Why Kidney Disease Often Goes Undetected

Your kidneys are hard at work 24/7—filtering waste, balancing fluids, and regulating key hormones. But you can lose up to 90% of kidney function before any major symptoms appear. Many people only discover they have kidney disease after routine bloodwork—or when symptoms become severe. By that point, intervention becomes more challenging.

That’s why it’s crucial to understand how kidney disease progresses, what signs might appear early, and when to seek medical evaluation. Early action can make all the difference.

Understanding the 5 Stages of Kidney Disease

Chronic kidney disease (CKD) is typically divided into five stages, based on how well your kidneys filter waste. This is measured by your glomerular filtration rate (GFR), a critical indicator of kidney function.

Stage 1: Normal kidney function (GFR 90+) but signs of damage, like protein in the urine or high blood pressure. Most people experience no symptoms, but the disease may already be developing.

Stage 2: Mild loss of function (GFR 60–89). Fatigue, slightly higher blood pressure, or subtle urine changes may occur, though many people still feel normal.

Stage 3: Moderate loss (GFR 30–59). Symptoms such as swelling, muscle cramps, frequent urination, and skin dryness become more common. This is often when people are first diagnosed.

Stage 4: Severe decline (GFR 15–29). Nausea, loss of appetite, trouble concentrating, and breathing difficulties may arise. Planning for dialysis or transplant often begins here.

Stage 5: Kidney failure (GFR below 15). The kidneys no longer filter blood effectively. Dialysis or transplant is typically necessary for survival.

Early Warning Signs to Watch

Kidney disease can manifest in subtle ways. Here are key signs to look out for:

Changes in urination: foamy, dark, or painful urine; frequent or reduced urination.

Fatigue and brain fog: poor kidney function can reduce oxygen in the body.

Swelling: fluid retention may cause puffiness in the face, hands, or legs.

Muscle cramps: mineral imbalances can lead to spasms or night cramps.

Metallic taste or bad breath: toxin buildup affects taste and breath odor.

Itchy or dry skin: signs of waste buildup in the bloodstream.

Shortness of breath: often due to fluid in the lungs or anemia.

When to Get Tested

You should ask your doctor for kidney screening if you:

Have high blood pressure or diabetes

Are over age 60

Have a family history of kidney disease

Experience urinary tract problems or infections

Testing typically includes blood tests to measure creatinine and estimate GFR, urine tests for protein or albumin, and regular blood pressure monitoring. These tests are quick, non-invasive, and affordable.

How to Protect Your Kidneys

Even if you're at risk, there are steps you can take to protect kidney health:

Stay well-hydrated

Avoid excessive use of NSAIDs like ibuprofen

Control your blood sugar and blood pressure

Limit processed foods and high-sodium snacks

Talk to your doctor before starting any new supplements or medications

Don’t ignore warning signs—early detection can slow or prevent serious damage

Why Seeing a Nephrologist Early Helps

A kidney specialist, or nephrologist, can track your kidney health, offer protective treatments like SGLT2 inhibitors, and help delay disease progression. Getting a referral as early as stage 2 or 3 could mean years more without dialysis.