- News
- Health News
- You can lose up to 80% of kidney function without knowing it: Doctors explain the warning signs of chronic kidney disease
You can lose up to 80% of kidney function without knowing it: Doctors explain the warning signs of chronic kidney disease
Aadya Jha / TIMESOFINDIA.COM / Jul 18, 2026, 18:49 IST
AAText Size
- Small
- Medium
- Large
1/5
Why early CKD detection and proper dialysis access care can save lives
The kidneys are among the hardest-working organs in the body. Every day, they filter nearly 180 litres of blood, remove waste, regulate fluids, help control blood pressure, maintain healthy mineral levels, and even support the production of red blood cells. Yet despite carrying out so many vital functions, they often fail quietly.Unlike many illnesses that announce themselves with pain or obvious discomfort, chronic kidney disease (CKD) can develop over several years without causing noticeable symptoms. Doctors say this is one of the biggest reasons why millions of people are diagnosed only after the disease has already reached an advanced stage.According to the World Health Organization (WHO) and the International Society of Nephrology, chronic kidney disease affects more than 800 million people worldwide, making it one of the fastest-growing causes of illness and premature death. In India, diabetes and high blood pressure, the two biggest drivers of CKD, continue to rise, placing millions more at risk. The National Health Mission’s National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) also recommends regular screening for people with diabetes and hypertension because early kidney damage often has no symptoms.”The kidneys possess an extraordinary functional reserve. Healthy filtering units automatically overwork to compensate for damaged ones. Because of this compensation, patients routinely lose up to 80% of renal function before experiencing a single outward sign of illness,” explained Dr Srivatsa A, Consultant Nephrologist and Transplant Physician, Apollo Hospitals, Bengaluru.
2/5
Why chronic kidney disease is often called a silent disease
One of the most frustrating aspects of CKD is that people can feel perfectly healthy while their kidneys are slowly losing their ability to filter waste from the blood.The kidneys are built with remarkable reserve capacity. Even when some filtering units become damaged, the remaining healthy ones work harder to keep the body functioning normally. This compensation helps people stay symptom-free for years, but it also delays diagnosis.When symptoms finally appear, kidney damage is often already significant.Dr Srivatsa said, “When symptoms finally surface in advanced stages, they reflect a profound systemic failure. As metabolic waste builds up in the bloodstream, patients experience persistent fatigue, nausea, loss of appetite and severe itching. Swelling in the ankles, feet and hands develops because the kidneys are no longer able to regulate fluid balance effectively.”Some people also develop breathlessness because damaged kidneys produce less erythropoietin, a hormone that helps the body make red blood cells. The resulting anaemia can leave patients feeling constantly exhausted.Other symptoms may include:​Swelling in the feet, ankles or facePersistent tirednessPoor appetiteNausea or vomitingMuscle crampsDifficulty concentratingChanges in urinationItchy skinHigh blood pressure that becomes difficult to control​Doctors stress that none of these symptoms automatically mean someone has kidney disease. However, persistent symptoms, especially in people with diabetes or hypertension, should never be ignored.
3/5
Diabetes and high blood pressure remain the biggest culprits
Many people think kidney disease begins in the kidneys. In reality, it often starts elsewhere.Diabetes remains the leading cause of chronic kidney disease worldwide. Over time, persistently high blood sugar damages the tiny blood vessels that act as the kidneys’ natural filters. As these filters weaken, proteins that should remain in the bloodstream begin leaking into urine, triggering inflammation and scarring that gradually reduces kidney function.High blood pressure follows closely behind.According to Dr Srivatsa, “Chronic hypertension narrows and thickens the fine blood vessels supplying the kidneys. This reduces oxygen and nutrient delivery and gradually replaces healthy filtering tissue with scar tissue.”These are not the only causes.Autoimmune diseases such as glomerulonephritis can inflame the kidneys, while inherited conditions like polycystic kidney disease gradually replace healthy tissue with fluid-filled cysts. Long-term use of certain painkillers, recurrent kidney infections, smoking and obesity can also increase the risk.Because early kidney disease rarely causes symptoms, doctors recommend routine screening for people who already have diabetes, hypertension, heart disease or a family history of kidney problems. Simple blood tests to estimate kidney function (eGFR) and urine tests to detect protein leakage can often identify CKD before permanent damage becomes severe.
4/5
Treatment has changed, but early diagnosis still matters most
For years, chronic kidney disease treatment focused mainly on slowing further damage. Today, doctors say the approach has shifted. Newer medicines can help protect kidney function, especially when the disease is detected early.Dr Srivatsa explained, “The cornerstone of modern treatment relies on sodium-glucose cotransporter-2 (SGLT2) inhibitors. Although these medicines were first developed for diabetes, they also reduce mechanical stress on the kidneys and help preserve their filtering function. Other newer therapies, including glucagon-like peptide-1 (GLP-1) receptor agonists and non-steroidal mineralocorticoid receptor antagonists, further reduce inflammation and slow scarring in appropriate patients.”However, once the kidneys lose most of their function, dialysis or a kidney transplant may become necessary.While many people associate dialysis with the machine that filters the blood, experts say there is another equally important part of treatment that often goes unnoticed, the arteriovenous (AV) fistula, a surgically created connection between an artery and a vein that provides reliable access for haemodialysis.”For every patient on haemodialysis, the AV fistula is quite literally a lifeline. Without it, dialysis cannot be performed effectively. Yet fistula care remains one of the least understood aspects of kidney disease,” said Dr Avik Bhattacharyya, Senior Consultant – Interventional Radiology, CK Birla Hospitals, CMRI.He added that many patients seek medical attention only after the fistula has already narrowed or become blocked. A weaker buzzing sensation over the fistula, swelling of the arm, prolonged bleeding after dialysis, pain or difficulty inserting dialysis needles should never be ignored. Detecting these warning signs early can often help doctors restore blood flow with minimally invasive procedures and prevent the loss of this vital dialysis access.
5/5
Medical experts consulted
This article includes expert inputs shared with TOI Health by:Dr Srivatsa A, Consultant Nephrologist & Transplant Physician, MBBS; MD(Gen Med); DM(Nephrology); AST Fellowship in Kidney Transplant(Canada), Apollo Hospitals, Bengaluru.Dr Avik Bhattacharyya, Senior Consultant – Interventional Radiology, CK Birla Hospitals, CMRIInputs were used to explain why chronic kidney disease often goes unnoticed until significant kidney damage has occurred, what warning signs to watch for, and why early medical evaluation is essential.
Follow Us On Social Media
