10 top tips to manage CKD

10 top tips to manage CKD

CKD may not (usually) be curable but there is alot you can do. This is what this article is all about. Here goes, we start with a summary

Key Points

1. Make sure CKD is detected early and a clear cause is identified
2. Keep your blood pressure down
3. Treat your other medical conditions
4. Avoid illnesses that cause AKI
5. Keep your weight down
6. Know your numbers – especially kidney function (creatinine/GFR)
7. Know your tablets
8. See (and continue to see) a kidney specialist (nephrologist)
9. Be referred for a kidney transplant (if you need one)
10. Stay employed.

1. Make sure CKD is detected early and a clear cause is identified

CKD is not a diagnosis. It is a syndrome (group of diseases) that has causes.

So if your GP is not certain what it is, and what to do, encourage them to refer you to a nephrologist (hospital kidney doctor; also, see point 8). Most people don’t need to be referred. Make sure you have a kidney ultrasound as well. After that, have regular blood tests and follow up.

“Don’t allow yourself to be discharged unless things are stable and the risk of kidney failure is low.”

2. Keep your blood pressure down

Keep your blood pressure below 140/90 mm Hg (or 130/80 if you have diabetes) all the time – at home, at your GPs or hospital. This is the single most important thing you can do. CKDEx has advice on how to lower blood pressure.

In fact, proper control of high blood pressure is often the most effective way of slowing down the progression of CKD.

“Keep your blood pressure 130/80 mm Hg or below, all the time.”

The best way to attain good control is to monitor your blood pressure regularly at home, and maintain a chart. This will help your doctor immensely, so they can adjust your blood pressure medication accordingly.

In terms of tablets, for many patients, the combination of a full dose of BP medication called an ACE (or ARB) and an SGLTi is very effective. Examples include Ramipril (ACE) and Dapagliflozin (SGLTi). 1-3 additional BP tablets may be necessary as well.

3. Treat other chronic medical conditions

These include diabetes and heart failure. See hospital specialists for these conditions as well, if your GP is not sure what to do.

4. Avoid illnesses that can cause AKI (rapid onset kidney failure)

This is because they can further damage the kidneys, and may even lead to temporary (or permanent dialysis).

In CKD, the kidneys are very sensitive to other illnesses: especially infection and sepsis; things that cause hypotension (low blood pressure, e.g. dehydration), urinary tract obstruction (e.g. prostate problems in men), and drugs toxic to the kidneys.

“Avoiding infection, and getting it treated promptly is especially important if you have CKD.”

In fact all these things need to be promptly identified and treated, as all can affect kidney function and/or cause AKI.

Also, keep up to date with your vaccinations as these can prevent infections (like COVID-19 and the flu) that can worsen kidney function.

5. Lose weight if you’re overweight or obese

We have advice on how to lose weight. Also you may find fluid restriction and/or ‘kidney-friendly’ diets (e.g. low in sodium, potassium, phosphate or protein) may make you feel better.

Dietician
Meet with a dietician to create a kidney-healthy eating plan. The plan may need to change as you get older or if your CKD grade changes.

General health and fitness
Get active. Physical activity helps control blood pressure and blood sugar levels.

Smoking
If you smoke, quit. Smoking can cause and worsen chronic kidney disease. Here is advice on how to stop here.

6. Know your numbers – especially kidney function (creatinine/GFR)

Get kidney function  tested regularly (at least every three months) and know your numbers. You can follow them on the Patient Knows Best website (register with them on their website).

7. Know your tablets

Know your medication all the time – dose, frequency and indication (why are you taking it). Take medications as instructed.

8. See (and continue to see) a kidney specialist (nephrologist)

If you have more severe CKD (CKD3B, CKD4 and CKD5), you should be seeing a kidney specialist regularly at your nearest kidney (renal) unit. You may see the consultant (boss), registrar (deputy) or specialist nurse.

After this, attend follow-up appointments carefully.

“Don’t allow yourself to be discharged unless you are sure your CKD is stable and unlikely to progress to Stage 5 CKD (kidney failure)”

9. Be referred for a kidney transplant (if you need one)

If you have CKD4 or CKD5, many patients will be suitable for a kidney transplant. Ask your loved ones if they will donate a kidney to you. If that is not possible, make sure that you have been referred for transplant work-up and then are placed on the deceased donor transplant waiting list.

Check (check check) you are on it. Don’t assume you are on it. When on the list, be contactable 24h a day.

10. Stay employed

Even if you have to take some time off work to adjust to a new situation, try to work part-time or full-time. Keeping a job is a good way to stay active, and is good for mental health. The money is useful as well!

Summary

We have described 10 top tips for your to manage your CKD. We hope it has been helpful.

 

Last Reviewed on 29 April 2024