Kidney disease is a growing global health problem, and not many people are aware of their condition until it becomes severe. This is because the early symptoms are not always apparent, further investigations
may be required based on physical evidence, such as swelling of the legs or neurological alterations in the body.
Many kidney diseases can be avoided or their course can be changed with the help of doctors who recognise them at the very first stages. In fact, even uncomplicated daily habits can be quite effective, for example, not self-medicating, drinking enough water, regular exercise, maintaining a healthy weight, etc.
On World Kidney Day today, we speak to Dr Topoti Mukherjee, Lead Consultant – Nephrology & Kidney Transplant, Aster Whitefield Hospital, who shares different symptoms that one might see in their legs that can hint at kidney issues:
Swelling in the Legs, Ankles, or Feet (Peripheral Oedema)
Oedema or swelling due to the presence of fluid in the tissues is one of the most common indications of kidney dysfunction. Oedema is common in legs, ankles and feet, and when the person is in a gravity, the excess fluid is retained in the leg.
Why it happens:
• Healthy kidneys get rid of the extra salt and water in your body by urinating. When they don’t, fluid accumulates in the body.
• Clinical data
Oedema is a regular complication of kidney diseases, in particular nephrotic syndrome and end-stage CKD. Up to 75% of the patients with CKD had oedema in one clinical study, besides other signs and symptoms like breathlessness and nausea. Oedema in general becomes more apparent in stage 3 or higher stages of CKD.
What to look for:
- Puffy ankles by evening
- Sock marks on the legs
- Swelling that leaves an indentation when pressed (pitting edema)
- Persistent leg swelling should not be ignored because it can signal kidney disease, heart disease, or liver disease.
Heavy or Tight Legs Due to Fluid Retention
Others have a heavy sensation on legs, tight legs, sore legs, particularly at the end of the day. This might actually be the initial indicated symptom of systemic fluid imbalance due to poor kidney filtration. Constant heaviness or swelling in the lower extremities could occasionally indicate a kidney issue or a circulatory issue. That is why it would be prudent to have yourself examined by a doctor.
Muscle Weakness and Reduced Leg Strength
Kidney disease can also affect muscle strength and physical function. A clinical study examining CKD patients found that individuals with leg edema had reduced knee extensor muscle strength and poorer balance, suggesting a direct link between kidney disease and lower-limb physical decline.
Why it occurs:
• Electrolyte imbalances
• Chronic inflammation
• Protein loss in urine
• Less physical activity caused by fatigue.
Numbness, Tingling, or Burning in the Legs
When the kidneys fail to excrete toxins in the body, the toxins accumulate in the blood making the kidneys fail in their normal functioning. Uraemia damages the body through its effect on the peripheral nervous system.
The commonest neurological disorder is defined by peripheral neuropathy. It is manifested in 90 percent of patients with CKD under dialysis. The beginning of symptoms occurs in the legs of affected people. The main symptoms of this condition include numbness or reduced sensation in the feet tingling or “pins and needles,” and Burning pain and Weakness in the lower limbs. The symptoms begin in the feet and distal legs before they move to higher body parts.
Restless Legs Syndrome
Restless Legs Syndrome (RLS) is another condition strongly linked to kidney disease.
What it feels like:
• An uncontrollable urge to move the legs
• Uncomfortable sensations when resting
• Symptoms that worsen at night
Research indicates that restless legs syndrome (RLS) is 2, 3 times more prevalent in individuals with chronic kidney disease than in the general population. Of those on dialysis, around a quarter have been found to suffer from symptoms of RLS, which in a major way disrupts both sleep and overall life quality. It’s believed that the condition is caused by an imbalance of iron, malfunction of nerves, and metabolic changes that come with kidney failure.
When to Seek Medical Attention
Doctors recommend evaluation if leg symptoms occur along with:
• Persistent swelling of legs or ankles
• Reduced urine output
• Fatigue or weakness
• Shortness of breath
• Changes in urination patterns
Simple tests such as serum creatinine, estimated glomerular filtration rate (eGFR), and urine albumin tests can help detect kidney disease early.
