Written by By Dr. Narishha Jegan, MBBS (AIMST), OHD (NIOSH)
Medical Director, Dr. Prevents PJ Old Town
Published: 30/09/2025 | Reading Time: 6 minutes
Kidney disease affects millions worldwide, yet early stages often go unnoticed until significant damage has occurred. As a medical professional specializing in preventive care at our PJ Old Town clinic, I’m sharing the three most critical early warning signs of kidney disease that every person should know. Whether you’re in Petaling Jaya, Section 14, Ara Damansara, or anywhere within 5km of our clinic, early kidney disease detection and expert care are available just minutes from your location.
Understanding Kidney Disease: The Silent Health Threat
Chronic kidney disease (CKD) is often called a “silent killer” because symptoms typically don’t appear until kidney function has declined significantly. At Dr. Prevents PJ Old Town, we see patients from Taman Paramount, SS2, and surrounding areas who benefit from early detection through routine screening and awareness of warning signs.
Kidney Disease Statistics:
- 850 million people worldwide have kidney diseases
- 15% of Malaysian adults have some degree of kidney disease
- 90% of people with early kidney disease don’t know they have it
- Early detection can slow progression by 50-70%
- Leading causes: diabetes (40%) and high blood pressure (30%)
Dr. Narishha emphasizes that recognizing these early warning signs can be life-saving, as kidney disease is often reversible or manageable when caught early.
The Three Critical Early Warning Signs
#1: Changes in Urination Patterns
Most Important Early Indicator: Changes in urination are often the first noticeable sign of kidney problems, as the kidneys’ primary function is filtering waste and producing urine.
Key Urination Changes to Watch:
- Increased frequency: Especially at night (nocturia)
- Decreased urine output: Less than usual amounts
- Foamy or bubbly urine: Indicates protein in urine
- Blood in urine: Pink, red, or cola-colored urine
- Difficulty urinating: Straining or incomplete emptying
- Cloudy urine: May indicate infection or protein
What These Changes Mean:
- Foamy urine: Often the earliest sign of protein leakage (proteinuria)
- Night urination: Kidneys losing ability to concentrate urine
- Blood in urine: Damage to kidney filters or urinary tract
- Frequency changes: Kidney function decline affecting urine production
When to Seek Medical Attention:
- Persistent foamy urine for more than 3 days
- Any visible blood in urine
- Significant changes in urination frequency
- Waking up more than twice nightly to urinate
2. Persistent Fatigue and Weakness
Often Overlooked but Significant: Kidney disease causes fatigue through multiple mechanisms, making it one of the most important early warning signs that’s frequently attributed to other causes.
How Kidney Disease Causes Fatigue:
- Anemia: Kidneys produce erythropoietin, which stimulates red blood cell production
- Toxin buildup: Waste products in blood cause tiredness
- Electrolyte imbalances: Affect muscle and nerve function
- Sleep disruption: From frequent nighttime urination
- Poor appetite: Leading to nutritional deficiencies
Types of Fatigue to Recognize:
- Morning fatigue: Feeling tired despite adequate sleep
- Exercise intolerance: Unusual tiredness during physical activity
- Mental fatigue: Difficulty concentrating, brain fog
- Weakness: Muscle weakness, especially in legs
- Breathlessness: Easy fatigue with minimal exertion
Red Flags for Kidney-Related Fatigue:
- Fatigue that doesn’t improve with rest
- Progressive worsening over weeks or months
- Associated with other kidney disease risk factors
- Accompanied by changes in urination or swelling
3: Swelling (Edema) in Feet, Ankles, or Face
Visible Sign of Kidney Problems: Swelling occurs when kidneys can’t properly remove excess fluid and sodium from the body, leading to fluid retention in tissues.
