Chronic Kidney Disease : Self-Care at Home

Chronic kidney disease is a disease that must be managed in close consultation with your health care practitioner. Self-treatment is not appropriate.

• There are, however, several important dietary rules you can follow to help slow the progression of your kidney disease and decrease the likelihood of complications.
  
  
• This is a complex process and must be individualized, generally with the help of your health care practitioner and a registered dietitian.

The following are general dietary guidelines:

• Protein restriction: Decreasing protein intake may slow the progression of chronic kidney disease. A dietitian can help you determine the appropriate amount of protein for you.
  
  
• Salt restriction: Limit to 4-6 grams a day to avoid fluid retention and help control high blood pressure.
  
  
• Fluid intake: Excessive water intake does not help prevent kidney disease. In fact, your doctor may recommend restriction of water intake.
  
  
• Potassium restriction: This is necessary in advanced kidney disease because the kidneys are unable to remove potassium. High levels of potassium can cause abnormal heart rhythms. Examples of foods high in potassium include bananas, oranges, nuts, and potatoes.
  
  
• Phosphorus restriction: Decreasing phosphorus intake is recommended to protect bones. Eggs, beans, cola drinks, and dairy products are examples of foods high in phosphorus.

Other important measures that you can take include:

• carefully follow prescribed regimens to control your blood pressure and/or diabetes;
  
  
• stop smoking; and
  
  
• lose excess weight.

In chronic kidney disease, several medications can be toxic to the kidneys and may need to be avoided or given in adjusted doses. Among over-the-counter medications, the following need to be avoided or used with caution:

• Certain analgesics: Aspirin; nonsteroidal antiinflammatory drugs (NSAIDs, such as ibuprofen [Motrin, for example])
  
  
• Fleets or phosphosoda enemas because of their high content of phosphorus
  
  
• Laxatives and antacids containing magnesium and aluminum such as magnesium hydroxide (Milk of Magnesia) and famotidine (Mylanta)
  
  
• Ulcer medication H2-receptor antagonists: cimetidine (Tagamet), ranitidine (Zantac), (decreased dosage with kidney disease)
  
  
• Decongestants such as pseudoephedrine (Sudafed) especially if you have high blood pressure
  
  
• Alka Seltzer, since this contains large amounts of salt
  
  
• Herbal medications

If you have a condition such as diabetes, high blood pressure, or high cholesterol underlying your chronic kidney disease, take all medications as directed and see your health care practitioner as recommended for follow-up and monitoring.