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One in three American adults are at risk for developing kidney disease, and 26 million people already have it. Many don’t even know it until it’s too late. The symptoms of kidney disease can be hard to catch, and that’s why early diagnosis and treatment is so important. Fatigue, weakness, difficult, painful urination, changes in your urine, increased need to urinate (especially at night), puffy eyes, swollen face, hands, abdomen, ankles, feet and increased thirst can all be signs of kidney problems.