Managing chronic kidney disease is no easy task. There’s a lot of time required for it, a lot of things to learn, and a lot of information to absorb. Appointments, team members, medications, diet, dialysis regime; it can be overwhelming. Simple management tips can help you feel in control of your health. That is the key to thriving. Often, patients will say ‘just tell me what to do!’ To help increase your confidence, and to help you regain control of your health, the following tips may help:
1. Consider vaccination. Vaccines are meant to prevent serious illnesses that can cause long term effects and/or increase mortality. When you have chronic kidney disease, your ability to fight infection is compromised. If you are on dialysis, you have open sites, which can significantly increase your risk for infections. Talk to your doctor about vaccines and how they may help.
2. Manage diabetes. Up to fifty percent of people with chronic kidney disease have diabetes. High blood sugars, over time, damage vital organs. Poorly managed diabetes increases the risk for further kidney damage, increases the risk of other diabetes complications, increases the risk of infections, and increases the risk of cardiovascular disease. Achieve and maintain target blood sugars 80% of the time. Discuss with your health care team your numbers, your diabetes management, and your goals for optimal success. Your diabetes management may change if your kidney disease changes.
3. Know your medications. What they are, what they do, when to take them, their dose, and what to take them with, or what to avoid with them are all equally important pieces of information regarding your medications. Get to know your pharmacist and ask questions. Keep your medications in a visual place — where you can see them to remember to take them.
4. Know your dialysis method and regime if you have end-stage renal disease (ESRD). Doing dialysis properly is extremely important. It is essential to draw off wastes, excessive fluids, and excessive electrolytes. Doing it properly also helps reduce the risk of infection. The more you can dialyze, usually the more flexible the diet and medical management. Healthy kidneys filter blood and wastes 24 hrs/day, 7 days a week. Talk with your team about which dialysis method works best for you, and how often you can dialyze.
5. Follow your diet and fluid restriction. Your diet and fluid needs are designed for five main components:
- To minimize waste and fluid and manage electrolytes
- Preserve kidney function
- Reduce potential complications from kidney disease (such as constipation, weight, fluid retention, high blood pressure, etc.)
- Reduce the risk of malnutrition
- Portion size allows for balanced, healthy eating on the renal diet by maximizing nutrients, balancing electrolytes, and balancing calorie needs.
All of this is meant to try to decrease the stress on the kidneys and / or make you as healthy as possible.
6. Know your labs. You will have lab and urine tests with chronic kidney disease management. Know what your labs mean. It can be a lot of detailed information at first. The common information to know is your electrolytes (potassium-K, phosphorus-P, calcium-Ca, and sodium-Na), your cholesterol, your iron levels (anemia is common and managed with medication), your albumin (protein levels), and your eGFR (kidney function). Others may have to be learned as determined by your health care team.
7. Manage your weight. Daily weighing with chronic kidney disease is important to minimize the risk of fluid overload, also known as edema. Usually, a daily weight fluctuation of more than 5 lbs indicates too much fluid. Unhealthy kidneys are not able to manage fluid levels which can increase the fluid in the body to be circulated. This can put stress on your heart and on your arteries, as they circulate it, thus increasing your blood pressure. If you are overweight, start with small goals to help reduce your weight to a health weight range. If you have challenges with emotional eating, talk to your health care team.
8. Check your mental health. Managing your emotions enables you to be in better control of your kidney disease. Anger, sadness, despair, depression, and anxiety are some of the emotions that patients feel with chronic kidney disease. These are all normal to have. Do what you can do to help manage your emotions: go for a walk, listen to music, watch a movie, read a book, etc. However, if coping with these emotions is a challenge, seek some professional help. If you are struggling with unhealthy coping mechanisms such as smoking (quit!), excessive eating, substance abuse, etc. talk to your team about managing them. The social worker on your team is the qualified professional to help you with these challenges.
9. Get regular exercise. Whatever the exercise is that you like to do and that you can-do it. Regular exercise is essential for physical, mental, and emotional health. If you have limitations due to your kidney disease, do what you can do. A brisk walk 3x /day after meals for 10 minutes is a simple and effective exercise.
10. Cheat days. Yes, cheat days happen. Why? Because patients with chronic kidney disease may feel deprived. If you’re going to cheat, pick an item you really want to have, and have it AFTER you get your labs done. If you have your cheat item before your lab or urine sample day, it can affect the results of those samples. This can mean more aggressive treatment due to a poorly timed indulgence. Talk to your dietitian about treats and how you can have them.
There is a lot of information with chronic kidney disease management, but once you know your numbers, your medications, and your team, you can learn to manage and thrive with chronic kidney disease. Remember — your team does all of this with you to help preserve your kidney function and to help you be as healthy and as successful as possible.
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