End-Stage Renal Disease: Care Instructions

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Your Care Instructions

End-stage renal (or kidney) disease is the failure of the kidneys to 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. End-stage renal disease usually happens after years of ongoing (chronic) kidney disease. At this stage of the disease, the kidneys work so poorly that you cannot live without a machine or other method to remove the waste from your blood (called dialysis) or 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?

  • 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.
  • Follow your dialysis schedule.
  • Do not take aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), or similar medicines, unless your doctor tells you to. These medicines may make chronic kidney disease worse.
  • Make sure your doctor knows all of the medicines and natural health products you take.
  • 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.
  • If your doctor recommends it, get more exercise. Walking is a good choice.
  • 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.

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 new or worse nausea and vomiting.
  • You have much less urine than normal, or you have no urine.
  • You are feeling confused or cannot think clearly.
  • You have new or more blood in your urine.
  • You have new swelling.
  • You are dizzy or light-headed or feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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