Managing Chronic Kidney Disease

If you have been told that you have chronic kidney disease (CKD), it means your kidneys are not working as well as they should. The kidneys are two fist-sized organs located in the back of the body just under the ribcage. They contain about a million nephrons filters that clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and your blood healthy.

In CKD, some of the nephrons become damaged. Over time, the kidneys become less able to filter off the waste products, which begin to accumulate in the blood. At this point, you may experience lack of energy, trouble sleeping, poor appetite, nausea, cramping at night, swelling in the feet and ankles, puffiness around the eyes, itchy skin, and trouble concentrating. Eventually, dialysis or transplantation is necessary.

Although there are many causes of CKD, high blood pressure and diabetes are the two main causes in the United States.

Can I keep my kidneys from getting worse?

Possibly. The goal of treatment is to slow down or stop your kidneys from getting worse. Two proven methods:

Reduce your blood pressure

The goal is to get your blood pressure under 130/80. You may be able to do this by eating less salt, losing weight, and avoiding alcohol. If not, you may be asked to take one or more medications to lower blood pressure. Some types of blood pressure medications also help to protect the filters in your kidneys (angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)).

Control your blood sugar if you have diabetes

One test that helps show how well diabetes is under control is called the hemoglobin A1c (HbA1c). This test reflects the average blood sugar over the most recent three months. Ideally this should be less than 7%.

Other measures may help

  • Keep a healthy level of fats (cholesterol) in your blood. It is not always possible to do this only with diet and exercise. You also may be asked to take a medication to lower your cholesterol.
  • Avoids NSAIDS. NSAIDS (non-steroidal anti-inflammatory drugs) are over the counter and prescription pain medications that can contribute to kidney damage. There are many. Some examples are ibuprofen (Advil, Motrin, Nuprin), naproxen (Naprosyn, Aleve), indomethacin (Indocin), etc.
  • Ask your health care provider what other measures you can take to slow the damage done to your kidneys.

Take control! It is important to learn all you can about CKD and its complications. You are the most important member of your health care team.