What are the early signs of kidney trouble?

Often none, which is why testing matters for anyone with diabetes or hypertension. When signs do appear they can include swelling of the ankles or around the eyes, frothy urine indicating protein, reduced or increased urine frequency particularly at night, fatigue, poor appetite and itching. The two tests that matter are eGFR from a blood creatinine, and urine albumin-to-creatinine ratio, which detects damage far earlier than creatinine alone and is frequently omitted. Annual testing is recommended for anyone with diabetes or hypertension. Avoiding routine painkiller overuse is one of the most controllable risks.