Ckd what to do?

Taking an active role in managing your chronic kidney disease (CKD) can improve your overall well-being. Learn what you can do to feel your best.

Kidneys that work properly are critical to keeping you healthy. If you have CKD, your kidneys can’t filter blood as well as they should, and this can lead to other health problems, such as heart disease and stroke.

While it’s not possible to reverse kidney damage, you can take steps to slow it down. Taking prescribed medicine, being physically active, and eating well will help. You’ll also feel better and improve your overall well-being.

Taking care of your health will keep you feeling your best. Here are some tips that can help you manage your CKD and stay healthy.

Some medicines are designed to prevent serious problems in the future. It’s very important that you take any prescribed medicine, even if you feel well.

Check with your care team if you plan to take any painkillers or nutritional supplements. These can sometimes affect your kidneys or interfere with your medicine. If you have concerns or side effects with medicine you’re taking, talk to your care team.

Physical activity is good for anyone with kidney disease, whether you have mild, moderate, or severe CKD. It can boost your energy, help you sleep, strengthen your bones, and help prevent depression. It may also reduce your risk of problems such as heart disease.

If you have mild to moderate CKDexternal icon, you should be able to do physical activity as often as someone the same age as you with healthy kidneys. If you have later-stage (or severe) CKD, you may become tired more quickly. Speak with your doctor about which physical activity is right for you.

A few other things you can do to help manage your CKD:

A healthy, balanced diet can help improve your general health and reduce your risk of developing further problems.

While you should limit salt, your food doesn’t have to be bland! Get creative with herbs, spices, mustard, and flavored vinegars in your favorite recipes. Cooking food at home instead of eating out at restaurants will also help reduce your salt intake.

If you have diabetes and CKD, finding the best foods to eat can be challenging. Don’t be overwhelmed with a list of “can’t.” There are still plenty of foods you can enjoy. Some foods that work for both diabetes and CKD include:

CKD is when your kidneys are damaged and lose their ability to filter waste and fluid out of your blood. Waste can build up in your body and harm your health. Kidney failure or end-stage renal disease (ESRD) is when your kidneys have stopped working well enough for you to survive without dialysis or a kidney transplant.

Damage to your kidneys cannot be reversed. But if doctors find CKD early, there are ways you can keep the damage from getting worse, such as following a kidney-friendly eating plan, being active and taking certain medicines.

In the U.S., 37 million people have CKD. That is more than 1 in 7 adults.

The two most common causes of CKD are diabetes and high blood pressure. Diabetes means that your blood sugar is too high, which can damage your kidneys. High blood pressure means that the force of blood in your blood vessels is too strong, which can damage your blood vessels and lead to CKD.

There are other kidney problems that can lead to CKD, such as:

Anyone can get CKD, but some people have a higher chance, such as people who:

Talk to your doctor about getting tested if you have any of these risk factors for CKD.

In the early stages of kidney disease, you may not have any symptoms. Over time, your kidneys do not work as well to filter waste and fluid out of your blood. In the later stages of kidney disease, you may notice symptoms, such as:

Talk to your doctor if you notice any of these symptoms.

Your kidneys help your whole body work properly. When you have CKD and your kidneys are not working as well as they should, it can cause other health problems, such as:

The sooner you know you have kidney disease, the better. The steps you take to protect your kidneys from damage also may help prevent heart disease—and improve your health overall. Making these changes when you have no symptoms may be hard, but it’s worthwhile.

The most important step you can take to treat kidney disease is to control your blood pressure. High blood pressure can damage your kidneys. You can protect your kidneys by keeping your blood pressure at or less than the goal set by your health care provider. For most people, the blood pressure goal is less than 140/90 mm Hg.

Work with your health care provider to develop a plan to meet your blood pressure goals. Steps you can take to meet your blood pressure goals may include eating heart-healthy and low-sodium meals, quitting smoking, being active, getting enough sleep, and taking your medicines as prescribed.

To reach your blood glucose goal, check your blood glucose level regularly. Use the results to guide decisions about food, physical activity, and medicines. Ask your health care provider how often you should check your blood glucose level.

Your health care provider will also test your A1C. The A1C is a blood test that measures your average blood glucose level over the past 3 months. This test is different from the blood glucose checks you do regularly. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. Stay close to your daily blood glucose numbers to help you meet your A1C goal.

The A1C goal for many people with diabetes is below 7 percent. Ask your health care provider what your goal should be. Reaching your goal numbers will help you protect your kidneys. Learn more about how to manage diabetes.

