Last Updated: September 15, 2025
Medically reviewed by NKF Patient Education Team
Table of Contents
- About kidney disease symptom
- One: Foamy urine (pee)
- Two: Seeing blood in your urine (pee)
- Three: Feeling the need to pee more often
- Four: Swollen ankles and feet
- Five: Feeling tired or having less energy
- Six: Trouble sleeping
- Seven: Puffy eyes
- Eight: Poor appetite
- Nine: Dry and itchy skin
- Ten: Muscle cramps
- Questions for your healthcare team
- More resources
About kidney disease symptom
Many people with kidney disease have no symptoms at all. Others may notice mild symptoms that are easy to ignore. But the earlier you find kidney disease, the better your chances of slowing or stopping damage.
If you have risk factors like high blood pressure, diabetes, heart disease and/or heart failure, obesity, or a family history of kidney disease, it’s especially important to get tested with two simple tests – eGFR and uACR.
Most people with kidney disease don’t know they have it. A simple urine and blood test can check your kidney health
These 10 signs are common in people with advanced kidney disease. Having one or more of these symptoms doesn’t always mean you have kidney problems, but it’s important to talk to your healthcare professional. Early testing can help you take steps to protect your kidneys.
One: Foamy urine (pee)
If you see lots of bubbles or foam in your urine, especially if it happens often, it may be a sign of protein in your urine. This can be one of the first signs that your kidneys are not working the way they should.
Your kidneys have tiny filters that keep important things, like protein, inside your body while removing waste. When these filters are damaged, protein can leak into your urine. The extra protein changes the way your urine looks, making it bubbly or foamy.
Some people describe the foam as looking like the bubbles you see when you pour soda or beer. While occasional bubbles can be normal, ongoing foamy urine should be checked.
Foamy urine can be an early sign of kidney disease. A simple urine test can check for protein and help catch problems early.
Two: Seeing blood in your urine (pee)
If you see blood in your urine, it can be alarming. The medical word for this is hematuria. Dark or red-colored urine does not always mean there’s blood in the urine. Certain medications, foods, or food coloring can change the color of your urine. Always talk with your doctor if you aren't sure of the cause of color changes in your urine.
Blood in the urine can happen when the filters in your kidneys are damaged. These filters are supposed to keep red blood cells in your body, not let them pass into your urine. This can be an early sign of kidney disease.
However, hematuria can also be caused by other conditions like urinary tract infections, kidney stones, or even heavy exercise. It is important not to ignore it.
Blood in your urine is never normal. See your healthcare professional to find out what is causing it and protect your kidney health.
Three: Feeling the need to pee more often
If you notice that you are peeing more than usual, especially at night, it could be a sign that your kidneys are not working properly. Healthy kidneys filter your blood and make urine, helping your body get rid of waste and extra fluid.
When your kidneys are damaged, the filters in your kidneys (called nephrons) may not hold fluids and nutrients the way they should. This can cause more urine to be made and can make you feel like you need to pee often. You might also feel an urgent need to go, even if only a small amount comes out.
This symptom is easy to overlook because it can also be caused by other health problems like urinary tract infections, diabetes, or an enlarged prostate.
If you are peeing more than usual, especially at night, ask your healthcare professional about a simple urine test to check your kidney health.
Four: Swollen ankles and feet
If your ankles, feet, or lower legs are swollen, it could mean that your kidneys are not removing extra fluid and salt from your body the way they should. This kind of swelling is called edema and is a common sign of kidney problems.
Healthy kidneys help balance fluids in your body. When they are damaged, fluid can build up in your tissues, especially in the lower parts of your body where gravity pulls it down. You may notice that your socks leave marks on your skin or that your shoes feel tighter by the end of the day.
Swelling in the legs can also be caused by heart or liver problems, so it is important to get checked to find out what is causing it.
Swelling in your feet or ankles could be a sign of kidney trouble. Talk to your healthcare professional about ways to manage fluid buildup.
Five: Feeling tired or having less energy
Feeling tired all the time, even after a good night's sleep, can be an early sign of kidney disease. Your kidneys play a big role in keeping your body healthy. They remove waste and extra fluid from your blood, help make red blood cells, and keep your bones strong by balancing certain minerals.
