Signs of chronic kidney disease

Symptoms: What are the signs of chronic kidney disease (CKD)?

In earlier stages of chronic kidney disease, there may be no symptoms at all and patients do not feel ill or the symptoms are very vague like

  • Feeling tired and having less energy than usual
  • Having trouble concentrating
  • Having a poor appetite
  • Weight loss
  • Swollen feet and ankles
  • Muscle cramps
  • Need to urinate more often (especially during night)
  • Pale or dry, itchy skin
  • Shortness of breath
  • Blood in urine

In later stages, and particularly in end-stage kidney disease, the following symptoms may occur:1

  • Nausea or vomiting
  • Tiredness
  • Reduced appetite
  • Concentration problems
  • Dry, itching skin and
  • Sleeping problems mainly because of the higher amount of waste products in the blood.
  • Swelling (oedema) in hands/face and legs, and
  • High blood pressure because the kidneys are excreting less water.
  • Muscle twitches and cramps because of the altered amount of electrolytes (minerals) in the blood.
  • Anaemia (low red blood cell count) mainly because the kidneys produce less erythropoietin.
  • Bone disease ("renal osteodystrophy") because of altered bone metabolism. For example, the kidneys’ ability to produce active vitamin D is decreased, which reduces calcium absorption from the intestines. Other factors also contribute to bone disease.

Cardiovascular diseases secondary to chronic kidney disease

Many people with chronic kidney disease develop diseases of the heart and blood vessels (cardiovascular diseases), such as arteriosclerosis of heart vessels (coronary artery disease) and heart failure. The high risk for developing cardiovascular diseases is mainly due to high blood pressure and anaemia. Therefore, treatment of chronic kidney disease aims to reduce these risk factors as well.2


  1. National Kidney Foundation (accessed 13.02.2019)
  2. Jameson, Fauci et al.: Harrison´s Principles of Internal Medicine, 20th Edition,  McGraw Hill 2018
  3. National Kidney Foundation (Accessed 13.02.2019)