Chronic Kidney Disease: Care Instructions

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Your Care Instructions

Chronic kidney disease happens when the kidneys cannot remove waste and keep your body's fluids and chemicals in balance. Normally, the kidneys remove waste from the blood. The waste then leaves the body in your urine. The kidneys also balance the fluids in your body. When the kidneys are not working well, waste and excess fluid can build up so much that it can poison the body. This can be life-threatening.

Diabetes and high blood pressure are the most common causes of ongoing (chronic) kidney disease. Chronic kidney disease can develop in 2 to 3 months but usually develops over many years. You may be able to keep kidney damage from getting worse by taking medicine and making lifestyle changes. If the condition gets worse, you may need to use a machine or other method to filter waste. This is called dialysis. In some cases, a person may have a kidney transplant.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Treatments and appointments

  • Take your medicines exactly as prescribed. Call your doctor or nurse call line if you have any problems with your medicine. You also may take medicine to control your blood pressure or to treat diabetes. Many people who have diabetes take blood pressure medicine.
  • If you have diabetes, keep your blood sugar in your target range with a healthy diet, regular exercise, and medicine if needed.
  • Go to your dialysis appointments if you have this treatment.
  • Do not take ibuprofen (Advil, Motrin), naproxen (Aleve), or similar medicines, unless your doctor tells you to. These medicines may make chronic kidney disease worse.
  • Do not take any vitamins, over-the-counter medicines, or herbal products without talking to your doctor first.
  • Do not smoke or use other tobacco products. Smoking can reduce blood flow to the kidneys. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Do not drink alcohol or use illegal drugs.
  • Talk to your doctor about an exercise plan. Exercise helps lower your blood pressure and makes you feel better.
  • If you have not already done so, prepare an advance care plan. An advance care plan provides instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.


  • Talk to a nutritionist or dietitian to help you make a meal plan that is right for you. Most people with chronic kidney disease need to limit salt (sodium), fluids, and protein. Some also have to limit potassium and phosphorus.
  • You may have to give up many foods you like. But it is very important to make the changes to your diet so you can stay healthy for as long as possible.
  • If you have a hard time eating enough, talk to your doctor or dietitian about ways to add calories to your diet.
  • Your diet may change over time as your disease changes. See your doctor for regular testing, and work with a dietitian to adjust your diet as needed.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have less urine than normal or no urine.
  • You have trouble urinating or can urinate only very small amounts.
  • You are confused or have trouble thinking clearly.
  • You feel weaker or more tired than usual.
  • You are very thirsty, light-headed, or dizzy.
  • You have nausea and vomiting.
  • You have new swelling of your arms or feet, or your swelling is worse.
  • You have blood in your urine.
  • You have new or worse trouble breathing.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have any problems with your medicine or other treatment.

Where can you learn more?

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