When your kidneys are not working well, waste builds up in your body and your red blood cell levels can drop. This can lead to a condition called anemia, which means your body doesn’t have enough red blood cells to carry oxygen through your body. Without enough oxygen, you may feel weak, tired, short of breath, or have trouble concentrating.
Tiredness from kidney disease is not just regular fatigue from a busy day, it can feel like you’re always dragging or too exhausted to do daily tasks.
What you can do:
Fatigue is one of the most common signs of kidney disease. Don’t ignore talking to your healthcare professional and ask for a kidney check.
What are the signs of kidney disease?
Six: Trouble sleeping
If you have trouble falling asleep or staying asleep, your kidneys might be involved. Healthy kidneys help filter waste and extra fluid from your blood. But when your kidneys aren’t working well, toxins (waste products) can build up in your body. This buildup may make it hard for your brain and body to relax at night.
People with kidney disease are also more likely to have sleep apnea, a condition where breathing stops and starts during sleep. This can cause you to wake up often, feel tired during the day, or have headaches in the morning.
Sleep apnea is more common in people with kidney disease, especially if they also have fluid buildup or high blood pressure. Left untreated, it can increase your risk for heart problems and make kidney disease worse.
Poor sleep over time can affect your energy, mood, memory, and even your blood pressure, all of which are important for your kidney health.
Poor sleep can be a warning sign of kidney disease—and can also make it worse. Talk to your healthcare professional if you're not sleeping well.
Seven: Puffy eyes
Waking up with swelling or puffiness around your eyes can be a sign that your kidneys are leaking protein into your urine. This happens when the filters in your kidneys are damaged and cannot keep protein where it belongs, in your blood.
Protein is important for many body functions, including keeping fluid in your blood vessels. When protein leaks out into your urine, fluid can shift into other parts of your body and cause swelling. Puffy eyes may be one of the first signs of this kind of fluid shift.
This symptom can happen even before you notice changes in how often you pee or how you feel. Some people may think the swelling is from lack of sleep or allergies, but if it continues, your kidneys may be involved.
Puffy eyes can be an early sign that your kidneys are leaking protein. Talk to your healthcare professional and ask about a urine test.
Eight: Poor appetite
If you do not feel hungry or if food starts to taste different, it could be a sign that your kidneys are not working well. When your kidneys cannot remove waste from your blood, those waste products build up in your body. This can affect your sense of taste and make you feel sick to your stomach.
You may notice that food tastes metallic or bitter. Some people feel full after only a few bites. Others feel nauseated or have no desire to eat at all. Over time, this can lead to weight loss and poor nutrition, which can make kidney problems worse.
A poor appetite may seem like a minor issue, but it can be an early warning sign of kidney disease.
Loss of appetite can be an early sign of kidney disease. Talk to your healthcare professional and ask if it is time to check your kidney function.
Nine: Dry and itchy skin
Dry or itchy skin may be more than just a skin problem; it can be a sign that your kidneys are not working as they should. Healthy kidneys help keep the right balance of minerals in your blood, such as calcium and phosphorus. They also help remove waste from your body through your urine (pee).
When your kidneys are damaged, minerals like phosphorus can build up in your blood. This buildup can make your skin feel dry, rough, or itchy. You may also notice that your skin feels tight, flaky, or uncomfortable, even if you use lotion.
Some people with kidney disease also get itching that feels deep under the skin, especially on their back, arms, or legs. This is called uremic pruritus, and it’s caused by waste and mineral imbalances in the body.
Dry, itchy skin can be a sign of kidney trouble. Ask your healthcare professional about blood tests that check your mineral levels.
Ten: Muscle cramps
Muscle cramps, especially in your legs or feet, can be painful and may happen more often if you have kidney disease. These cramps can occur during the day or wake you up at night.
Healthy kidneys help keep the right balance of electrolytes in your blood. Electrolytes are minerals like calcium, potassium, and phosphorus that help your muscles, nerves, and heart work properly. When your kidneys are not working well, these levels can become too high or too low, which can lead to cramping.
Muscle cramps can also be caused by fluid loss, dehydration, or poor blood flow to your muscles—all of which can happen in people with kidney disease.
Muscle cramps may be caused by changes in your blood minerals. Ask your healthcare professional if they could be related to kidney disease.
