The kidneys work continuously to filter waste products and excess substances from the blood and remove them through urine. They also help maintain fluid and electrolyte balance, regulate blood pressure and support several important metabolic processes.
When the kidneys are not working properly, these functions may become impaired.
The effects can range from a minor and temporary change in kidney function to severe kidney disease requiring specialized treatment.
Importantly, kidney dysfunction does not always produce obvious symptoms in the beginning. A person may feel completely normal while blood or urine tests already show an abnormality.
This makes early evaluation particularly important when kidney disease is suspected.
At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides specialist evaluation and management for patients with abnormal kidney function and kidney-related conditions.
How Can You Tell If Your Kidneys Are Not Working Properly?
There is no single symptom that confirms kidney dysfunction.
Instead, doctors look at a combination of symptoms, medical history, blood tests, urine findings and changes in kidney function over time.
Possible warning signs include:
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Changes in the amount or frequency of urine
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Swelling around the feet, ankles or face
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Persistent tiredness
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Foamy urine
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Blood in urine
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Nausea or reduced appetite
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Persistent itching
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Muscle cramps or weakness
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Breathlessness
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High blood pressure
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Flank discomfort in certain kidney conditions
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Difficulty concentrating in advanced disease
Having one of these symptoms does not necessarily mean that the kidneys are failing. Many symptoms have causes unrelated to the kidneys.
Testing is needed to determine whether kidney function is actually impaired.
Changes in Urine Can Provide Important Clues
Because the kidneys produce urine, changes in urination can sometimes provide an early indication of a urinary or kidney problem.
Possible changes include:
Passing Less Urine
A sudden reduction in urine output can occur with dehydration, acute kidney injury, urinary obstruction or other serious conditions.
Frequent Urination
Frequent urination can occur with diabetes, urinary infections, prostate conditions, certain medications and other disorders. It does not automatically indicate kidney failure.
Foamy Urine
Persistent foamy urine may sometimes indicate excess protein in the urine.
Proteinuria can occur with diabetes-related kidney disease, high blood pressure and diseases affecting the kidney's filtering units.
Blood in Urine
Blood in urine can have several causes, including kidney stones, infections, glomerular diseases and urinary tract conditions.
Repeated or visible blood in urine should be medically evaluated.
Swelling May Occur When Fluid Builds Up
Healthy kidneys help regulate the amount of salt and water retained by the body.
When kidney function becomes significantly impaired, excess fluid may accumulate.
This can lead to swelling around:
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Feet
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Ankles
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Legs
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Hands
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Eyelids
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Face
Swelling can also occur because of heart disease, liver disease, venous problems and other conditions.
Therefore, persistent swelling requires proper assessment rather than assuming that it is caused by kidney disease.
Unexplained Fatigue Can Be Associated With Kidney Dysfunction
Feeling tired occasionally is normal.
Persistent or unusual fatigue, however, can occur in people with significant kidney disease.
Advanced kidney dysfunction may be associated with anemia, accumulation of waste products and disturbances in metabolism.
Fatigue is not specific to kidney disease, so doctors may investigate other possible causes as well.
Nausea, Poor Appetite and Taste Changes
When kidney function becomes severely reduced, waste products can accumulate in the bloodstream.
Some people may then develop:
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Nausea
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Vomiting
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Poor appetite
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Changes in taste
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An unpleasant or metallic taste
These symptoms can also occur because of gastrointestinal illness, medications, infections and other medical conditions.
When these symptoms occur together with known kidney disease or abnormal kidney-function tests, medical evaluation is important.
Itching and Skin Changes
Persistent itching can occur in advanced chronic kidney disease.
Changes in mineral balance and other effects of reduced kidney function may contribute to kidney disease-associated pruritus.
The skin may also become dry.
However, itching can result from many other conditions, including allergies, dermatological disorders, liver disease and medication reactions.
A skin problem by itself cannot establish that the kidneys are failing.
