Chronic Kidney Disease: Care Instructions

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Chronic kidney disease happens when your kidneys don't work as well as they should. Your kidneys have a few important jobs. They remove waste from your blood. This waste leaves your body in your urine. They also balance your body's fluids and chemicals.

When your kidneys don't work well, extra waste and fluid can build up. This can poison the body and sometimes cause death.

The most common causes of this disease are diabetes and high blood pressure. In some cases, the disease develops in 2 to 3 months. But it usually develops over many years.

If you take medicine and make healthy changes to your lifestyle, you may be able to prevent the disease from getting worse. But if your kidney damage gets worse, you may need dialysis or a kidney transplant. Dialysis uses a machine to filter waste from the blood. A transplant is surgery to give you a healthy kidney from another person.

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 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?

Treatments and appointments

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor 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, do your best to keep your blood sugar in your target range. You may do this by eating healthy food and exercising. You may also take medicines.
  • Go to your dialysis appointments if you have this treatment.
  • Do not take ibuprofen, naproxen, or similar medicines, unless your doctor tells you to. These may make the disease worse.
  • Do not take any vitamins, over-the-counter medicines, or herbal products without talking to your doctor first.
  • 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.
  • Limit your use of alcohol and avoid illegal drugs.
  • Talk to your doctor about an exercise plan. Exercise helps lower your blood pressure. It also makes you feel better.
  • If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes if you become unable to speak for yourself.


  • Talk to a registered dietitian. A dietitian can help you make an eating plan with the right amounts of salt (sodium), potassium, and protein. You may also need to limit how much fluid you drink each day.
  • You may have to give up many foods you like. But try to focus on the fact that this will help you stay healthy for as long as possible.
  • If you have a hard time eating enough, talk to your doctor or dietitian about ways to add calories to your diet.
  • Your diet may change as your disease changes. See your doctor for regular testing. And work with a dietitian to change your diet as needed.

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 now or seek immediate medical care if:

  • You have less urine than normal or no urine.
  • You have trouble urinating or can urinate only very small amounts.
  • You are confused or have trouble thinking clearly.
  • You feel weaker or more tired than usual.
  • You are very thirsty, lightheaded, or dizzy.
  • You have nausea and vomiting.
  • You have new swelling of your arms or feet, or your swelling is worse.
  • You have blood in your urine.
  • You have new or worse trouble breathing.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have any problems with your medicine or other treatment.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.