kidney when to seek care

Overview

The kidneys are two bean-shaped organs that filter waste and extra water from your blood to make urine. Kidney problems happen when these organs are damaged or not working as well as they should. This guide helps you recognize symptoms that need medical attention.

Yes, kidney problems are fairly common. Around 1 in 10 adults worldwide has some form of chronic kidney disease, and many don't know it until a routine test finds it.

Anyone can be affected, but they are more common in older adults and people with diabetes, high blood pressure, heart disease, or a family history of kidney disease.

Symptoms

Common symptoms

• Changes in urination – producing more or less urine, dark urine, foamy urine, or needing to urinate especially at night
• Swelling in the feet, legs, hands, or face
• Unexplained tiredness or difficulty concentrating
• Itchy skin
• Muscle cramps
• Nausea or loss of appetite

Symptoms in children

• Fever that doesn't go away
• Swelling around the eyes, feet, or hands
• Poor appetite or vomiting
• Pain or burning during urination
• Wetting the bed after being potty-trained
• Less wet nappies than usual

Symptoms in older adults

• Confusion or drowsiness
• Swelling in the lower legs or around the eyes
• Producing much less urine than usual
• Nausea or vomiting
• Feeling unusually weak or tired

Causes

Main causes

• Infections, such as a kidney infection
• Reduced blood flow to the kidneys from severe dehydration, bleeding, or heart failure
• Obstructions like kidney stones or an enlarged prostate
• Autoimmune diseases where the body's immune system attacks the kidneys
• Long-term damage from high blood sugar or high blood pressure

Risk factors

• Diabetes
• High blood pressure
• Heart disease
• Obesity
• A family history of kidney disease
• Being over the age of 60
• Smoking
• Long-term use of some over-the-counter pain medicines

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have a fever with pain or burning when urinating, or if you notice blood in your urine
• Make an urgent appointment if you suddenly start making much less urine than usual
• Seek care promptly if you have severe vomiting and can't keep fluids down

Book a routine appointment if:

• Make a routine appointment if you've had swelling, tiredness, or urination changes for more than a few days
• Have regular check-ups if you have diabetes, high blood pressure, or a family history of kidney disease
• Ask your doctor for a simple blood and urine test to check your kidney function

Diagnosis

Doctors diagnose kidney problems with a combination of blood and urine tests, and sometimes imaging or a small tissue sample. These tests show how well your kidneys are filtering and whether there is damage.

Tests that may be done

• Blood test to measure creatinine and estimate your glomerular filtration rate (eGFR) – a number that reflects your kidney function
• Urine test to check for protein or blood in the urine
• Ultrasound scan to look at the size and structure of your kidneys
• CT scan if more detail is needed
• A kidney biopsy (removing a tiny piece of kidney tissue) in some cases

What to expect at your appointment

Your doctor will ask about your symptoms, medical history, and any medicines you take. They may also check your blood pressure and feel your abdomen. Based on the results, they will explain what the numbers mean and what next steps you might need. You usually get results within a few days, and you may need to repeat some tests.

Treatment

Treatment depends on the underlying cause. If a condition like diabetes or high blood pressure is damaging your kidneys, your doctor will work with you to manage it. If a stone or blockage is causing problems, that will be addressed. Early treatment can often slow or stop further damage.

Self-care at home

• Staying well hydrated by drinking water unless your doctor tells you to limit fluids
• Eating a balanced diet and limiting salt
• Avoiding smoking
• Keeping your blood pressure and blood sugar within the range recommended by your doctor
• Doing gentle exercise like walking, if you feel able

Medical treatments

Your healthcare provider may prescribe medicines to control blood pressure, lower blood sugar, or reduce protein in the urine. They might also recommend medications to help with fluid balance or to treat an underlying infection. Always take any medicines exactly as prescribed and speak to your doctor before taking over-the-counter products, because some can affect the kidneys.

When is surgery considered?

Surgery is sometimes needed for kidney stones that don't pass on their own, for blockage relief, or to remove a kidney in cases of cancer. Your specialist will discuss options if surgery is relevant for you.

Living with this condition

Living with kidney problems often means being consistent with your daily routine. Keep your appointments, take your medicines as recommended, and check in with your care team if you notice changes.

Lifestyle tips

• Stay physically active in a way that suits you, like walking or swimming
• Quit smoking and limit alcohol
• Manage stress with relaxation exercises or hobbies you enjoy
• Keep a symptom diary to help spot patterns and discuss them with your doctor

Diet and exercise

Your doctor or a dietitian can help you plan meals that support your kidney health. This might mean limiting salt, choosing foods lower in potassium and phosphorus if needed, and eating the right amount of protein. Regular exercise can help control blood pressure and blood sugar, but start gently and build up gradually.

Mental health and emotional wellbeing

A kidney diagnosis can feel overwhelming and sometimes brings anxiety or low mood. It's normal to worry. Talk to your healthcare team about how you're feeling, and if you have thoughts of self-harm or crisis, contact your local emergency number or crisis support line right away.

Prevention

Not all kidney problems can be prevented, but many can. The best steps are to keep your blood pressure and blood sugar well controlled, avoid smoking, stay hydrated, and limit long-term use of pain medicines without medical advice.

Vaccines

Staying up to date with recommended vaccines, such as flu and pneumonia vaccines, can help prevent infections that might stress your kidneys. Ask your healthcare provider which vaccines are right for you.

Screening programmes

If you have diabetes, high blood pressure, a family history of kidney disease, or are over 60, ask your doctor about regular simple blood and urine tests to check your kidney function.

Complications

If left untreated

• Progressive loss of kidney function that can lead to kidney failure
• Fluid build-up causing swelling and shortness of breath
• High blood pressure that becomes harder to control
• Anaemia (low red blood cells), causing tiredness and weakness
• Bone problems due to mineral imbalance

Long-term outlook

With early care, many kidney problems can be slowed down or managed well. Even if kidney function is reduced, many people live long and active lives with the right treatment and support. Your healthcare team will help you understand your own outlook and options.

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