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Strategies to Prolong Kidney Function

What Can I Do About Kidney Disease?

Unfortunately, chronic kidney disease often progresses to stage 5 despite early diagnosis and aggressive treatment. If you are still in stage 3 or 4 of kidney disease, you are still able to live without dialysis. Even though the kidneys are damaged, they are still able to filter some wastes and excess fluid from the blood. The primary focus at stages 3 and 4 is keeping your body well nourished, reducing protein waste build-up in the blood, and managing other conditions you may have by taking your prescribed medications and keeping your regularly scheduled doctor appointments. You will need to visit your doctor about every three months. It is important that your blood is checked at regular intervals by your nephrologist so that he or she can monitor your kidney function and make adjustments in your diet and medications as needed. You may still be able to make your kidneys last longer by taking steps to slow further kidney damage. You should be seeing a nephrologist at this stage. If you are not, you should be referred to one as soon as possible so that you can be assessed regularly for renal changes.

If You Have Been Diagnosed with Diabetes

The most common cause of end stage renal disease is diabetes mellitus. If you have diabetes, watch your blood glucose (sugar) closely to keep it under control. Make sure you are taking your oral anti-diabetic agent or insulin as directed by your doctor.

Follow your diet. Consult your doctor for the latest in treatment.

If You Have Been Diagnosed with High Blood Pressure

High blood pressure is the second leading cause of chronic renal failure. High blood pressure damages the small vessels in the kidneys. Blood pressure should be checked regularly. People with reduced kidney function should have their blood pressure controlled. Work with your doctor to find the anti-hypertension medicine that works best for you. Many people will require two or more types of medication to keep their blood pressure normal. Along with prescribing medication, your doctor may recommend lifestyle changes such as exercising regularly and reducing your salt intake in order to keep your blood pressure under control.

Treating Anemia

Anemia is a shortage of red blood cells. These cells are important because they carry oxygen throughout the body. If you are anemic, you will feel tired and will look pale. Anemia may also stress your heart. Heart disease is the leading cause of death in people with kidney disease. Healthy kidneys make the hormone erythropoietin (EPO), which stimulates the bone marrow to make red blood cells. Diseased kidneys may not make enough EPO. Ask your doctor about medications such as epoetin (EPO) to treat anemia.

Iron Management

Adequate iron must be available in your body in order for epoetin (EPO) therapy to work. Your doctor will check your lab work to evaluate your iron status. If you suffer from iron deficiency, he or she may prescribe an iron supplement for you to take to build your iron stores. Correction of anemia has been shown to lower the chances of heart failure in people with CKD.

Keeping Your Bones Healthy

Your doctor will check your lab work periodically to evaluate you for bone disease.

  • Phosphorus: If you suffer from high phosphorus levels, your doctor may prescribe a phosphorus binder. It will be important for you to take your phosphorus binder as your doctor prescribes. (Usually it is taken with your meals and snacks.)
  • Calcium: Your lab work will tell the doctor if your calcium levels are within normal range. If your calcium levels are low, your doctor may prescribe a calcium supplement, or, if your calcium levels are high, you may need to limit your calcium.
  • Vitamin D: Your doctor may check your vitamin D level. If it is low he or she may prescribe a vitamin D supplement. Remember, only take vitamins and minerals prescribed by your doctor.

Medications to Avoid

If you have been prescribed medications such as ibuprofen (Advil), naproxen sodium (Aleve), and celecoxib (Celebrex), take only your prescribed dose. If your doctor has NOT prescribed these medications, it is important to ask him or her before you take them. Be sure your doctor knows about all prescription medicines, over-the-counter medicines, and herbs that you are taking.

Procedures that Use Dyes

If you need to have an x-ray or a procedure that uses dye, be sure the doctor performing the procedure knows you have kidney disease so that either no dye or a special dye is used.

Immunizations

In order to start as healthy as possible, you should talk to your doctor about getting immunized against influenza, pneumococcus, and hepatitis B.

Lifestyle Changes May Need to Occur

It is important to keep yourself as healthy as possible to help slow down the progression of your kidney disease. You can succeed in this by making the necessary lifestyle changes.

  • Maintain a healthy weight by following the prescribed diet.
  • Limit alcohol consumption.
  • Maintain good control of your blood sugar if you have diabetes. Diabetes is the number one leading cause of kidney disease.
  • It is important to manage your blood pressure if you have hypertension. It is the second leading cause of kidney disease.
  • Strive to include some form of physical activity in your day. Regular exercise can improve your mood, lower bad cholesterol and triglycerides and keep your muscles and bones healthy.
  • You should try your best to stop smoking. Smoking not only increases the rate of kidney disease progression, but it also contributes to deaths from strokes and heart attacks in people with CKD.
  • Reduce stress in your life. It may take time to adjust to CKD. Be patient and set realistic goals. Continue to perform your normal activities and responsibilities of daily life, and share your feelings with your close friends and family. Consider joining a support group.
  • Visit your doctor regularly to monitor your health and adjust your diet and medications as needed. Remember to tell your doctor if you are having any problems with your medications.
  • Make sure to keep your appointments with your nephrologist. Discuss any problems you have had since your last visit.
  • You should have routine lab tests completed. Each test has a specific range, or "normal," indicating a healthy or unhealthy level. You should review your lab results and see what range you are in. You can use the various "Laboratory Tests" charts located on the following pages as a guide to some common lab tests that will be completed.

Notice what the normals (or recommended range) should be. Keep in mind that laboratories may use different equipment that will result in different normals. Consult with your doctor on what your lab results should be and what the normal range is for your lab. If you are not in the normal range, work with your doctor to develop a plan that will help you to achieve that range.

Laboratory Tests That Measure Kidney Function

Laboratory Tests That Measure Anemia

Laboratory Tests That Measure Diabetes Control

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