Chronic Kidney Disease: A guide for patients

Chronic Kidney Disease: A guide for patients

our doctor has recently told you that you have chronic kidney disease. Getting this news is an important first step towards taking control of your health. Take the time to learn all you can about chronic kidney disease, what treatments your healthcare team may choose, and how you can make small, but important, changes to your lifestyle. To get you started, this brochure will help answer some of the many questions you may have, such as: Why are the kidneys important? What is chronic kidney disease? What causes chronic kidney disease? What can I do about my chronic kidney disease? Continue reading to learn more about living with chronic kidney disease. The kidneys are just below the rib cage, one on each side of the spine. 2

Why are the kidneys important? The kidneys do many things that allow your body to work properly. Some of the kidneys most important jobs are to: help make red blood cells Remove wastes and fluid from the body Control the body s balance of water and certain chemicals Help control blood pressure Help make red blood cells Help keep bones healthy What is chronic kidney disease? Chronic kidney disease is a condition that takes some time to develop. Once the kidneys are unable to work as well as they should for 3 months or more, it is considered chronic kidney disease. keep bones healthy help control blood pressure remove wastes balance water levels 3

What causes chronic kidney disease? The two main causes of chronic kidney disease are high blood pressure and diabetes. Other causes may include: A disease that damages the kidney s filtering parts Inherited diseases that damage kidney tissue Lupus and other diseases that affect the immune system An obstruction of the kidneys that blocks the flow of urine Frequent use of over-the-counter pain relievers Also, certain people have a higher risk of developing chronic kidney disease: People with a family history Native Americans of chronic kidney disease Pacific Islanders African Americans Seniors Hispanics How does my doctor know I have chronic kidney disease? Your doctor screens for chronic kidney disease using routine tests. Urine: When you have chronic kidney disease, protein from your body leaks into your urine. If you have two positive protein tests over several weeks, it is a sign of chronic kidney disease Blood: Your blood is tested for creatinine, a waste product that comes from muscle activity. When you have chronic kidney disease, creatinine may build to a high level in your blood. Your creatinine level is one of the values used to estimate your glomerular filtration rate (GFR). Your GFR measures how well your kidneys filter wastes from your blood 4

What happens now that I have chronic kidney disease? Your doctor may refer you to a kidney specialist, called a nephrologist. The nephrologist and/or your regular doctor will need to see how well your kidneys are working and what caused your chronic kidney disease. To do this, they may need to run more tests. They will use the test results to help plan your treatment. How can my chronic kidney disease affect my overall health? There is a chance you may not notice anything different or even feel sick. But when you have chronic kidney disease, your kidneys are slowly losing their ability to filter. Over time, wastes can build up in your blood. This can make you feel sick and lead to other health problems. For example, people with chronic kidney disease are at a higher risk for strokes and heart attacks. Can my chronic kidney disease be cured? Chronic kidney disease often cannot be cured. Over time, your chronic kidney disease could get worse and lead to kidney failure. If that happens, you would need to start dialysis or have a kidney transplant. But remember, your doctor will design a treatment plan to help slow your disease progression. You can do things to make the most out of this treatment plan. What can I do about my chronic kidney disease? By reading this brochure, you have already taken a big step. Continue learning about your chronic kidney disease and treatment. By being informed, you will be able to make good decisions that can help prolong your kidneys health. Keep reading to find out more. 5

Take an active role in your treatment it s the most important thing you can do. There are certain changes you can make to your habits and lifestyle that can help slow your chronic kidney disease progression: Control other health problems Think about your diet Exercise Make changes to your lifestyle Stay informed 6

Control other health problems High blood pressure Over half the people with chronic kidney disease have high blood pressure. High blood pressure can make your chronic kidney disease worse. It also increases your chances of developing heart disease. If you have high blood pressure, you should: Eat a low-sodium diet Exercise Take the medications your doctor prescribes Diabetes Diabetes creates high levels of glucose in your blood. These high levels of glucose make the kidneys filter too much blood. The kidneys will not be able to filter as well, and wastes will build up in the blood. If you have diabetes, managing your blood glucose may help slow your chronic kidney disease. If you have diabetes, you should: Test your blood glucose as your doctor instructs Take your insulin or other diabetes medicines as directed by your doctor Follow your recommended diet Keep all your doctor appointments Exercise High cholesterol Cholesterol is a fat-like substance found in your blood. If you have high cholesterol, it can build up inside your blood vessels. Over time, this buildup can block the small arteries in the kidneys. High cholesterol can also lead to heart attacks and strokes. To manage your cholesterol, you should: Have your cholesterol tested regularly Eat a low-fat diet Maintain a healthy weight Exercise 7

