Many, upon noticing early morning puffy eyes, brush them under the carpet, attributing them to late nights or a poor sleeping position. But as you continue to do this, are you ignoring any serious health issues?
We asked Dr Hardik Patel, consultant- nephrology and transplant nephrology at Manipal Hospital, Goa, who, with his medical perspective, evaluated why a morning puffy face may occur. From his medical perspective, he said it could indicate an issue with the kidneys. This highlights how certain ailments can show up through non-typical symptoms, making it easy to misinterpret or overlook, both of which are harmful.
Alarmingly, the nephrologist called facial swelling one of the earliest cues.
Why is ‘eye swelling’ the earliest cue of a kidney issue?
First, let’s understand the basics of the kidneys, a critical organ essential for many major physiological functions.
Dr Patel outlined the functions: “Every day they filter nearly 180 litres of blood, removing waste, balancing salt and water levels, and keeping our body’s internal chemistry stable, along with regulating blood pressure and maintaining the fluid balance in the body.”
It can be observed that many essential functions depend on the kidneys, including some related to other systems, such as the cardiovascular system. This only reiterates how the body is one large interconnected system, with major physiological functions overlapping in multiple ways.
This is why symptoms are often overlooked, as people expect changes in urination to be the first sign of a kidney problem, but this is not always the case.
Now that the kidney functioning is clear, the urologist explained why the face swelling happens, “One of the earliest clues can be swelling around the eyes, especially in the morning. We call this periorbital puffiness, and it can occur when the kidneys start leaking protein into the urine.”
Then the urologist named a particular protein which gets affected when the kidneys are damaged. He continued, “An important protein called albumin helps keep fluid inside the blood vessels. When the kidney’s tiny filtering units become damaged, albumin escapes into the urine. With less protein holding fluid in the circulation, water begins to seep into surrounding tissues.”
The natural sleeping position can exacerbate the problem. As Dr Patel explained, when you lie flat during sleep, fluid in the body settles in soft tissues, especially around the eyes. But why does it improve later in the day? He answered, “The swelling is usually most noticeable first thing in the morning and tends to improve as the day progresses and gravity redistributes fluid to the legs or feet.”
What other issues can it mean?
Besides kidney issues, the urologist named several other causes as well, like lack of sleep, allergies, dehydration, or a salty meal, all of which can cause temporary swelling.
When can puffy eyes be an actual problem?
The worry rises if it stays persistent. If it appears alongside other symptoms, it can strongly suggest a kidney issue. Dr Patel listed the following:
- Foamy urine
- Ankle swelling
- Fatigue
- Rising blood pressure
Who is at risk?
The urologist urged these groups to be careful: people living with diabetes, high blood pressure, or a family history of kidney disease. They are more likely to have puffy eyes because of kidney-related problems.
Dr Patel then named these two detection tests that can quickly reveal what’s wrong with the kidneys: urine examination and a blood creatinine test.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.


