Kidney disease can be building inside you for years without a single clear symptom, and by the time something does feel off, it’s often already advanced. That’s the blunt reality Dr. Vishal Saxena, Vice-Chairman of Nephrology & Renal Transplant at Max Hospital Gurugram, wants people to understand. Kidney illness can sometimes develop without showing any signs and early symptoms might appear unconnected to the kidneys, he says. So someone could spend months blaming tiredness on work stress, or puffy eyes on a bad night’s sleep, while the actual problem is happening quietly in an organ they haven’t thought about in years.And this isn’t a small, isolated concern. The World Health Organization notes that noncommunicable diseases now kill more than 40 million people every year, with kidney disease sitting inside that broader cluster alongside diabetes and cardiovascular disease as one of the fastest-rising contributors. In May 2025, the World Health Assembly passed a formal resolution specifically on reducing the burden of noncommunicable diseases through kidney health. That’s a fairly strong signal of where this has landed globally, no longer a niche medical issue, but something being treated as a structural health crisis tied directly to rising diabetes, high blood pressure and an aging population worldwide.
The two cheap tests that catch it before damage sets in
Here’s the part that actually matters most for someone reading this right now. Kidney illness may not show any signs; hence, basic tests may reveal some abnormalities before the kidneys incur serious damage, Dr. Saxena says.The first is serum creatinine paired with eGFR, or estimated glomerular filtration rate. Creatinine is a byproduct of metabolism, which is normally eliminated from the body through filtration, he explains, and the test result can be used to determine the kidney’s effectiveness. A low eGFR simply means the kidneys aren’t filtering the way they should.The second is the urine albumin-to-creatinine ratio, or UACR, and this one’s worth paying attention to because it can catch something creatinine alone might miss. The test detects albumin, which is a protein that enters urine when the filtering mechanism is injured, Dr. Saxena says. The key line here, a higher amount of albumin in urine can mean chronic kidney disease is already developing even when eGFR is normal. So a person could test fine on one marker and still be showing early trouble on the other.Third is just blood pressure, the simplest check of all. High blood pressure negatively influences the kidney’s functioning, he notes, which is why it gets tracked alongside kidney tests rather than treated as its own separate issue.Diabetics, patients suffering from hypertension or heart disease, or individuals with a family history of kidney illnesses should consult their doctors about their kidney problems and undergo screening. Given how silently this disease tends to build, that screening conversation is genuinely one of the cheapest ways to catch trouble before it turns into something much bigger.
What the body actually tries to tell you, if you’re paying attention
Even though kidney disease is often symptomless in its early stages, there are signs worth knowing, mostly because people tend to explain them away as something else entirely.Swelling is one of the more common ones. When the kidney function is impaired and the surplus amount of fluids and sodium cannot be eliminated, swelling in the legs, feet and around the eyes becomes possible, Dr. Saxena says. That puffiness under the eyes some mornings, usually blamed on a salty dinner, can sometimes actually be the kidneys failing to clear out extra fluid and sodium properly.Fatigue is another. Chronic fatigue and asthenia might also arise due to the fact that decreased kidney function is linked with such phenomena as anaemia and accumulation of waste products in the blood, he explains. When kidneys slow down, waste that should be filtered out starts building up, and the body also tends to produce less of the hormone that keeps red blood cells healthy. Together, that produces a kind of tiredness that no amount of sleep or coffee really fixes.Changes in urination matter too, and this one gets ignored the most. Changes in urination, for example, increasing or decreasing the amount of urination, passing foamy urine and seeing blood in the urine, can be seen as initial symptoms of the issue with the kidneys, Dr. Saxena says. Foamy urine especially tends to get brushed off as nothing. But persistent foam can mean protein is leaking into urine, often one of the earliest catchable signs something’s wrong.There’s a longer list too, continuous itching, dry skin, nausea, lack of appetite and difficulties with concentrating due to bad functioning of the kidneys, as Dr. Saxena puts it. And separately, persistent high blood pressure is also something remarkable because kidneys shape several diseases connected with high pressure. It’s a two-way relationship. Kidneys help regulate blood pressure, and damaged kidneys let blood pressure creep upward in return, which then damages the kidneys further still. That loop can run quietly for years before anyone notices.
Don’t panic, but don’t ignore the pattern either
Dr. Saxena is careful to add an important caveat here. However, these symptoms may occur due to other illnesses and do not mean the existence of kidney disease. Swollen ankles after a long flight aren’t a diagnosis. Nobody should read a list of symptoms and assume the worst.But a pattern of these signs, especially alongside diabetes or high blood pressure, is exactly the kind of thing that deserves an actual conversation with a doctor rather than a guess pieced together from the internet. Given how easy and inexpensive the basic tests are, and how much of the damage from kidney disease is preventable if it’s caught early, that conversation is a fairly small ask against what’s at stake.
