More than one in seven (1 in 7) adults in the U.S. are estimated to have chronic kidney disease (CKD), or approximately 37 million people, according to the Centers for Disease Control and Prevention (CDC). Until it reaches a later stage, CKD often doesn’t exhibit symptoms, and even when experiencing symptoms, most people attribute them to other causes and don’t realize they have CKD.

Certain people are at high risk for CKD, including those with high blood pressure, diabetes, and/or a family history of the disease, and should be checked annually. Getting tested by your doctor is the only way to get an official diagnosis, but the following are possible signs of CKD to look out for.

Are you feeling more tired than normal? It could be a sign of CKD.
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Some possible signs of chronic kidney disease include:

• More tired, less energy, and/or trouble concentrating
• Trouble sleeping
• Dry and itchy skin
• More frequent urination
• Blood in your urine
• Foamy urine
• Puffy eyes
• Swollen ankles and feet
• Decrease in, or loss of, appetite
• Muscle cramping

The majority of these symptoms are a byproduct of decreased kidney function. When your kidneys start to work less efficiently, toxins and impurities, like protein, start to build up in your blood. Minerals and nutrients in your blood can also become imbalanced, as mineral and bone disease often occurs in the more advanced stages of CKD.

“Chronic kidney disease can affect almost every part of your body,” according to the Mayo Clinic. The organ most often affected is the heart; kidney disease can cause heart disease, or cardiovascular disease, and vice versa. The most frequent related condition is high blood pressure (HBP), or hypertension.

One of the most common related conditions experienced by people with CKD is heart disease.
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Diabetes is another extremely common related condition, which is when your blood glucose, or sugar, is too high. The potassium and iron levels in your blood can also affect your body and can cause hyperkalemia and/or anemia, respectively. Other organs in the body that can be affected by CKD include:

• Lungs, which can retain fluid and result in pulmonary edema
• Bones, which can weaken and lead to an increased fracture risk
• Brain and spinal cord (central nervous system), which can “cause difficulty concentrating, personality changes, or seizures”

Kidney disease can also cause “decreased sex drive, erectile dysfunction, or reduced fertility” and a “decreased immune response,” as well as “pregnancy complications that carry risks for the mother and the developing fetus” in women, as noted by the Mayo Clinic.