Think about your diet What you eat has a big impact on your chronic kidney disease. By eating a balanced diet, you can slow the disease progression and improve your overall health. Eating right can be tricky though. Even foods that seem healthy may not be right for you. When discussing your diet with your doctor, ask about the following: Sodium Sodium is a chemical found in salt and some foods. It can contribute to high blood pressure and fluid retention. Both of these will cause more harm to your kidneys. You may need to avoid foods high in sodium like frozen dinners and hot dogs. A healthy diet can help slow the progression of chronic kidney disease. Potassium Potassium is a mineral found naturally in many fruits and vegetables. When you have chronic kidney disease, your kidneys may not be able to remove extra potassium. With very poor kidney function, high potassium levels can cause abnormal heart rhythms. You may need to limit the amount of potassium you eat. Some foods high in potassium are oranges, potatoes, bananas, dried fruits, dried beans and peas, and nuts. 8

Phosphorus Just about everything you eat contains some phosphorus. When your kidneys are not working properly, there can be too much phosphorus in your blood. This can lead to bone disease. You should limit the amount of phosphorus you eat to protect your bones. Eggs, beans, cola drinks, and dairy products are examples of foods high in phosphorus. Protein The body gets protein from foods like meat, dairy, and beans. Your body uses protein to repair muscles and fight disease. When you have chronic kidney disease, your kidneys may not be able to separate the protein from the wastes. You may need to limit the amount of protein you eat. This may help slow your chronic kidney disease progression. There are lots of things to consider at mealtime. Talk to your doctor about your specific needs. 9

Exercise If you are overweight, losing that extra weight could be helpful in managing diabetes, high blood pressure, and high cholesterol. By controlling these conditions, you may help slow your chronic kidney disease. You do not need to join a gym or buy fancy equipment. Simple activities like walking, gardening, or dancing in your living room can have a positive effect on your health. Start small and find ways to make exercise fun: Park your car farther away from your destination than you normally would Take the stairs instead of the elevator Find someone to exercise with you, like a friend, co-worker, or grandchild Listen to music Go somewhere that you enjoy, like a park Check your progress over time. See if you can exercise longer before you get tired Remember that any exercise you do should match your current abilities. Check with your doctor before you start a new exercise routine. 10

Make changes to your lifestyle Stop smoking Smoking increases the risk of death from strokes and heart attacks. It also makes chronic kidney disease progress faster. If you smoke, you should make every effort to quit. Avoid certain medications Some medications are harmful if you have chronic kidney disease. Check with your doctor before taking any medication, even if it is over-the-counter. Avoid the following: Pain relievers: You could do more damage to your kidneys if you take large amounts of over-the-counter pain relievers. These include aspirin, acetaminophen, or ibuprofen. None of these medicines should be taken regularly without talking to your doctor Laxatives and antacids: Some laxatives and antacids contain magnesium, aluminum, aspirin, and a lot of salt. It is best to avoid these ingredients Decongestants: Avoid decongestants that contain pseudoephedrine, especially if you have high blood pressure Limit alcohol Alcohol can worsen your chronic kidney disease because of how it affects many other areas of your health. For example, alcohol can change the way your medicines work and cause your blood pressure to rise. If you drink, you should limit the amount of alcohol you consume. Talk to your doctor about what is safe for you. STOP smoking AVOID certain medications LIMIT alcohol 11

Stay informed Talk with your healthcare team You may have different people involved in your care: a primary care doctor, a specialty doctor (such as a nephrologist), a dietitian, and nurses. By keeping them informed, you can help them provide the best possible care for you. Before your appointment, think if there is anything you want to ask, and write it down. Try to remember if there have been any new problems or symptoms, or if there have been any changes in the medications you are taking. It is also important that you tell them when there are any changes in how you feel. When you are in the doctor s office, be sure to listen to what he or she tells you. Do not be afraid to take notes. Ask questions if you do not understand, and make sure they are all answered. Primary Care Doctor Nephrologist Nurse Dietitian 12

Be aware of how you feel Several signs and symptoms can mean complications of chronic kidney disease. Call your doctor if you notice any of the following: Puffiness or swelling in the legs, around the eyes, or in other parts of the body. This could be a sign of increased water retention Shortness of breath or a change in your normal breathing Know your lab values Your healthcare team runs a variety of lab tests to check on your chronic kidney disease and related conditions. They use these test results to see how well your treatment is working and if any changes are needed. Ask your doctor for more information about these lab tests. When you know what your results mean, you can see how your efforts are helping to manage your chronic kidney disease. Nausea or vomiting Light-headedness Severe bone or joint pain Bruising Itching Difficulty doing basic physical activities that you can normally do (like walking up the stairs) See your doctor right away if you are pregnant or think you might be pregnant. 13

14 Questions:

Notes: 15

Other resources For additional information about chronic kidney disease, contact the organizations listed below. By making changes to your lifestyle and learning about your chronic kidney disease, you can take an active role in your treatment. National Kidney Foundation 1-800-622-9010 www.kidney.org American Association of Kidney Patients 1-800-749-2257 www.aakp.org National Kidney and Urologic Diseases Information Clearinghouse 1-800-891-5390 www.kidney.niddk.nih.gov National Kidney Disease Education Program 1-866-454-3639 www.nkdep.nih.gov American Kidney Fund 1-800-638-8299 www.kidneyfund.org Amgen One Amgen Center Drive Thousand Oaks, CA 91320-1799 www.amgen.com 2009 Amgen. All rights reserved. MC44936 50M/07-09 P35673