Eyes May Reveal Kidney Trouble — Don’t Miss These Warning Signs

{By: Dr. Ayan Dey} 

“The eyes are the windows to your soul.” This poignant phrase remains a testament to the importance given to our eyes since ancient times, both philosophically and metaphorically. In the medical context, as Nephrologists, we find more and more evidence of the truth behind this statement.

Many people are surprised to learn that the eyes and the kidneys are connected in some way. Understanding this connection helps doctors in myriad ways to make early diagnosis and better outcomes. Examination of the eyes form an important aspect of training of medical students, the knowledge of which they carry throughout their lifetime in their medical practice.

Both the eyes and the kidneys are highly vascular organs, depending on a rich network of tiny blood vessels for their functions. This makes them susceptible to damage over the long term due to systemic diseases like high blood pressure and diabetes mellitus.

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The Shared Pathway

While a comprehensive discussion of the symptoms, signs and findings of the eyes remain beyond the scope of this discussion, it is worthwhile examining a few important connections.

Retina is the light sensitive layer at the back of the eyes, enriched with blood vessels, thereby remaining vulnerable to systemic diseases. In Diabetes, persistently high blood sugar damages blood vessels throughout the body. In the eyes, this leads to diabetic retinopathy while in the kidneys, it results in diabetic nephropathy. Presence of diabetic retinopathy is a key finding aiding Nephrologists to gauge the effect of Diabetes on the kidneys.

Similarly, uncontrolled high blood pressure causes hypertensive retinopathy and hypertensive nephrosclerosis — medical terms describing damage to the eye and kidney vessels, respectively.

Some genetic and hereditary disorders also share a common link between the eyes and the kidneys. In young patients presenting with kidney disease, eye findings are actively searched to find such links.

Changes in the retina mirror changes in kidney function. In fact, ophthalmologists can sometimes detect kidney disease by observing abnormalities during a routine eye exam, such as microaneurysms, hemorrhages, or swelling in the retina. Conversely, as Nephrologists, we often request an eye checkup in patients with kidney disease to assess the extent of systemic vascular damage.

Symptoms Which Should Not Be ignored

The danger lies in the silent progression of these diseases. Kidney damage often occurs without pain or any other symptoms, and vision changes can be subtle at first. However, certain symptoms should not be ignored:

  • Swelling around the eyes, especially in the morning
  • Blurred vision or sudden vision loss
  • Seeing floaters or flashes of light
  • Concurrent foamy urine or reduced urine output
  • Persistent fatigue or puffiness of the eyes, face and legs

If you have diabetes or hypertension, these signs should prompt an immediate consultation with both an eye specialist and a kidney doctor. Early detection remains key.

Prevention and Early Action

The good news is that kidney and eye damage can be delayed or prevented with regular monitoring and good control of risk factors. Keeping the blood pressure below 130/80 mmHg and HbA1c under control if diabetic, go a long way in preventing the long term damage to these organs. Annual eye exams and urine tests for protein are essential, these can pick up early signs of damage before symptoms appear.

Additionally, smoking cessation, maintaining a healthy weight, staying hydrated, and avoiding over-the-counter painkillers like NSAIDs, which can further harm the kidneys, remain essential.

Paying close attention to visual symptoms and seeking regular checkups, especially in people with risk factors like diabetes or high blood pressure; will go a long way in not only protecting the eye-sight but also the kidney function.

If in doubt, patients should consult a nephrologist or an ophthalmologist. In the world of chronic disease, what you don’t see can still hurt you, but what you do see might just save your life.

The author, Dr. Ayan Dey, is Consultant, Nephrologist and Transplant Physician, at P. D. Hinduja Hospital & Medical Research Centre, Mahim.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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