The tests that health care providers use to test for kidney disease can also be used to track changes to kidney function and damage. Kidney disease tends to get worse over time. Each time you get checked, ask your provider how the test results compare to the last results. Your goals will be to

Your health care provider will also check your blood pressure and, if you have diabetes, your A1C level, to make sure you are meeting your blood pressure and blood glucose goals.

Bring this document to your appointment to help keep track of your kidney test results (PDF, 262 KB) .

The more you plan for your visits, the more you will be able to learn about your health and treatment options.

Make a list of questions It’s normal to have a lot of questions. Write down your questions as you think of them so that you can remember everything you want to ask when you see your health care provider. You may want to ask about what tests are being done, what test results mean, or the changes you need to make to your diet and medicines.

About your tests

About treatment and self-care

About complications

Bring a friend or relative with you for support A trusted friend or family member can take notes, ask questions you may not have thought of, offer support, and help remember what the provider said during the visit. Talk ahead of time about what you want to get out of the visit and the role you would like your friend or relative to play.

The following health care providers may be part of the health care team involved in your treatment:

Primary care provider. Your primary care provider (PCP)—doctor, nurse practitioner, or physician assistant—is the person you see for routine medical visits. Your PCP may monitor your kidney health and help you manage your diabetes and high blood pressure. A PCP also prescribes medicines and may refer you to specialists.

Nurse. A nurse may help with your treatment and teach you about monitoring and treating kidney disease, as well as managing your health conditions. Some nurses specialize in kidney disease.

Registered dietitian. A registered dietitian is a food and nutrition expert who helps people create a healthy eating plan when they have a health condition such as kidney disease. Dietitians can help you by creating an eating plan based on how your kidneys are doing. “Renal dietitians” often work in dialysis centers and are specially trained to work with people with kidney failure.

Diabetes educator. A diabetes educator teaches people with diabetes how to manage their disease and handle diabetes-related problems.

Pharmacist. A pharmacist educates you about your medicines and fills your prescriptions. An important job for the pharmacist is to review all of your medicines, including over-the-counter (OTC) medicines, and supplements, to avoid unsafe combinations and side effects.

Social worker. When you are close to needing dialysis, you may have a chance to meet with a social worker. A dialysis social worker helps people and their families deal with the life changes and costs that come with having kidney disease and kidney failure. A dialysis social worker also can help people with kidney failure apply for help to cover treatment costs.

Nephrologist. A nephrologist is a doctor who is a kidney specialist. Your PCP may refer you to a nephrologist if you have a complicated case of kidney disease, your kidney disease is quickly getting worse, or your kidney disease is advanced.

Many people with CKD take medicines prescribed to lower blood pressure, control blood glucose, and lower cholesterol.

Two types of blood pressure medicines, ACE inhibitors and ARBs, may slow kidney disease and delay kidney failure, even in people who don’t have high blood pressure. The names of these medicines end in –pril or –sartan.

Many people need to take two or more medicines for their blood pressure. You may also need to take a diuretic, sometimes called a water pill. The aim is to meet your blood pressure goal. These medicines may work better if you limit your salt intake.

Your health care provider may change your medicines as your kidney disease gets worse. Your kidneys don’t filter as well as they did in the past, and this can cause an unsafe buildup of medicines in your blood. Some medicines can also harm your kidneys. As a result, your provider may tell you to

Your pharmacist and health care provider need to know about all the medicines you take, including OTC medicines, vitamins, and supplements.

If you take OTC or prescription medicines for headaches, pain, fever, or colds, you may be taking nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include commonly used pain relievers and cold medicines that can damage your kidneys and lead to acute kidney injury, especially in those with kidney disease, diabetes, and high blood pressure.

Ibuprofen and naproxen are NSAIDs. NSAIDs are sold under many different brand names, so ask your pharmacist or health care provider if the medicines you take are safe to use.

You also can look for NSAIDs on Drug Facts labels like the one below:

Watch a video explaining how NSAIDs can harm your kidneys.

If you have been taking NSAIDs regularly to control chronic pain, you may want to ask your health care provider about other ways to treat pain, such as meditation or other relaxation techniques. You can read more about pain management at the NIH National Center for Complementary and Integrative Health website.

The next time you pick up a prescription or buy an OTC medicine or supplement, ask your pharmacist how the product may

Fill your prescriptions at only one pharmacy or pharmacy chain so your pharmacist can

Keep track of your medicines and supplements:

What you eat and drink can help you

As your kidney disease gets worse, you may need to make more changes to what you eat and drink.

