People can go on for a long time with such reduced kidney function, because some of the initial symptoms — tiredness and changes of appetite — are so vague that they could be caused by many other things. But when they are combined with other symptoms like itching, water retention, and anemia, this is when the pieces slowly fall into place. As the kidneys become less able to filter fluids and remove them from the body, more fluids are retained, and the person may experience swelling and puffiness. Even their urine may become more clear, because fewer impurities are being excreted.
Naturally this contributes to higher blood pressure. But the blood itself becomes more anemic, because it’s when the kidney releases the hormone erythropoietin (EPO) that red blood cells can be created. When the kidney can’t release as much EPO as it’s supposed to, the blood cell count goes lower and the patient becomes more anemic. In turn, the blood carries less oxygen and the body has to work harder in order to function. As a result, the person experiences greater and greater fatigue.
At this stage, the patient absolutely must take steps to reduce sodium in the diet and bring the blood pressure down. The higher the pressure, the more damage to vein walls, and the more damage to veins in the kidneys, the worse kidney function becomes. Adjustments must also be made to other elements of diet: protein will need to be reduced, though the patient can’t live completely without it. Patients may also need to take a phosphorus binder and vitamins that help boost kidney function. Working on these things with a knowledgeable dietitian is essential.
Even if earlier stages have been missed and the person has advanced well into Stage Three, it’s vital to get diagnosed as early as possible, to preserve what kidney function is left and prevent the disease from progressing any further.