What are the first signs of liver and kidney failure?

September 26, 2025 •

5 min read

According to the Centers for Disease Control and Prevention (CDC), millions of Americans are affected by chronic liver and kidney diseases, and often the earliest signs go unnoticed. Recognizing what are the first signs of liver and kidney failure is crucial for early intervention and better outcomes.

Quick Summary

The early signs of liver and kidney failure can be subtle and overlap, including fatigue, nausea, and loss of appetite, with liver-specific symptoms like jaundice and kidney-specific changes in urination becoming more apparent as conditions progress.

Key Points

Subtle Onset: Both liver and kidney failure can begin with vague, overlapping symptoms like fatigue, nausea, and loss of appetite, making early self-diagnosis difficult.
Key Differences: Jaundice and easy bruising are strong indicators of liver issues, while swelling in the extremities and changes in urination often point toward kidney problems.
Underlying Causes: Risk factors include chronic conditions like diabetes, high blood pressure, and autoimmune diseases, as well as substance use and viral infections.
Importance of Testing: Routine blood and urine tests are the most effective way to detect early organ dysfunction, often before noticeable symptoms appear.
Early Action is Crucial: Prompt medical evaluation upon noticing persistent symptoms is vital for effective treatment and to potentially reverse damage or slow progression.
Prevention is the Best Strategy: Healthy lifestyle habits, including diet, exercise, and managing chronic illnesses, are key to preventing organ failure.

Understanding Liver and Kidney Failure

Your liver and kidneys are vital organs that play interconnected roles in maintaining your health. The liver filters blood from the digestive tract, detoxifies chemicals, and metabolizes drugs, while the kidneys filter waste products from the blood, regulate fluid balance, and produce hormones. When one organ begins to fail, it can place extra strain on the other, potentially leading to a dangerous condition known as hepatorenal syndrome.

Early Signs of Liver Failure

Early liver failure symptoms are often vague and can be mistaken for other, less serious conditions. However, paying close attention can help in early diagnosis.

Fatigue: Persistent and unexplained fatigue is a very common early symptom. The liver’s inability to metabolize toxins efficiently can cause a general feeling of unwellness.
Nausea and Loss of Appetite: Digestive issues, including nausea, vomiting, and a decreased interest in food, often occur. This can lead to unintentional weight loss.
Upper Abdominal Discomfort: Mild pain or a feeling of fullness in the upper right quadrant of the abdomen, where the liver is located, can be a sign of inflammation.
Easy Bruising: The liver produces proteins necessary for blood clotting. When it fails, you may notice that you bruise easily or experience prolonged bleeding.
Skin Changes: Itchy skin (pruritus) without a rash can occur due to a buildup of bile salts. Other signs include spider-like blood vessels (spider angiomas) on the skin and reddened palms.
Digestive Changes: Pale or clay-colored stools and dark-colored urine can indicate that the liver is not processing bile correctly.

Early Symptoms of Kidney Failure

Like liver failure, the initial symptoms of chronic kidney failure can be subtle. Many people don't experience noticeable signs until the disease is quite advanced.

Changes in Urination: A change in the frequency or appearance of urine is a key indicator. This can mean needing to urinate more often, especially at night, or producing less urine than usual. The urine may also be foamy (due to protein) or darker in color.
Swelling (Edema): Failing kidneys cannot remove excess fluid effectively, leading to fluid retention. This causes swelling in the ankles, feet, hands, and face.
Fatigue and Weakness: A drop in kidney function can lead to a buildup of toxins and waste products, causing overall fatigue. Healthy kidneys produce erythropoietin, a hormone that helps make red blood cells, and a lack of this can cause anemia, contributing to exhaustion.
High Blood Pressure: The kidneys help regulate blood pressure. When they malfunction, blood pressure can increase, potentially causing headaches.
Itchy Skin: A buildup of waste products in the blood can lead to dry, itchy skin.
Nausea and Loss of Appetite: Similar to liver issues, a toxic buildup from poor kidney filtration can cause nausea and a general loss of appetite.

The Overlap: Distinguishing between Liver and Kidney Issues

While some symptoms overlap, such as fatigue and nausea, some key differences can help differentiate between liver and kidney problems in their early stages. A medical professional is necessary for proper diagnosis.


