Kidney doctors, i.e., nephrologists, are accustomed to fielding many questions daily about the kidneys. You will likely have a plethora of questions for your doctor about kidney disease, especially if you’ve only just been diagnosed. No matter how simple or bizarre you feel your question may be, it’s important to ask it—and get the answer from a trusted professional. Dr. Cynthia Kristensen answers the most common questions about kidney disease that doctors receive.* 

What do the kidneys do?

The kidneys are multifunctional, and they help to:

• Remove food and water, which become waste products
• Regulate blood pressure
• Control the amount of blood you produce
• Balance calcium, potassium, and several other chemicals in the body
• Support bone health

If I go to the bathroom frequently, does that mean my kidneys are working normally?

Frequent urination does not equal healthy kidneys for kidney disease patients. Some patients make urine with a lot of water but with nearly no waste products in it. Blood tests will determine the amount of waste in your blood and, thus, your level of kidney disease. 

Frequent urination can also be a symptom of a bladder problem. Doctors will use blood tests, urine tests, and x-rays to determine if you are experiencing an irregular bladder condition. 

How would I know if I have kidney disease?

Since kidney disease may not initially come with symptoms, your doctor will do screening tests for kidney disease. People who are at a higher risk of developing kidney disease should have regular visits with their doctor. These people include patients with diabetes, high blood pressure, and/or a family history of kidney disease.

Common screening tests include:

• Blood tests
• Measuring blood pressure
• Urinalysis (checking the urine for protein)

Can I have a kidney problem without experiencing pain?

Most kidney diseases are painless. The ones that typically have associated pain are:

• Polycystic kidney disease (PKD)
• Kidney stones
• Severe kidney infections

What are the common causes of kidney disease?

The most common causes are:

• Diabetes
• High blood pressure (hypertension)

Less common causes include:

• Inherited kidney disease, such as PKD or Alport syndrome
• Lupus
• Acute kidney failure (occurs suddenly)

I have had high blood pressure forever—is that normal? 

Regardless of age or any other factors, high blood pressure is never normal. Prolonged high blood pressure can:

• Damage blood vessels 
• Put stress on the heart
• Harm the kidneys

In turn, kidney disease can also cause or worsen high blood pressure. If you have high blood pressure, it is important to have regular check-ups with your doctor and take any prescribed blood pressure medications. This will prevent damage to the kidneys and other organs.

How do I know if my kidneys are bad? 

A specific test, called the glomerular filtration rate (GFR), is calculated with your creatinine level, age, gender, and race. The GFR tells you how well the glomeruli, or tiny filters in the kidneys, are filtering waste products, which indicates how well your kidneys are working. 

The GFR goal is to be above 60, with lower numbers showing kidney disease. If you have kidney disease, it is important to monitor your GFR as a declining GFR shows worsening kidneys. 

What are the symptoms of kidney disease?

Some kidney disease patients may not have symptoms until GFR is less than 30. Common symptoms may include:

• Swelling in the ankles and legs
• Foamy or bloody urine
• Fatigue
• Poor appetite
• Nausea
• Itchiness all over the body
• Bad taste in the mouth
• Confusion

What is anemia?

Often seen in kidney disease patients, anemia means there are too few red blood cells in your bloodstream. Red blood cells ensure oxygen is delivered throughout the body. If left untreated, the most common symptom is tiredness and lack of energy. Fortunately, it is treatable with medication. 

How does my doctor know if I need to have dialysis or get a transplant?

With regular check-ups, your doctor will monitor you for signs of uremia and blood test results that may focus on nutrition. When your doctor sees a declining GFR with abnormal nutrition-related blood tests, they will start to discuss dialysis and/or a kidney transplant as a treatment option for you.

*Kristensen, C. (n.d.). Most common questions kidney patients ask doctors. DaVita Kidney Care. https://www.davita.com/education/kidney-disease/symptoms/most-common-questions-kidney-patients-ask-doctors