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  According to Stoppler (2010) suggested that effects and
symptoms of chronic kidney disease include need to urinate frequently, especially at night
(nocturia); swelling of the legs and puffiness around the eyes (fluid retention); high blood
pressure; fatigue and weakness (from anemia or accumulation of waste products in the body);
loss of appetite (nausea and vomiting); itching, easy bruising, and pale skin (from anemia);
shortness of breath from fluid accumulation in the lungs; headaches, numbness in the feet or
hands (peripheral neuropathy), disturbed sleep, altered mental status (encephalopathy from the
accumulation of waste products or uremic poisons), and restless legs syndrome; chest pain due
to pericarditis (inflammation around the heart); bleeding (due to poor blood clotting); bone pain
and fractures; and decreased sexual interest and erectile dysfunction.

In addition, Patel (2009) discussed the early symptoms of chronic kidney disease often
occur with other illnesses, as well. These symptoms may be the only signs of kidney disease until
the condition is more advanced. Symptoms may include: general ill feeling and fatigue,
generalized itching (pruritus) and dry skin, headaches, weight loss without trying to lose weight,
appetite loss and nausea. Other symptoms that may develop, especially when kidney function has
worsened: abnormally dark or light skin, bone pain, brain and nervous system symptoms
(drowsiness and confusion, problems concentrating or thinking, numbness in the hands, feet, or
other areas, and muscle twitching or cramps), breath odor, easy bruising, bleeding, or blood in
the stool, excessive thirst, frequent hiccups, low level of sexual interest and impotence,
menstrual periods stop (amenorrhea), sleep problems, such as insomnia, restless leg syndrome,
and obstructive sleep apnea, swelling of the feet and hands (edema), and vomiting typically in
the morning.

On the other hand, Roberts (2008) that sometimes, kidney disease causes symptoms
(swelling, sleeplessness, tiredness, vomiting, itchiness, darkened skin, muscle cramps, and
weakness). But often, people have no symptoms until their kidney disease is advanced. That¶s
why regular kidney screening is so important for all people with diabetes. The American
Diabetes Association recommends three tests to screen for kidney disease. First is the High
Blood Pressure which can be a sign of kidney damage as well as a cause of it, other than this,
there is an elevated amounts of albumin in the urine via Urine Albumin test that causes damage
to kidneys due to protein leakage in urine which albumin is mainly present and a low GFR
(Glomerular Filtration Rate) through eFGR test.

The above remarks justified the Signs and Symptoms that is mainly assigned to those
patients having Chronic Kidney Disease. And since kidneys perform so many functions for the
body, kidney disease can affect the body in a large number of different ways, hence briefing and
by understanding the indications of this disease should convince us, or more preferably the
people experiencing those. And eventually decide that it is necessary for them to visit a doctor as
soon as they suspect themselves or any person that they were concerned of in having this kind of
disease.
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 According to study conducted by Bad-ang (2010), she said that the Department of Health
and medical societies are "focused on getting the public's attention on prevention." "There are no
particular vitamins that can prevent kidney failure. If you take too much vitamins it could cause
formations of stones. What do we need to do is to avoid sodium or salty food. The good thing
about renal failure is it can be prevented just drink adequate water and most preferably the
distilled one," Bad-ang said. "Taking care of your kidneys would directly improve the other parts
of your body. It's a matter of controlling your food intake especially on those that have sodium,"
she added.

In addition, in the study conducted by Choudhury et al (2008) mentioned that the

complex care that must be provided for patients with renal disease might interfere with provision
of basic preventive measures in this population. Preventive health care, including infection
screening and prophylaxis, vaccinations, management of blood glucose and lipid levels, and
cancer screening, is important, as it might decrease acute morbidity and mortality. This Review
highlights useful preventive and health maintenance strategies for patients with chronic kidney
disease and those with end-stage renal disease.

Moreover, in the study made by Anandarajah ‘

(2005), although 5% of the population

had stages 3 to 5 CKD, only a small proportion (8%) of these individuals had received a renal
diagnosis or had been seen by a renal physician. Earlier identification of CKD in primary care,
better management of cardiovascular risk, and the avoidance of medication that impairs renal
function and specialist referral where appropriate may improve long-term outcomes. However,
our understanding of this disease, its risk factors, and its impact on the public health system is
incomplete, and no large epidemiologic studies have been performed in Europe.

The aforementioned studies explained the preventive measures that is merely prevalent in
the Philippines, Europe and United States. It also focused in the prevention of the disease rather
than the treatment. Prevention of CKD and its associated complications needs a clear
understanding of the prevalence and outcome of renal disorders, the earlier stages of renal
disease, the risk factors, and the appropriate treatment of populations at risk. And I think, Future
studies should focus on the prevalence and outcome of CKD and on the pathology of the
interaction between the kidney and cardiovascular system to prevent the progression of renal
dysfunction, which should have a beneficial effect in reducing the risk and prevalence of
cardiovascular disease.
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 According to study conducted by Bad-ang (2010), Signs and symptoms of a kidney

