Patient education: Chronic kidney disease (The Basics)

What is chronic kidney disease? — Chronic kidney disease ("CKD") is when the kidneys stop working as well as they should. When they are working normally, the kidneys filter the blood and remove waste and excess salt and water (figure 1).

In people with CKD, the kidneys slowly lose the ability to filter blood. In time, the kidneys can stop working completely. That is why it is so important to keep CKD from getting worse.

What are the symptoms of CKD? — At first, CKD causes no symptoms. As the disease gets worse, it can:

●Make your feet, ankles, or legs swell (doctors call this "edema")

●Give you high blood pressure

●Make you very tired

●Damage your bones

Will I need tests? — Yes. Your doctor will want to see you regularly. You will probably have appointments at least once a year, and you will get regular tests to check your kidneys. These include blood and urine tests.

If your CKD gets worse over time, you will probably need to see a "nephrologist." This is a doctor who takes care of people with kidney disease.

Is there anything I can do to keep my kidneys from getting worse? — Yes. If you have CKD, you can protect your kidneys if you:

●Take all of your prescribed medicines every day, and follow all of your doctor's instructions for how to take them.

●Keep your blood sugar in a healthy range, if you have diabetes.

●Change your diet, if your doctor or nurse recommends to. They might suggest working with a dietitian (nutrition expert).

●Quit smoking, if you smoke.

●Lose weight, if you are overweight.

●Avoid medicines that can harm the kidneys – One example is "nonsteroidal antiinflammatory drugs," or "NSAIDs." These medicines include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve). There are other medicines that people with CKD need to avoid, too. Check with your doctor, nurse, or kidney specialist before starting any new medicines or supplements, even those you can buy without a prescription.

How is CKD treated? — People in the early stages of CKD can take medicines to keep the disease from getting worse. For example, many people with CKD should take medicines known as "ACE inhibitors" or "angiotensin receptor blockers." If your doctor or nurse prescribes these medicines, it is very important that you take them every day as directed. If they cause side effects or cost too much, tell your doctor or nurse. They might have solutions to offer.

What happens if my kidneys stop working completely? — If your kidneys stop working completely, you can choose between 3 different treatments to take over the job of your kidneys. Your choices are:

●You can have kidney transplant surgery. That way, the new kidney can do the job of your own kidneys. If you have a kidney transplant, you will need to take medicines for the rest of your life to keep your body from reacting badly to the new kidney. (You only need 1 kidney to live.)

●You can have your blood filtered by a machine. This treatment is called "hemodialysis," but many people call it just "dialysis." If you choose this approach, you will need to be hooked up to the machine at least 3 times a week for a few hours for the rest of your life. Before you start, you will also need to have surgery to prepare a blood vessel for attachment to the machine.

●You can use a special fluid that you pipe in and out of your belly every day. This treatment is called "peritoneal dialysis." If you choose this type of dialysis, you will need surgery to have a tube implanted in your belly. Then, you will have to learn how to pipe the fluid in and out through that tube.

How do I choose between the different treatment options? — You and your doctor will need to work together to find a treatment that's right for you. Kidney transplant surgery is usually the best option for most people. But often, there are no kidneys available for transplant.

Ask your doctor to explain all of your options and how they might work for you. Then, talk openly with them about how you feel about all of the options. You might even decide that you do not want any treatment. That is your choice.

More on this topic

Patient education: Type 1 diabetes (The Basics)
Patient education: Type 2 diabetes (The Basics)
Patient education: Hemodialysis (The Basics)
Patient education: Peritoneal dialysis (The Basics)
Patient education: Preparing for hemodialysis (The Basics)
Patient education: Choosing between dialysis and kidney transplant (The Basics)
Patient education: Dialysis and diet (The Basics)
Patient education: Kidney transplant (The Basics)
Patient education: Planning for a kidney transplant (The Basics)
Patient education: Glomerular disease (The Basics)
Patient education: Low-potassium diet (The Basics)
Patient education: Bone problems caused by kidney disease (The Basics)
Patient education: Lupus and kidney disease (The Basics)
Patient education: Medicines for chronic kidney disease (The Basics)

Patient education: Chronic kidney disease (Beyond the Basics)
Patient education: Dialysis or kidney transplantation — which is right for me? (Beyond the Basics)
Patient education: Edema (swelling) (Beyond the Basics)
Patient education: Glomerular disease (Beyond the Basics)
Patient education: Hemodialysis (Beyond the Basics)
Patient education: Low-potassium diet (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Peritoneal dialysis (Beyond the Basics)
Patient education: Polycystic kidney disease (Beyond the Basics)
Patient education: Protein in the urine (proteinuria) (Beyond the Basics)
Patient education: Kidney (renal) biopsy (Beyond the Basics)
Patient education: Split urine collection for orthostatic proteinuria (Beyond the Basics)
Patient education: The nephrotic syndrome (Beyond the Basics)