Basics

A chronic kidney disease (CKD) diagnosis may come as a surprise to many people, because the symptoms are often times subtle. The signs of kidney disease are:

• Change in urination
• Swelling
• Fatigue
• Skin rash
• Metallic taste in mouth
• Nausea and/or vomiting
• Shortness of breath
• Feeling cold
• Dizziness
• Trouble concentrating
• High blood pressure

In many cases, kidney damage is the result of another illness that has progressed slowly over the years. The two main causes are diabetes and high blood pressure. If your kidney disease is the result of one of these conditions, the best way to manage it is to treat the illness that is causing it.

Once it’s determined that you have kidney disease, it’s important that you learn about your condition. Kidney disease is one of the few diseases that can be managed. You play a crucial role in maintaining your kidney function.

The five stages of chronic kidney disease

There are five stages of chronic kidney disease. Stage 1 is the closest to healthy kidney function and Stage 5 requires dialysis or a kidney transplant.

Stage	Description	GFR Level
Normal kidney function	Healthy kidneys	90 mL/min or more
Stage 1	Kidney damage with normal or high GFR	90 mL/min or more
Stage 2	Kidney damage and mild decrease in GFR	60 to 89 mL/min
Stage 3	Moderate decrease in GFR	30 to 59 mL/min
Stage 4	Severe decrease in GFR	15 to 29 mL/min
Stage 5	Kidney failure	Less than 15 mL/min or on dialysis

Talking to your doctor when you’re new to kidney disease

It’s common for patients to feel overwhelmed in a doctor’s office, because there is a lot of information to take in at once. The best way to gain control is to become your own advocate. It’s OK to ask as many questions as you like and to ask for the information to be repeated. If being assertive is difficult, ask a friend or family member to come with you. Take notes you can remember any additional questions or concerns that occur between visits. It’s good to become proactive when you’re new to kidney disease. Here are some questions to ask your doctor:

• What caused my kidney disease?
• What percentage of kidney function do I have now?
• What are my lab test results, including my GFR?
• What treatment is available for my symptoms?
• What are the next steps?
• What can I do to keep my kidneys from becoming more damaged?
• Will I eventually need dialysis or a transplant? If so, what is the timeline?

Treatment when you’re new to kidney disease

The goal of treatment for kidney disease is to slow the progression of the disease. Each person is different and requires individual treatment. The number of doctor visits, dietary modifications and type of treatments will depend on your stage of CKD, additional health issues, weight, blood pressure and lab results.

If you have early stage kidney disease, it may not be necessary to have regular visits with a nephrologist (kidney doctor), but it’s recommended to meet with a nephrologist at least once to help your primary care physician design an effective treatment plan, including:

• Slowing the rate of kidney damage;
• Determining if a kidney biopsy is needed;
• Diagnosing the type of kidney disease and whether it’s reversible with treatment;
• Managing complications of kidney disease, such as anemia, high blood pressure, heart disease, metabolic acidosis and changes in mineral balance

Getting support when you’re new to kidney disease

Being diagnosed with kidney disease can bring up many emotions, such as fear, anger, anxiety, depression and helplessness. These are all natural responses. Managing health isn’t just about the physical aspects; it’s also about emotional well-being.

You may be able to find support from close friends and family. You can also look to the Internet for support groups and helpful tips when you’re new to chronic kidney disease. DaVita.com has a list of topics in its discussion forums, from coping with kidney disease and treatment, to diet and other health issues.

Tips to slow kidney disease progression

Now that you’ve learned about kidney disease, you can do something about its progression. In order to slow the progression of kidney disease, it’s recommended that you make healthy choices. Here are some tips to improve health:

• Maintain healthy blood pressure
• Lose excess weight (or gain weight if advised by a doctor)
• Adopt a kidney-friendly diet as prescribed by a renal dietitian
• Follow an exercise program recommended by your physician
• Take your prescribed medications each day
• Keep regular doctor appointments
• Do not smoke
• Reduce or avoid alcohol consumption
• Manage blood glucose if you have diabetes

New to the kidney diet

Changing your eating habits can be an effective way to slow the progression of kidney disease in some cases. Even when you have early stage CKD, you may find it helpful to start working with a renal dietitian. Your doctor, nurse or local hospital’s nutrition department may be able to recommend one; or visit the American Dietetic Association website.

Adopting healthy eating practices when you are new to kidney disease is one of the best ways to support your health. The recommendation for an early stage CKD diet is to eat high quality proteins, carbohydrates (fruits, vegetables and grains) and fats that provide a healthy amount of calories. Your dietitian may ask you to decrease the amount of protein you eat, especially if you normally eat a high protein diet. When protein is digested, waste products are created. And the less your kidneys have to work to remove waste from your body, the better.

If you have comorbidities such as diabetes, high blood pressure or high cholesterol, your dietitian will take that into consideration and guide you to limit or avoid foods that are high in sugar, salt and saturated fats.

Although the kidney diet isn’t a cure, it can help slow the development of your kidney disease.

Summary

When you’re new to kidney disease, it is important to pay attention to your physical and emotional wellness. Work with your kidney health care team to know your lab results and build a support system. Healthy lifestyle and diet choices can be effective in slowing progression of CKD.