What You Can Do

"The more informed I was, the better I felt about it. I felt I had some control." - CKD patient

Most chronic kidney disease (CKD) is not curable. The good news is that if your doctor finds out that you have a kidney problem, there may be a number of ways to help slow down the disease, help you feel better, and help you make better medical decisions. What can you do?

1. Know Your Lab Tests — know the names of the lab tests your doctor orders and what the results mean. Kidney disease is often diagnosed, and always monitored, by measuring levels of substances in the blood or urine. Knowing—and tracking—your lab tests is an important way for you to be involved in your care. Normal lab test ranges vary slightly from one laboratory to another. When you get your results, be sure to ask what the laboratory's normal range is. Common lab test values can be found here.
   • Measures of kidney function
   • Measures of anemia
   • Measures of diabetes control
   • Measures of nutrition
2. Control Your Blood Pressure — keep your blood pressure below 130/85 (adults) with weight loss and exercise, a low sodium/low fat diet, reducing stress, and taking your blood pressure medication correctly. For some patients, the target blood pressure is lower (125/75). Controlling high blood pressure may delay the progression of kidney disease by slowing damage to the kidneys.
3. Ask Your Doctor About Certain Medications That May Help Treat Kidney Disease — ACE (angiotensin converting enzyme) inhibitors are a class of blood pressure medicines that can protect kidney function in some cases (generic names include ramipril, captopril, and enalapril). In some people, ACE inhibitors cause a persistent cough, which stops when the drug is discontinued. This is not a serious side effect of the drug. ARBs (angiotensin receptor blockers) may sometimes be used along with or instead of ACE inhibitors. Calcium channel blockers and beta blockers are other drugs that may help to control blood pressure and protect kidney function.
4. Ask Your Doctor About Anemia — Anemia—a shortage of red blood cells—starts very early in kidney failure. Anemia can cause you to feel tired and worn out, and can damage your heart. Heart disease is the leading cause of death in people with kidney problems. Ask your doctor about medications such as epoetin (EPO) and iron to treat anemia.
5. Ask Your Doctor About a Low Protein Diet — some doctors believe a diet lower in some proteins can help slow kidney disease. Ask your doctor to refer you to a dietitian who specializes in treating those with chronic kidney disease. A dietitian can help you learn how to keep your kidneys healthy longer by eating the right foods. It is important not to adjust your protein intake until you have discussed this with your doctor or dietitian.
6. Control Your Blood Sugar Levels — if you have diabetes, stay at a healthy weight, exercise, and take medications as prescribed to keep your blood glucose in the "normal" range. Tight control of blood sugar can help slow the progression of kidney disease. Your HbA1c levels, which measure your blood sugar control over a period of 3 months, should be less than 6.5%.
7. Quit Smoking — in people with kidney disease, smoking is linked to an increase in the amount of protein spilled in the urine. In smokers with diabetes, kidney disease may progress twice as fast. Scientists are not sure why this is the case, but if you have kidney disease and you smoke, quitting may help slow down the damage.
8. Avoid Certain Pain Medications — ask your doctor or healthcare specialist about certain pain medications. Some over-the-counter pain pills containing ibuprofen, naproxen, and ketoprofen (e.g., Motrin® and Advil® and Aleve®) can affect kidney function. This is especially true if you have kidney, heart, or liver disease or take diuretics (water pills). Avoid using combinations of these pain medications and caffeine because these combinations can further damage your kidneys.
9. Exercise — with your doctor's permission, start a regular exercise program to control weight and keep your heart healthy and blood vessels working as well as possible. It is very important to keep your muscles and joints in good working order. Although written for people on dialysis, Exercise: A Guide for People on Dialysis has useful information to help anyone with a chronic illness increase physical activity.