Answer: Taking care of one’s kidneys is very important. The good news is the kidney can compensate when partial damage occurs. The bad news is you can have kidney damage or worsening kidney function and not know it. For that reason, it is important for persons with even mild chronic kidney disease (CKD) to have their kidney function checked every six months or so (3-12 months). Your health care provider will determine how frequently you need to be checked.

Make Time to Visit Your Health Care Provider

The doctor, nurse and dietitian can give you advice, but in the end it comes down to you to do what is needed. First, make sure to stick to your schedule for seeing your health care provider and taking your medicine. Make sure your health care provider is checking the status of your kidneys and is checking to adjust or change your medicine if necessary.

Taking care of your kidneys includes having your health care provider monitor your estimated glomerular filtration rate (eGFR). The eGFR is calculated from your blood creatinine level (you only need a simple blood test), age, gender and race. The eGFR and amount of protein in your urine are important to have checked regularly. This can be determined with a urine sample taken any time of the day. It is no longer necessary to have an early morning urine or 24-hour urine collection, except in special situations.

It is also important to remember that many medicines are filtered and removed from the body by the kidneys. Depending on how well the kidneys are working, the dose of many medicines may need to be adjusted. Keep a record of all your medicine, including non-prescription medicine. Bring the list to your health care provider and remind them to adjust or change your medicine because you have CKD.

Be Proactive

Another thing you can do is drink plenty of water. This helps lower the chance of kidney stones and kidney infections. Risk factors for CKD, such as hypertension and/or diabetes, are more common than ever. If you have either condition, make sure it is under good control. Ideally, blood pressure should be below 130/80 mmHg and the HbA1c below 7 percent. Several blood pressure medications do more than lower blood pressure, such as angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). They help lower the amount of protein in the urine and protect the kidneys. If you have high blood pressure and CKD you should be taking one of these unless your doctor indicates otherwise.

Get Help for Your Diet

The diet is important for people with CKD. Make sure to get an appointment with a renal dietitian or nutritionist – they can review your case. Your diet will depend on how well your kidneys are working and other medical conditions you may have. Usually, you will be placed on a low sodium, low protein diet. The sodium may be limited to about 2 grams per day. The protein will be limited to about 0.8-1.0 grams of protein for each kg (2.2 lbs) of body weight, or about 40 grams of protein for every 100 lbs you weigh. If your kidney function gets too low, you will have to lower the phosphorus in your diet (mainly dairy, meats and cola beans). Make sure to tell your dietitian what you like to eat so he or she can help design a diet that works for you, that way your diet will be something you can look forward to eating.

Important Items to Monitor for Taking Care of Your Kidneys

• Make sure your health care provider is monitoring your kidney function through an eGFR test.

• Make sure to tell your health care provider about all over-the-counter and herbal/natural products you are taking.

• Make sure your health care provider is monitoring the amount of protein in your urine.

• Drink plenty of fluids (lowers chance of kidney stones and kidney infections).

• Remind your health care provider to check if your medicines need to be adjusted or changed.

• Keep up with your health care appointments.

• Pay close attention to kidney disease risk factors, such as diabetes, high blood pressure and family history.

• Make sure you’re taking your medicine as prescribed.

• Is there a special diet you need to be on? Usually, there is, such as low protein, low salt (sodium), and low phosphorus.

You Are in Charge of Your Life

You can take better care of your kidneys if you are enjoying taking care of them. Make taking care of your health and your kidneys a priority. And remember, to really know if you are taking proper care of your kidneys, see your health care provider regularly. Keep a record of your kidney function and other key laboratory tests. Bring your medications and a list of questions to each visit and take charge of your health!

Answer provided by Keith Norris, MD. Dr. Norris is a faculty member in the Department of Internal Medicine and associate dean for research at Charles R. Drew University in Los Angeles. He is also a member of the AAKP Medical Advisory Board.

The American Association of Kidney Patients presents Ask the Doctor, an opportunity for readers to submit kidney related health questions to healthcare professionals who specialize in an area of concern. The answers are not to be construed as a diagnosis and therefore, alterations in current healthcare should not occur until the patient’s physician is consulted.

This article originally appeared in the December 2005 issue of Kidney Beginnings: The Magazine, Vol. 4, No. 5.

Back