease if symptoms are severe enough and or some of your labs are
dangerously abnormal you might need to start either dialysis or undergo kidney
transplantation in stage 5 let’s do one more question
which symptom would you not expect to occur in chronic kidney disease is it a
fatigue or B leg swelling or C increase in appetite or D muscle cramps let’s
think about this and which symptoms would you not it’s a tricky question and
the correct answer is C increase in appetite if anything there is decrease
in appetite in advanced kidney disease some people lose weight all other
symptoms often occur in patients with chronic kidney disease so you will
experience fatigue leg swelling and muscle cramps alright congratulations to
you guys you have completed the module on symptoms of kidney disease please
check our website for additional educational modules on kidney health
thank you


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