failure include: Fluid Retention: As the kidney loses its ability to regulate the amount of fluid
and salt in the body, you may notice swelling in the feet and legs, fingers, or around the eyes.
Initially treatment usually involves restricting fluid and limiting salt intake. You may also begin
taking fluid pills (diuretics); Hypertension: High blood pressure can be a cause of kidney disease,
and kidney disease can cause high blood pressure. Treatment is with salt restriction, weight
reduction if necessary, and sometimes a combination of fluid pills and high blood pressure
medications; Fatigue: As the kidney loses its ability to remove toxins from the body, they will
accumulate and cause symptoms including fatigue, itching, insomnia, irritability, loss of appetite,
nausea, and vomiting. Usually more of these symptoms appear as kidney failure worsens, with
people experiencing only mild or moderate kidney impairment having few or none of these
symptoms. Initially, treatment will be with diet changes, specific medications to treat specific
symptoms, and eventually dialysis and kidney transplantation; Anemia: Anemia is common in
patients with kidney disease and generally is caused by the inability of the failing kidneys to
make the hormone erythropoietin, which stimulates the bone marrow to make red blood cells.
Symptoms of anemia include weakness and lack of stamina. Erythropoietin has now been
genetically engineered, and is now available in drug form to combat the anemia caused by
chronic kidney disease and lastly; Bone Disease: Failure of the kidney to produce vitamin D an
lead to bone softening, and eventually bone pain and muscle weakness. Oral and IV forms of
vitamin D are available and can be given to slow the development of such problems.

In addition, the work of Zongpei (2009) contended the following clinical manifestation of
chronic renal failure. He includes: fluid, electrolyte and acid base disorders; bone disease and
disorders of calcium and phosphate metabolism; cardiovascular abnormalities; hematologic and
neuromuscular abnormalities; gastrointestinal and nutritional abnormalities; and last endocrine
metabolic disturbances.

Furthermore, Kidney problems are also seen among children as well. This is seen by the
study conducted by the Department of Health (DOH) and National Kidney Transplant Institute
(NKTI). The results of their study points out to the fact that majority of the children suffer from
urinary tract infection in their adolescent life. When the function of the kidney is compromised
then it results in a variety of symptoms, particularly swelling of the hands and feet, frequent
thirst, increased fatigue and sleepiness, decrease in appetite, poor growth, the passing of very
small amounts of urine, unpleasant taste in the mouth and urine-like odor to the breath, pale skin,
excessively dry, persistently itchy skin, shortness of breath, and a frequent urge to urinate. (2006)

The above-mentioned studies are concern to the related symptoms of patients having
Chronic Kidney Disease in the Philippines and China. These studies are related to know if
there¶s a problem that prevents the kidneys from functioning efficiently that is not yet identified
and other aspects of a person health that can be affected. Knowing the symptoms of kidney
disease can help people to seek treatment early and can prevent kidney disease progressing to
kidney failure.
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      According to Nicholas (2010), early screening, along with

prevention, can be a lifesaver. About 25 percent of people who are screened show signs of
possible kidney damage; if it's caught early, many will never face the ordeal of costly dialysis
and the nightmare of waiting for a transplant. Its MIKE program (Minority Intervention and
Kidney Education) provides free medical testing, including checks for kidney function,
cholesterol levels, blood pressure, blood sugar, and other important health measures. Screenings
take place at various locations around the city from March through November. Over the last ten
years the number of people living with kidney disease has increased by 25 percent. It's a silent
condition at first, but you don't have to become a kidney-failure statistic² take steps to break
free of the cycle by taking responsibility for your health and wellbeing.

In addition, Cruz (2006), early detection prevents chronic disease conditions and can be
treated with medications, lifestyle changes. By this way one can avoid the development of heart
disease.

In addition, Gonzales (2004) affirmed that kidney disease could be prevented but to a
certain extent. Through simple test that detect the disease very early. These tests include blood
pressure determination, urinalysis which should include tests for proteins, and certain blood tests.
Everybody will benefit from regularly undergoing these tests. They are a must for those who are
at risk of developing chronic kidney disease people who have diabetes mellitus, high blood
pressure and those with a family history of chronic kidney disease. f chronic kidney disease is
detected in its early stage, lifestyle changes (e.g., dietary modification and exercise) and
appropriate medications can delay or prevent the progression of the disease and stop its
complications from developing.

The above articles said that screening, early detection and lifestyle change are general
key to prevent the detection or occurrence of kidney disease. Prevention is possible, and early
detection and management can delay the disease¶s progression. Help enhance patients¶ length
and quality of life. Teach them and test them to help keep their kidneys safe.
 *

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http://www.sunstar.com.ph/davao/kidney-failure-one-top-causes-death

Stoppler, Melissa Conrad.      . emedicinehealth. Experts for everyday
emergencies www. emedicinehealth.com: February 23, 2010.

Parul Patel, MD.    . Medline Plus. Date Issued: September 12, 2009

Roberts, Shauna S. 

  !   . Diabetes Basics p.28, March 2008.

Dr. Theresa Bad-and. Philippines:   "
    "    "  . Date: July 09,
2010

Dr. Dinna Cruz.         
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 . Date issued: March 08,2006

Dr. Eduardo G. Gonzales. $ %
  Manila Bulletin Date Issued: June 21, 2004.

Jiang Zongpei. Related Studies about  c 
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Anandarajah ‘

(2005).  
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pubished: March 31-April 06, 2010. www.kidneyfund.org