Symptoms of kidney disease – blood in the urine and swelling of the feet and body

Two weeks ago I discussed one of the symptoms of kidney disease, namely pain. This week, I will be discussing other signs and symptoms, namely hematuria or blood in the urine and swelling of the feet and body.{{more}}

Hematuria: this means blood in the urine and it may be obvious (you can actually see it!) when it is called gross hematuria, or you cannot see it, at which time it is called microscopic hematuria or microhematuria. Gross hematuria typically looks red, but there may be variations between gross and microscopic, from dark red with or without clots, to light red to brownish, to lightly brown or cloudy. Brown and brownish urine implies old blood in the urine. The blood may be associated with or without pain, in which case it is called painful or painless hematuria. Generally microscopic hematuria is painless, but gross may be painful or painless. So what are the causes of hematuria?

Blood can come from anywhere in the urinary system, namely the kidneys, ureters, bladder or the external urine passage called the urethra. Again, generally painless hematuria is caused by tumours, whether kidney, bladder or prostate, while painful hematuria is caused by infections, stones, trauma and blockage. In other words, the old adage that if you are not having pain then there is nothing to worry about is not true. In summary, gross hematuria, which is painful, is not as bad as the painless.

Microscopic hematuria is rarely painful and when it is, it is usually due to infections or stones. Painless microscopic hematuria in persons aged 40 and over should be investigated, as it may be an indicator of a silent tumour.

The same conditions cause gross and painless hematuria. These include tumours anywhere in the urinary system, infections of any sort, and stones anywhere in the urinary system. Obviously, trauma to the urinary system can cause gross or microscopic hematuria; however, other conditions not affecting the urinary system, like generalized blood infections and excessive thinning of the blood, tend to cause painless gross hematuria.

Swelling of the feet (pedal edema) is generally regarded as a sign of kidney disease, but can be caused by many other factors. The feet only swell in the late stages of chronic kidney disease and some people’s feet may not even swell. In acute kidney disease, the feet may swell suddenly because of excessive loss of protein in the urine (proteinuria) or excessive fluid retention (edema). Acute or sudden kidney disease can occur anytime for almost any reason and swelling of the feet is usually accompanied by swelling of the whole body, including the face and hands. Chronic kidney disease usually causes such gross swelling only in the late stages, when dialysis is needed and is usually associated with heart disease, which by itself can also cause pedal edema.

The other causes of swelling of the feet include heart failure, fluid retention for other reasons apart from kidney disease, tumours of the pelvis, including fibroids and large ovarian cysts, clots in the veins of the legs or thighs or circulatory problems. Any cause of loss of protein from the blood, like liver disease and malnutrition, may cause swelling of the feet, as can chronic anemia. These are just a few of the conditions that causing swelling of the feet, so one need not assume that feet swelling means kidney disease. Next week, I will discuss the other symptoms of kidney disease.

For comments or question contact:

Dr Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com