A dietitian who knows about kidney disease can work with you to create a meal plan that includes foods that are healthy for you and that you enjoy eating. Cooking and preparing your food from scratch can help you eat healthier.

Nutrition counseling from a registered dietitian to help meet your medical or health goals is called medical nutrition therapy (MNT). If you have diabetes or kidney disease and a referral from your primary care provider, your health insurance may cover MNT. If you qualify for Medicare, MNT is covered.

Your health care provider may be able to refer you to a dietitian. You can also find a registered dietitian online through the Academy of Nutrition and Dietetics. Work closely with your dietitian to learn to eat right for CKD.

Be active for 30 minutes or more on most days. Physical activity can help you reduce stress, manage your weight, and achieve your blood pressure and blood glucose goals. If you are not active now, ask your health care provider about the types and amounts of physical activity that are right for you.

View physical activity and weight-management resources to help you get and stay motivated.

Being overweight makes your kidneys work harder and may damage your kidneys. The NIH Body Weight Planner is an online tool to help you tailor your calorie and physical activity plans to achieve and stay at a healthy weight.

Aim for 7 to 8 hours of sleep each night. Getting enough sleep is important to your overall physical and mental health and can help you meet your blood pressure and blood glucose goals. You can take steps to improve your sleep habits.

Cigarette smoking can make kidney damage worse. Quitting smoking may help you meet your blood pressure goals, which is good for your kidneys, and can lower your chances of having a heart attack or stroke. For tips on quitting, go to Smokefree.gov.

Long-term stress can raise your blood pressure and your blood glucose and lead to depression. Some of the steps that you are taking to manage your kidney disease are also healthy ways to cope with stress. For example, physical activity and sleep help reduce stress. Listening to your favorite music, focusing on something calm or peaceful, or meditating may also help you. Learn more about healthy ways to cope with stress.

People with kidney disease may need to control these important nutrients: sodium, potassium and phosphorus. Please discuss your specific and individual diet needs with your healthcare provider or the registered dietitian at your dialysis center. Here are some tips to follow for a renal diet.

Sodium is a mineral found in salt (sodium chloride). It’s widely used to prepare foods.

Salt is one of the most commonly used seasonings. It’ll take time for you to get used to reducing the salt in your diet. However, reducing salt/sodium is an important tool in controlling your kidney disease.

Here are some suggestions.

Potassium is a mineral involved in how muscles work. When your kidneys don’t work properly, potassium builds up in your blood. This can cause changes in how your heart beats and possibly even lead to a heart attack.

Potassium is found mainly in fruits and vegetables, as well as milk and meats. You’ll need to avoid certain fruits and vegetables and limit the amount of others.

These include:

You should also avoid:

Canned fruits usually have lower amounts of potassium than fresh ones. Be sure to pour off the juice before you eat the fruit.

Potatoes and sweet potatoes need special handling to allow you to eat them in small amounts. Peel them, cut them into small slices or cubes and soak them for several hours in a large amount of water.

When you're ready to cook them, pour the soaking water off and use a large amount of water in the pan. Drain this water before you prepare them to eat.

Phosphorus is another mineral that can build up in your blood when your kidneys don’t work properly. When this happens, calcium can be pulled from your bones and can collect in your skin or blood vessels. Bone disease can then become a problem, making you more likely to have a bone break.

Dairy foods are the major source of phosphorus in the diet, so limit milk to 1 cup per day. If you use yogurt or cheese instead of liquid milk, have only one container of yogurt or 1.5 ounces of cheese per day.

Some vegetables also contain phosphorus. Limit these to 1 cup per week:

Certain cereals should be limited to 1 serving per week. These are:

White or Italian bread and low-salt crackers made with white flour have less phosphorus than whole-grain bread and crackers.

Soft drinks contain phosphorus, so only drink clear ones. Don’t drink Mountain Dew® (any kind), colas, root beers, Dr.Pepper® (any kind). Also, avoid Hawaiian Punch®, Fruitworks®, Cool® iced tea, and Aquafina® tangerine pineapple.

• Quit smoking or don't start.
• Limit how much alcohol you drink.
• Keep your blood pressure below 140/90 mm Hg (or the target set by your doctor).
• If you have diabetes, stay in your target blood sugar range as much as possible.
• During flu season, get your flu shot.