Chronic kidney disease

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Kidney anatomy

Kidney - blood and urine flow

White nail syndrome

Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure

Controlling blood pressure is the key to delaying further kidney damage.

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often.
• The goal is to keep blood pressure at or below 130/80 mmHg

Other tips for protecting the kdineys and preventing heart disease and stroke:

• Do not smoke.
• Eat meals that are low in fat and cholesterol
• Get regular exercise (talk to your doctor or nurse before starting).
• Take drugs to lower your cholesterol, if necessary.
• Keep your blood sugar under control.

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Always talk to your kidney doctor before taking any over-the-counter medicine, vitamin, or herbal supplement. Make sure all of the doctors you visit know you have chronic kidney disease.

Other treatments may include:

• Special medicines called phosphate binders, to help prevent phosphorous levels from becoming too high
• Treatment for anemia, such as extra iron in the diet, iron pills, special shots of a medicine called erythropoietin, and blood transfusions
• Extra calcium and vitamin D (always talk to your doctor before taking)

You may need to make changes in your diet. See: Diet for chronic kidney disease for more details.

• You may need to limit fluids.
• Your health care provider may recommend a low-protein diet.
• You may have to restrict salt, potassium, phosphorous, and other electrolytes.
• It is important to get enough calories when you are losing weight.

Different treatments are available for problems with sleep or restless leg syndrome.

Everyone with chronic kidney disease should be up-to-date on important vaccinations, including:

• Pneumococcal polysaccharide vaccine (PPV)
• Influenza vaccine
• H1N1 (swine flu) vaccine
• Hepatitis B vaccine
• Hepatitis A vaccine

When loss of kidney function becomes more severe, you will need to prepare for dialysis or a kidney transplant.

• When you start dialysis depends on different factors, including your lab test results, severity of symptoms, and readiness.
• You should begin to prepare for dialysis before it is absolutely necessary. The preparation includes learning about dialysis and the types of dialysis therapies, and placement of a dialysis access.
• Even those who are candidates for a kidney transplant will need dialysis while waiting for a kidney to become available.