A young man's prolonged struggle with kidney disease, initially dismissed by doctors because of his age, underscores the challenges in diagnosing the condition and the importance of recognizing subtle symptoms. Callum Renton, 25, experienced a year of unexplained back pain, persistent urinary tract infections (UTIs), and constant fatigue before receiving an accurate diagnosis of IgA nephropathy, a form of chronic kidney disease (CKD).
Callum initially attributed his throbbing back pain to muscle strain from his desk job. However, the pain intensified, and he developed symptoms such as frequent urination, bubbly urine, and significant fatigue. When he raised concerns about his kidneys with his GP, he was told he was "too young" for such an illness and was sent home with antibiotics for the UTIs. This pattern of dismissal and repeated UTIs continued for ten months.
"The problem with kidney disease is that often symptoms are not there or very mild," said Professor Simon Davies, an honorary consultant nephrologist and trustee of Kidney Research UK. Early signs like itching and frothy urine, which indicate protein leakage due to impaired kidney filtration, can be easily missed. Other potential indicators, such as tiredness or fluid retention visible in the ankles and around the eyes, can be mistaken for other common ailments.
Recurrent UTIs and associated back pain can also be symptoms of kidney issues, but these too have multiple potential causes. When overlooked or misdiagnosed, CKD can progress, leading to kidney scarring and loss of function over time. In severe cases, the kidneys can fail, requiring dialysis or a transplant to survive.
Despite the potential for early detection through simple blood and urine tests, such as measuring creatinine levels to calculate the estimated glomerular filtration rate (eGFR) or a urine albumin creatinine ratio (UACR) test for protein, these are often not administered if a patient is not perceived to be at risk. Research suggests that between 30% and 50% of CKD cases in high-income countries go undiagnosed in their early stages.
Callum's case eventually led to a referral to a renal unit after he insisted on seeing a specialist. A kidney biopsy in August 2022, 18 months after his symptoms began, confirmed IgA nephropathy. The autoimmune condition causes antibodies to attack the kidney filters gradually. By this point, Callum's condition had worsened significantly, leading to weight loss, morning fatigue, and vomiting after eating. His kidney function declined rapidly, necessitating dialysis three times a week for four-and-a-half hours per session.
"Dialysis meant spending three days a week in hospital for four-and-a-half hours each session and completely changed my day-to-day life," Callum stated. He had to leave his banking job and is now on a waiting list for a kidney transplant, as no family members are a suitable match. The average kidney transplant lasts about 20 years, often requiring multiple transplants throughout a person's life.
Professor Davies noted that common causes of kidney disease include diabetes and high blood pressure, which can damage kidney filters and blood vessels. Other factors include aging, genetics, and lifestyle. In younger individuals, congenital abnormalities of the kidney and bladder can also play a role, hindering proper bladder emptying and leading to infections that can spread to the kidneys. Kidney Research UK is advocating for government support to prioritize prevention and early diagnosis of kidney disease within the National Health Service, including an increase in routine blood and urine tests.
Callum hopes his story will encourage others experiencing similar symptoms to seek thorough medical investigation, emphasizing that age should not be a barrier to proper diagnosis. "I’m sharing my story so that anyone else with these symptoms receives the support, investigations and diagnosis they need as early as possible."