Managing chronic kidney disease (CKD) day to day comes down to a few steady habits: knowing your kidney numbers, keeping blood pressure and blood sugar near your goals, using medicines and supplements carefully, eating with guidance, staying active and not smoking. These steps can help protect your kidneys from more damage and may also help prevent heart disease. The tips below draw on guidance from the National Kidney Foundation (NKF) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Key Takeaways
- Ask for your eGFR and urine albumin results at every visit, and compare them with your last ones.
- NIDDK calls blood pressure control the most important step you can take to treat kidney disease.
- Tell every doctor and pharmacist about all your medicines, vitamins and herbal supplements.
- There is no single CKD diet, and a registered dietitian can build a plan around your lab results.
- Activity, sleep, not smoking, vaccines and support for stress all help you manage CKD over time.
Why Does Day-to-Day Management Matter With CKD?
Your kidneys remove waste and extra water, help make red blood cells, balance minerals, help maintain blood pressure and keep bones healthy. CKD means they have been damaged over time and do not work as well as they should. It usually develops slowly, often with no early symptoms, and NKF is clear that symptoms alone cannot tell you whether you have it. Blood and urine tests can.
MedlinePlus notes that whether CKD gets worse, and how quickly, depends on the cause of the damage and on how well you take care of yourself. Tell your provider about past kidney problems, such as acute kidney injury, kidney stones or long-lasting urinary tract infections, and any family history of kidney failure. Our guide to CKD stages and treatment covers how it is staged.
Which Kidney Numbers Should You Track?
Two tests find CKD and follow it. The eGFR (estimated glomerular filtration rate) is a blood test of how well your kidneys filter waste; higher is usually better. The uACR (urine albumin-creatinine ratio) checks for albumin, a protein that can leak into urine when kidneys are damaged; lower is usually better. NIDDK says your goals are to keep your GFR the same and your urine albumin the same or lower.
NKF suggests writing down your eGFR, uACR, blood pressure and, if you have diabetes, your A1C. At each visit, ask how the results compare with last time. Our article on kidney function test results explains each number.
How Do You Keep Blood Pressure and Blood Sugar on Target?
High blood pressure can damage your kidneys, so NIDDK puts controlling it first. Your health care professional will set your goal and tell you how often to check. A home cuff lets you track readings between visits, so bring your log to appointments. Low-sodium meals, activity, sleep, not smoking and taking medicines as prescribed all help. Two types of blood pressure medicine, ACE inhibitors and ARBs (names ending in -pril or -sartan), may slow kidney disease, even in people without high blood pressure.
If you have diabetes, check your blood glucose as often as your provider advises. The A1C test shows your average blood glucose over the past 3 months. NIDDK says the A1C goal for many people with diabetes is below 7 percent, but ask what your own goal should be.
How Can You Use Medicines and Supplements Safely?
Take medicines as prescribed, and never stop or change one without talking to your doctor. As kidney function drops, some medicines can build up in your blood, so your provider may lower a dose or switch you to another. NSAID pain relievers, such as ibuprofen and naproxen, can damage the kidneys, so ask before using them.
NKF warns that herbal supplements can worsen kidney disease or interact with prescriptions, and that the FDA does not regulate them for dose, content or purity. People with kidney disease also hold on to vitamins longer, so levels can get too high. NIDDK suggests:
- Carry an up-to-date list of medicines and supplements, or bring the bottles to every visit.
- Use one pharmacy so it can check for harmful interactions.
- Before you get sick, ask what to do with your medicines if you have vomiting or diarrhea.
What Should You Eat When You Have CKD?
There is no single meal plan for everyone with CKD. In the early stages you may have few limits, and your needs change as the disease advances. Strict kidney diets found online may not fit your stage: too little protein can lead to malnutrition, for example, while people on dialysis may need more protein, not less. Talk with your kidney doctor before making big changes.
A registered dietitian who knows kidney disease can tailor a plan to your lab results. NIDDK notes that Medicare covers this counseling, called medical nutrition therapy, for people with CKD who have a written referral from a doctor. Common basics include eating less sodium (much of it comes from packaged, prepared and restaurant foods), seasoning with herbs instead of salt substitutes, which can be high in potassium, and asking how much fluid is right for you. If your potassium or phosphorus runs high, see our guide to managing potassium and phosphorus.
Which Everyday Habits Help You Live Well With CKD?
NIDDK recommends being active for 30 minutes or more on most days; if you are not active now, ask your provider what is safe. Aim for a healthy weight, since extra weight makes your kidneys work harder, and for 7 to 8 hours of sleep a night. If you smoke, stop: smoking can make kidney damage worse. The national quitline is 1-800-QUITNOW.
Vaccines matter too. NKF explains that CKD can weaken your immune system, raising the risk of serious infections such as pneumococcal disease. MedlinePlus says people with CKD should be up to date on hepatitis A, hepatitis B, flu, pneumococcal and COVID-19 vaccines. Ask your care team which you need and when.
Where Can You Find Reliable Information and Support?
MedlinePlus suggests checking who runs a site, whether it sells something, whether it names its sources and when it was updated, and being wary of promises of cures. Federal agencies such as NIDDK and nonprofits such as NKF are good places to start. Write down your questions, and ask your care team whether what you read applies to you.
Long-term stress can raise blood pressure and blood glucose, and depression is common with long-term illness. If you feel down, tell your care team and consider a mental health professional or support group. Our article on coping with a CKD diagnosis has more ideas.
When Should You Call Your Doctor or Get Urgent Care?
Call 911 or go to the emergency room for chest pain or pressure, trouble breathing, a very fast or pounding heartbeat, sudden confusion or a seizure. In people with CKD, these can signal dangerously high potassium, a serious infection or a sudden drop in kidney function.
Call your care team promptly if you are making much less urine than usual, notice new swelling in your face, arms, legs or belly, or have vomiting or diarrhea that keeps you from drinking. Make an appointment if your home readings keep running above goal, or you notice new tiredness, itching or loss of appetite.
Frequently Asked Questions
Can Lifestyle Changes Really Slow CKD?
They can help. NIDDK says steps such as controlling blood pressure, taking medicines as prescribed and not smoking can protect your kidneys from more damage. How much they help depends on the cause of your CKD.
How Often Should I See a Nephrologist?
It depends on your CKD stage and how your numbers change. In most cases you need a referral from your primary care doctor to see a nephrologist, though it may depend on your insurance plan.
Will I Eventually Need Dialysis?
Not necessarily. Whether CKD progresses to kidney failure, and how quickly, depends on the cause and how well it is managed. If kidney failure becomes likely, your provider will discuss dialysis with you before you need it.
Should I Take Supplements to Help My Kidneys?
Not without checking first. NKF advises talking with your health care team before starting any herbal supplement, bringing the bottle or a photo of the label, and avoiding products sold as a kidney “detox” or “cleanse.”
How Can Family Members Help?
A trusted friend or relative can come to visits, take notes and ask questions you may not think of. Agree ahead of time on the role you want them to play.
Talk to ANC About Managing Your CKD
Associated Nephrology Consultants, founded in St. Paul in 1977, sees patients with all types of acute and chronic kidney disease, including kidney disease related to diabetes and high blood pressure. If you have questions about managing CKD, Contact ANC or call 651-772-6251.
Sources
- NIDDK: Managing Chronic Kidney Disease
- National Kidney Foundation: Chronic Kidney Disease (CKD)
- NIDDK: Healthy Eating for Adults with Chronic Kidney Disease
- National Kidney Foundation: Herbal Supplements and Kidney Disease
- MedlinePlus: Chronic kidney disease
Medical Disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your specific care and treatment options.