Muscle Cramps, Weakness and Electrolyte Changes
The kidneys help maintain appropriate levels of electrolytes and minerals.
Significant kidney dysfunction can contribute to abnormalities involving substances such as:
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Potassium
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Sodium
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Calcium
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Phosphorus
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Bicarbonate
Depending on the abnormality, a person may experience weakness, cramps, fatigue or other symptoms.
Some electrolyte disturbances can become dangerous, particularly severe potassium abnormalities.
They require blood testing and medical treatment rather than home remedies.
Breathlessness Can Occur in Advanced Kidney Disease
Breathing difficulty can sometimes occur when kidney function is severely impaired.
Possible contributing factors include:
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Excess fluid accumulation
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Anemia
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Metabolic disturbances
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Associated heart problems
Sudden or severe breathlessness should always be treated as a potentially serious symptom because heart and lung diseases can also cause it.
High Blood Pressure and Kidney Function Are Closely Linked
The relationship between the kidneys and blood pressure works in both directions.
Long-standing hypertension can damage the small blood vessels and filtering structures of the kidneys.
At the same time, kidney disease can contribute to difficult-to-control blood pressure.
Therefore, people with persistent hypertension may benefit from regular kidney-function assessment, particularly when other risk factors are present.
What Causes the Kidneys to Stop Working Properly?
Kidney dysfunction can develop suddenly or gradually.
Acute Kidney Injury
Acute kidney injury (AKI) develops over a relatively short period.
Possible causes include:
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Severe dehydration
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Serious infection
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Major blood loss
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Low blood pressure
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Certain medicines
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Urinary obstruction
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Severe illness
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Complications around major surgery
Some cases of AKI can improve substantially when the underlying cause is treated promptly.
Chronic Kidney Disease
Chronic kidney disease (CKD) develops over a prolonged period.
Common contributors include:
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Diabetes
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High blood pressure
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Chronic glomerular diseases
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Polycystic kidney disease
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Recurrent kidney injury
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Certain inherited conditions
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Long-standing urinary tract problems
Chronic kidney damage may not be completely reversible, but appropriate treatment can help slow further deterioration.
Kidney Stones and Obstruction
A stone or another blockage can interfere with urine drainage.
Persistent obstruction can damage kidney function, particularly if it is severe or associated with infection.
Kidney Infection
Severe or complicated kidney infections can affect kidney function and may require prompt treatment.
Medication-Related Kidney Injury
Some medicines can adversely affect kidney function in susceptible people.
This does not mean that all prescribed medicines should be stopped.
Medication decisions should be made by a healthcare professional after considering the patient's kidney function and overall condition.
How Do Doctors Check Whether the Kidneys Are Working Properly?
Symptoms alone are not enough to diagnose kidney dysfunction.
A kidney evaluation may include several components.
Serum Creatinine
Creatinine is a waste product filtered by the kidneys.
An elevated creatinine result can indicate reduced kidney filtration, but the value can also be influenced by muscle mass, hydration, diet, medications and other factors.
eGFR
The estimated glomerular filtration rate (eGFR) provides an estimate of kidney filtration.
Doctors use eGFR along with other findings to assess kidney function and monitor changes over time.
Urine Testing
Urine tests can identify:
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Albumin
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Protein
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Blood
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Signs of infection
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Other abnormalities
A urine albumin-to-creatinine ratio may be recommended when assessment of albumin loss is appropriate.
Electrolyte Testing
Blood tests may measure:
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Potassium
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Sodium
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Bicarbonate
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Calcium
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Phosphorus
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Other relevant markers
Blood Pressure
Blood-pressure measurement is an important part of kidney assessment because hypertension can both contribute to and result from kidney disease.
Ultrasound or Other Imaging
Imaging may be recommended when doctors need to investigate:
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Kidney stones
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Urinary obstruction
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Kidney size
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Cysts
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Structural abnormalities
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Other causes of kidney dysfunction
Does High Creatinine Mean the Kidneys Have Stopped Working?
