| Overall Fitness
| End-Stage Renal Disease
| Be Part of Your Medical Team
Kidneys can become damaged after an acute
infection, exposure to toxins, a traumatic injury, an obstruction, or most often from an accumulating effect of chronic conditions like
high blood pressure
and diabetes. The damage interferes with the kidneys’ ability to filter blood to remove waste and excess fluids. As the kidneys fail, the damaging waste products increase in the blood and fluids build up. Heart disease and
are also more common in patients with kidney disease.
Most types of kidney disease are irreversible, but lowering the burden on the kidneys will slow further deterioration. Lifestyle changes and regular medical care are important steps. Keeping yourself in the best general health will also help keep you in the best health possible.
does not give many signs it is in trouble. A troubled kidney can fail to about 25% of its original workload before symptoms occur. As a result, many people have a high degree of failure before attention is brought to it. If you have any of the conditions below it is important to get regular medical care. Regular medical care will help you control or eliminate the risk of kidney damage and monitor kidney changes. These are common factors that lead to kidney damage:
- High blood pressure—Blood passes through filters in the kidney, which remove excess fluid and waste. High blood pressure puts too much stress on these filters and damages them. Fewer filters decrease the kidneys’ ability to function.
- Diabetes—The disease process often causes damage to smaller blood vessels. When smaller blood vessels in the kidney are damaged, blood cannot pass through to be filtered.
- Kidney disease—There are conditions that directly affect the kidney like infections, hereditary cystic disease, and inflammatory disease that can directly impair kidney function or damage kidney parts.
Toxins—Certain toxins, typically from long-term exposure, damage the kidney. This can include
cocaine, heavy metals, and solvents. As the kidney tries to remove the toxin, it can be exposed to higher amounts.
- Renal artery stenosis
—In arterial stenosis, blood vessels are narrowed and can become blocked. This impairs or even stops blood flow. If blood cannot pass through the kidneys it cannot be filtered.
Damage that has already been done to the kidney cannot be repaired. However, lifestyle changes and medical care can help manage most of these situations to decrease further damage.
Your nutrition can play a very important role in your kidney health. The waste products and fluid that your kidneys remove come from the foods you eat. Your doctor will likely recommend a special diet based on your stage of kidney disease. You may also be referred to a registered dietitian to help you plan your diet.
Common changes include:
is a vital part of your diet. It works to build muscle and repair tissue. However, when the body is done using it, there is a waste product called urea. A weakened kidney may have trouble filtering this. This includes protein from animal and plant sources. You need protein in your diet, but work with a dietitian to understand just how much you actually need and how to reduce it if necessary.
- Calorie intake
can consist largely of proteins. If you have decreased the amount of protein you eat, you may need to substitute healthy fats or carbohydrates to keep well-nourished. A well-nourished diet can provide all the necessary nutrients in appropriate amount of calories. Being overweight will also place extra stress on your kidneys and increase your risk of heart disease. Talk with a dietitian to create a balanced plan.
is a chemical commonly found in dairy products, nuts, dried beans, and beverages like soft drinks, cocoa, and beer. A damaged kidney may not be able to remove this from your blood. High levels of phosphorus in the blood can decrease calcium in your bones, making them susceptible to breaking.
is an element tied to high blood pressure and kidney disease. It can affect your fluid levels. It is not only found in table salt that you add to your food, but is already included in many products, particularly snack foods, fast foods, and luncheon meats.
Your diet needs will change as the disease progresses. Further stages may require
limits of potassium
and fluids. Secondary diseases like
and diabetes may also require special dietary changes. Find a dietitian that specializes in kidney disease and that you feel comfortable working with. It may make transitions easier to have the same dietitian work with you through each stage.
Adding physical activity to your regular routine can help your mind and body. Although there was a previous concern about physical activity and kidney disease, researchers have found that it can be beneficial in many ways.
- Overall health—Staying physically active can help your entire body work better. This will give you more energy, decrease wear and tear on joints and bones, and decrease the burden on your heart.
Disease management—Health concerns closely related to kidney disease, such as heart disease, high blood pressure,
high cholesterol, and diabetes, can be prevented or managed with regular physical activity.
- Mind boost—Managing a chronic disease can be very stressful. Physical activity has been shown to decrease stress and anxiety.
Check with your doctor before beginning an exercise program.
End-Stage Renal Disease
When the kidneys can no longer perform more than 10%-15% of its original function it is considered end-stage renal disease (ESRD).
is needed at this point.
For dialysis, either hemodialysis or peritoneal dialysis is used to perform the job of the kidneys. Hemodialysis filters your blood through a machine to remove waste. Peritoneal dialysis removes waste with a special liquid that is injected into the abdomen. Depending on the type of treatment and your situation this process is done at a special facility or at home.
Dialysis may have significant time requirements. Hemodialysis, where blood is filtered through a machine, may be done three days per week for about four hours at a time. Different types of dialysis will have different requirements. There will be an adjustment period as you develop a new schedule. Many people that have dialysis do return to work after an adjustment period. People with physically demanding jobs may not be able to return to work.
A kidney transplant may also be done. You may receive the donated kidney from a living donor (usually a relative) or from an organ registry. Although a kidney transplant can eliminate the need for dialysis, you will need to take immune suppressing medicines for the rest of your life.
Be Part of Your Medical Team
Working closely with your doctor will help you stay involved in your healthcare plan. Discuss any lifestyle changes you are planning with your doctor, especially major plans like pregnancy. This way you can make choices and plans that will create the best outcome possible.
Talk to your healthcare team about problems affecting your quality of life, as well as any medical problems. There may be alternative treatments or adjustments to your current treatment that can resolve the problems. You also have the right to refuse any treatment if its burdens outweigh its benefits. Discuss your decisions with your family and look into necessary legal work such as wills, living wills, and advance care directives.
The progress of kidney disease is different for each person. Being as informed as possible can help decrease the stress. Planning ahead for future challenges will also help you and your family cope with changes that may arise. Talk to your doctor or dietitian about support systems. Other people managing kidney disease may be able to give you the best insight on making lifestyle changes and working through the treatment process.
Chronic kidney disease. American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-kidney-disease/treatment.html. Updated November 2010. Accessed September 24, 2012.
Chronic kidney disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 18, 2012. Accessed September 24, 2012.
Keep your kidneys healthy. National Kidney Disease Education Program website. Available at: http://www.nkdep.nih.gov/learn/keep-kidneys-healthy.shtml. Updated September 7, 2012. Accessed September 24, 2012.
The kidneys and how they work. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/. Updated March 23, 2012. Accessed September 24, 2012.
Kidney disease basics. National Kidney Disease Education Program. Available at:
http://www.nkdep.nih.gov/learn/kidney-disease-basics.shtml. Accessed September 24, 2012.
Nutrition and chronic kidney disease. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/pdf/nutri_chronic.pdf. Accessed September 24, 2012.
What you should know about exercise. National Kidney Foundation website. Available at:
http://www.kidney.org/atoz/content/exercisewyska.cfm. Accessed September 24, 2012.
Last reviewed September 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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