Symptom	Primary Indication	Notes
Jaundice (yellow skin/eyes)	Liver Failure	A clear sign of liver dysfunction, stemming from a buildup of bilirubin.
Changes in urination	Kidney Failure	Alterations in frequency, volume, or appearance of urine.
Location of pain	Varies	Liver pain is often in the upper-right abdomen, while kidney pain is typically in the lower back or sides.
Pale/clay-colored stools	Liver Failure	Caused by insufficient bile reaching the digestive system.
High blood pressure	Kidney Failure	Can be a cause or a consequence of chronic kidney disease.
Bruising easily	Liver Failure	Related to the liver's role in producing blood-clotting factors.

Causes of Liver and Kidney Failure

Many different conditions can lead to the decline of liver and kidney function. Common causes include:

Liver Failure Causes

Viral Infections: Chronic hepatitis B and C are major contributors.
Alcohol-Related Liver Disease: Excessive alcohol consumption over time leads to liver damage.
Non-alcoholic Fatty Liver Disease (NAFLD): An accumulation of fat in the liver, often linked to obesity and diabetes.
Autoimmune Diseases: Conditions where the body's immune system attacks healthy liver cells.

Kidney Failure Causes

Diabetes: High blood sugar can damage the blood vessels in the kidneys.
High Blood Pressure (Hypertension): Uncontrolled high blood pressure can damage the small blood vessels in the kidneys.
Glomerulonephritis: Inflammation of the filtering units in the kidneys.
Polycystic Kidney Disease: An inherited disorder that causes fluid-filled cysts to grow in the kidneys.

Diagnosis and Treatment

Diagnosis typically begins with a physical exam and a discussion of symptoms. Doctors will then order blood and urine tests. These may include liver function tests and creatinine/urea tests to check kidney function. Imaging tests like ultrasounds or CT scans can provide a clearer picture of the organs' health. In some cases, a biopsy may be needed to determine the extent of the damage.

Early detection offers the best chance for successful treatment, which can range from lifestyle changes and medication to manage the underlying cause, to more drastic interventions like dialysis or organ transplantation in advanced cases. For instance, in acute liver failure, the cause may be reversible, while in chronic conditions, the focus is on managing the disease and preventing further progression.

Prevention is Key

Protecting your liver and kidneys starts with healthy habits. Maintain a healthy body weight through diet and exercise, limit or avoid alcohol consumption, and control underlying conditions like diabetes and high blood pressure. Additionally, avoiding illicit drug use and practicing safe sex can prevent infectious causes of organ failure. Always take medications as prescribed and discuss any potential side effects with your healthcare provider. For more information on proactive health, you can visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Conclusion: Listen to Your Body

Early signs of liver and kidney failure are often subtle and easily dismissed, making it crucial to be proactive about your health. By understanding the key symptoms and risk factors, you can engage in preventive measures and seek medical attention at the first sign of trouble. Prompt diagnosis and treatment are vital for slowing disease progression and preserving organ function. Never ignore persistent fatigue, digestive changes, or swelling, as these could be your body's early warning signals.

Frequently Asked Questions

The liver and kidneys are functionally linked. Severe liver disease can lead to hepatorenal syndrome, a form of kidney failure. This happens because liver damage alters blood flow and fluid regulation, placing significant stress on the kidneys.

Yes, especially in the early stages of chronic disease. Your body is very resilient and can often compensate for a decline in organ function for a long time. This is why regular health checkups and lab tests are important for early detection.

Acute failure has a sudden and rapid onset and may be reversible with treatment. Chronic failure progresses slowly over months or years, often with permanent damage. Chronic conditions like diabetes and hypertension are common causes of chronic failure.

No, fatigue is a common symptom of many conditions, including simple lack of sleep or nutritional deficiencies. However, when it is persistent, unexplained, and accompanied by other symptoms like nausea, swelling, or changes in urination, it warrants a doctor's visit to investigate further.

Swelling, or edema, can be caused by many factors, including minor issues like standing for too long or dehydration. However, persistent swelling in the feet, ankles, or hands that does not resolve should be evaluated by a healthcare professional, as it can indicate heart, liver, or kidney problems.

Doctors use blood tests to check levels of liver enzymes, bilirubin, creatinine, and blood urea nitrogen (BUN). A urine analysis can check for protein or blood. Imaging tests like ultrasound or CT scans are also used to visualize the organs.

The reversibility of liver failure depends on the cause and severity. Acute liver failure, such as that caused by a drug overdose, can sometimes be reversed. However, once advanced scarring (cirrhosis) has occurred in chronic liver failure, the damage is permanent, and a transplant may be necessary.