Common Swelling Patterns:
- Feet and ankles: Most common, especially after standing
- Around eyes: Particularly noticeable in the morning
- Hands and fingers: Rings feeling tight
- Face: Puffiness, especially upon waking
- Legs: Progressive swelling throughout the day
Types of Kidney-Related Swelling:
- Pitting edema: Leaves indentation when pressed
- Morning facial swelling: Particularly around eyes
- Bilateral swelling: Both sides affected equally
- Progressive swelling: Worsens throughout the day
- Non-responsive swelling: Doesn’t improve with elevation
When Swelling Indicates Kidney Problems:
- Sudden onset without injury or infection
- Persistent swelling lasting more than a few days
- Associated with urination changes or fatigue
- Swelling that worsens progressively
- Morning facial puffiness
Additional Supporting Signs to Monitor
Secondary Warning Signs
While not among the top three, these signs often accompany early kidney disease:
Cardiovascular Signs:
- High blood pressure (often the first detectable change)
- Irregular heartbeat or palpitations
- Chest pain or pressure
Digestive Symptoms:
- Loss of appetite
- Nausea or vomiting
- Metallic taste in mouth
- Unexplained weight loss
Skin Changes:
- Persistent itching
- Dry, flaky skin
- Skin discoloration
- Easy bruising
Sleep and Cognitive Issues:
- Insomnia or restless sleep
- Difficulty concentrating
- Memory problems
- Mood changes or irritability
Risk Factors for Kidney Disease
High-Risk Populations
Certain groups should be especially vigilant for early warning signs:
Medical Conditions:
- Diabetes: 40% of kidney disease cases
- High blood pressure: 30% of cases
- Heart disease: Increases kidney disease risk
- Family history: Genetic predisposition
- Autoimmune diseases: Lupus, rheumatoid arthritis
Lifestyle Factors:
- Age over 60: Natural kidney function decline
- Obesity: Increases diabetes and hypertension risk
- Smoking: Damages blood vessels in kidneys
- Excessive pain medication use: NSAIDs can damage kidneys
- Dehydration: Chronic dehydration affects kidney function
Early Detection Testing at Dr. Prevents PJ Old Town
Comprehensive Kidney Health Screening
Essential Kidney Function Tests:
- Serum creatinine: Measures waste product levels
- Blood Urea Nitrogen (BUN): Assesses kidney filtration
- Estimated GFR: Kidney function percentage
- Urinalysis: Detects protein, blood, and abnormal cells
- Albumin-to-creatinine ratio: Early protein leakage detection
Advanced Diagnostic Options:
- 24-hour urine collection: Comprehensive kidney function assessment
- Kidney ultrasound: Structural evaluation
- Blood pressure monitoring: Cardiovascular-kidney connection
- Diabetic screening: HbA1c and glucose testing
- Electrolyte panel: Sodium, potassium, phosphorus levels
Same-Day Testing Available:
- Immediate blood and urine collection
- Rapid preliminary results within hours
- Comprehensive reports within 24-48 hours
- Expert interpretation by Dr. Narishha
- Treatment planning and follow-up scheduling
Prevention and Early Intervention
Lifestyle Modifications:
- Blood pressure control: Target below 130/80 mmHg
- Diabetes management: HbA1c below 7%
- Heart-healthy diet: Low sodium, balanced nutrition
- Regular exercise: 150 minutes moderate activity weekly
- Adequate hydration: 8-10 glasses water daily
- Smoking cessation: Immediate and long-term benefits
Medical Management:
- ACE inhibitors or ARBs: Protect kidney function
- Diabetes medications: Optimize blood sugar control
- Blood pressure medications: Reduce kidney stress
- Dietary counseling: Kidney-friendly nutrition plans
- Regular monitoring: Prevent progression
Why Choose Dr. Prevents PJ Old Town for Kidney Health
Expert Kidney Disease Detection Serving 5km Radius
Areas We Serve:
- PJ Old Town: Premier kidney health screening location
- Section 14, Petaling Jaya: 5 minutes via Jalan 14/29
- Ara Damansara: 8 minutes via Federal Highway
- Taman Paramount: 6 minutes via Jalan Othman
- SS2, Petaling Jaya: 7 minutes via Jalan SS2/24
- Taman SEA: 9 minutes via Jalan Templar
- Section 13: 10 minutes via Jalan Universiti
- Bandar Utama: 12 minutes via LDP Highway
About Dr. Narishha Jegan:
Dr. Narishha Jegan, MBBS (AIMST), OHD (NIOSH), is the Medical Director at Dr. Prevents PJ Old Town. With specialized training in preventive medicine and occupational health, Dr. Narishha is dedicated to early detection and comprehensive management of kidney disease. Her expertise encompasses chronic kidney disease screening, hypertension-related kidney complications, and diabetic nephropathy prevention. Dr. Narishha’s evidence-based approach combines regular kidney function monitoring, dietary counseling adapted to Malaysian cuisine, and lifestyle modification programs to slow disease progression. Her comprehensive understanding of kidney health risk factors helps patients throughout the Petaling Jaya region maintain optimal renal function through early intervention, appropriate medication management, and proactive health monitoring tailored to individual needs.
The profile now emphasizes Dr. Narishha’s specialization in kidney disease management, highlighting early detection, risk factor management (hypertension and diabetes), and culturally-appropriate dietary counseling while maintaining her preventive medicine foundation.