No.
An elevated creatinine level does not automatically mean that the kidneys have stopped functioning.
Creatinine can rise because of:
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Acute kidney injury
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Dehydration
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Urinary obstruction
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Certain medications
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Severe illness
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Reduced kidney filtration
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Other factors
Doctors usually interpret creatinine alongside eGFR, previous results, urine findings and the patient's clinical condition.
The trend over time can also be very important.
Can Kidneys That Are Not Working Properly Recover?
Recovery depends largely on the underlying cause.
Kidney function may improve when the problem is acute and reversible.
For example, some patients recover after appropriate treatment of:
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Dehydration
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Infection
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Urinary obstruction
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Certain medication-related kidney injuries
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Other reversible causes of acute kidney injury
Established chronic kidney damage is usually more difficult to reverse.
Even when complete recovery is not possible, treatment may help preserve remaining kidney function and reduce complications.
What Treatment Is Used When Kidney Function Is Reduced?
There is no universal medicine for kidneys that are not working properly.
Treatment is selected according to the cause.
It may include:
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Controlling blood pressure
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Managing diabetes
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Treating infections
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Relieving urinary obstruction
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Treating kidney stones
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Managing proteinuria
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Adjusting medicines when appropriate
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Correcting electrolyte abnormalities
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Treating specific kidney diseases
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Managing anemia or mineral abnormalities when present
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Dialysis when kidney replacement therapy becomes necessary
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Kidney transplantation for appropriately selected patients
The objective is to treat the underlying disease and protect as much kidney function as possible.
What Should You Avoid If Your Kidney Function Is Reduced?
If kidney dysfunction has been diagnosed, avoid making treatment decisions based on internet remedies alone.
Be particularly cautious about:
Unnecessary Painkillers
Some NSAIDs can affect kidney function, especially in people with reduced kidney function or other risk factors.
Unverified Herbal Products
Herbal products marketed as kidney cleansers or detox remedies may contain substances that are not appropriate for people with kidney disease.
Excessive Water Intake
Drinking more water is not a universal treatment for kidney disease.
People with advanced kidney disease or certain heart conditions may need to restrict fluids.
Unsupervised Supplements
Protein supplements, minerals and other products may need to be modified according to kidney function and laboratory results.
Can Diet Help When the Kidneys Are Not Working Properly?
Dietary management can be an important part of kidney care, but there is no single kidney diet suitable for everyone.
Depending on the condition, a healthcare professional may recommend adjustments to:
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Sodium
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Protein
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Potassium
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Phosphorus
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Fluid intake
The appropriate diet depends on kidney function, blood-test results, nutritional status, medications and other medical conditions.
Severe self-imposed dietary restrictions can sometimes cause malnutrition and should be avoided.
Who Is at Higher Risk of Kidney Dysfunction?
People with certain medical conditions have a higher risk of developing kidney problems.
These include people with:
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Diabetes
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High blood pressure
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Cardiovascular disease
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Family history of kidney disease
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Previous acute kidney injury
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Recurrent kidney stones
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Recurrent urinary infections
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Certain autoimmune diseases
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Known structural kidney abnormalities
Regular kidney testing may be appropriate for people at increased risk.
When Should You Consult a Nephrologist?
A nephrologist specializes in diagnosing and treating medical kidney conditions.
Consider consulting a kidney specialist if you have:
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Persistently high creatinine
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Reduced eGFR
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Protein or albumin in urine
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Repeated blood in urine
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Difficult-to-control hypertension
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Recurrent kidney stones
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Progressive kidney-function decline
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Significant electrolyte abnormalities
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Suspected chronic kidney disease
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Advanced kidney disease
Early evaluation may help identify potentially treatable problems before kidney function declines further.
When Are Kidneys Not Working Properly an Emergency?
