Your kidneys quietly do a great deal of work: filtering waste from your blood, balancing fluid and salts, controlling blood pressure and keeping your bones and blood healthy. When they begin to struggle, the early signals can be easy to dismiss or blame on a busy life. Below are five changes that are worth paying attention to, especially if more than one appears together or you have diabetes, high blood pressure or a family history of kidney disease.

This is not a rare problem. India's national ICMR-INDIAB study (2025) estimated that about 1 in 30 adults already has reduced kidney function, and that this rises to roughly 1 in 12 among people who have both diabetes and high blood pressure. Because the early stages are usually silent, many never know until a lot of function has been lost.

01

Changes in how you pass urine

Urine that looks persistently foamy or frothy, waking more than once at night to pass urine, or noticing pink, red or tea-coloured urine can all point to the kidneys leaking protein or blood. Passing noticeably more or less urine than usual is also worth checking.

02

Swelling in the feet, ankles or around the eyes

When the kidneys cannot clear enough salt and fluid, it tends to collect in the lowest parts of the body and in the soft tissue around the eyes. Puffy ankles by evening, or shoes and rings that feel tighter, can be an early clue.

03

Constant tiredness and trouble concentrating

As waste builds up in the blood, many people feel drained, foggy or short of energy. Reduced kidney function can also lower the body's production of red blood cells, leading to anaemia, which deepens the fatigue.

04

Dry, itchy skin and disturbed sleep

An imbalance of minerals such as phosphate and calcium can leave the skin dry and persistently itchy. Poor sleep and restless legs at night are also commonly reported as kidney function declines.

05

Loss of appetite, nausea or a metallic taste

A build-up of toxins can take the edge off your appetite, cause mild nausea, or leave a metallic taste that makes food and even water taste different. Some people notice they are eating less without meaning to.

None of these signs is proof of kidney disease on its own, and each can have other, harmless explanations. What matters is the pattern: several of them appearing together, or any of them persisting, deserves a proper check.

When to see a doctor
If you have diabetes, high blood pressure, or a family history of kidney disease, ask your doctor about two simple tests: a blood test for creatinine (which gives your eGFR) and a urine test for protein (the ACR). International KDIGO 2024 guidance treats an eGFR below 60, or a urine ACR of 30 or more, persisting beyond three months, as a sign of chronic kidney disease. Together these tests can detect kidney trouble long before symptoms appear. If you notice blood in your urine or sudden swelling, please seek medical advice promptly.

The encouraging part is that caught early, kidney disease can very often be slowed or stabilised. Controlling blood pressure and blood sugar, staying well hydrated, being careful with painkillers, and having regular check-ups are some of the most effective things you can do.

References & further reading
  1. KDIGO. 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International, 2024.
  2. National Kidney Foundation. Signs and symptoms of kidney disease.
  3. National Kidney Foundation. Know your kidney numbers: two simple tests (eGFR & uACR).
  4. ICMR-INDIAB Collaborators. Prevalence of impaired kidney function & its association with diabetes & hypertension in India (ICMR-INDIAB-22). Indian Journal of Medical Research, 2025.
  5. American Diabetes Association. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes (2025).

This article is general information and not a substitute for personalised medical advice. If you are concerned about your kidney health, please consult a doctor.