Some signs require immediate medical attention.
Seek urgent medical care if you experience:
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Very little or no urine
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Severe breathlessness
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Rapidly increasing swelling
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Confusion or unusual drowsiness
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Persistent vomiting
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Severe weakness
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Severe flank pain with fever or chills
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Fainting
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Sudden major deterioration in health
These symptoms can occur with serious kidney, urinary, heart or systemic problems and should not be managed at home without medical assessment.
Kidney Function Evaluation at Prabhakar Bhurke Clinic
At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation for people experiencing symptoms of kidney dysfunction or abnormal kidney-function test results.
Depending on the clinical situation, evaluation may involve:
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Reviewing creatinine and eGFR
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Assessing urine protein or albumin
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Checking blood pressure
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Evaluating electrolyte levels
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Investigating acute kidney injury
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Assessing chronic kidney disease
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Reviewing kidney stones and urinary obstruction
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Evaluating medication-related kidney problems
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Monitoring progression of kidney disease
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Assessing dialysis requirements when appropriate
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Providing transplant-related kidney care when indicated
Treatment is planned according to the patient's diagnosis, kidney function and overall health.
Frequently Asked Questions
What are the signs that kidneys are not working properly?
Possible signs include changes in urination, swelling, persistent fatigue, foamy urine, blood in urine, nausea, itching, muscle weakness and breathlessness. However, early kidney disease may cause no symptoms.
Can kidneys work poorly without causing symptoms?
Yes. Some kidney diseases remain silent during their early stages. Blood and urine testing can identify abnormalities before symptoms become obvious.
Does less urine always mean kidney failure?
No. Reduced urine output can have several causes, including dehydration, obstruction and acute kidney injury. Very low or absent urine requires prompt medical assessment.
Can high creatinine return to normal?
It can in some cases, particularly when an acute and reversible cause is treated. Creatinine may remain elevated when established chronic kidney damage is present.
Can drinking more water repair poorly functioning kidneys?
No. Appropriate hydration is important for many people, but excessive water cannot repair damaged kidneys and may be unsafe for some patients.
What test confirms kidney function?
Kidney assessment commonly includes serum creatinine, eGFR and urine testing. Blood pressure, electrolytes and imaging may also be required depending on the situation.
When should I see a kidney specialist?
A nephrologist may be appropriate when kidney tests remain abnormal, eGFR is reduced, protein is present in urine, blood pressure is difficult to control or kidney function is progressively declining.
Conclusion
When kidneys are not working properly, the effects can range from subtle laboratory abnormalities to noticeable problems such as swelling, urine changes, fatigue, nausea, itching, weakness or breathlessness.
However, symptoms alone cannot establish the severity or cause of kidney dysfunction.
Blood tests such as creatinine and eGFR, urine examination, blood-pressure measurement and imaging when necessary can help determine what is happening.
Some acute kidney problems can improve when their underlying cause is treated. Chronic kidney disease may not be completely reversible, but timely management can help preserve remaining kidney function and control complications.
If you have noticed persistent changes in urination, swelling, unexplained fatigue, abnormal creatinine or reduced eGFR, consider discussing the findings with a qualified kidney specialist.
For individualized renal evaluation and kidney care, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.
Medical Disclaimer
This article is intended for general educational and informational purposes only and should not be considered medical advice, diagnosis or treatment. Symptoms of reduced kidney function can have many different causes, and symptoms alone cannot determine whether the kidneys are functioning normally. Proper evaluation may require blood tests, urine testing, imaging and clinical assessment. Do not start, stop or change prescription medicines, painkillers, supplements or fluid intake based solely on this article. Seek urgent medical attention for very little or no urine, severe breathlessness, confusion, severe flank pain with fever or chills, persistent vomiting, severe swelling or rapidly worsening symptoms. Consult Dr. Sandip Prabhakar Bhurke or another qualified nephrologist for individualized medical advice.
