Kidney Disease and Your Bones: Care Instructions

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Healthy bones are constantly growing and changing. To keep your bones strong, your kidneys must keep the right balance of several important substances. These include phosphorus, calcium, parathyroid hormone, and vitamin D.

When you have chronic kidney disease, your body no longer keeps the right balance of these substances. This can lead to bone disease. When bone disease is caused by kidney problems, it is called renal bone disease.

Renal bone disease is called a "silent disease" because the bone changes begin long before symptoms occur. As renal bone disease gets worse, you may have:

  • Calcium deposits in the blood vessels, which may lead to heart disease.
  • Itchy skin.
  • Pain in your bones and joints.
  • Weak muscles.
  • Broken bones.
  • Crooked bones or short height in children.

By working with your doctor, you can take steps to reduce your chance of having weak or broken bones.

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?

  • If you don't have renal bone disease, take steps to avoid it.
    • Get regular exercise, which can help keep your bones strong.
    • Get the right amount of phosphorus, calcium, and vitamin D. Follow the diet your doctor or dietitian gives you.
  • If you have renal bone disease, take steps to treat it. For example, you may need to:
    • Eat a diet that is low in phosphorus. A dietitian can help you make an eating plan that is low in phosphorus. You may need to:
      • Limit dairy products, such as milk, yogurt, or ice cream.
      • Avoid nuts, peanut butter, seeds, lentils, peas, and beans.
      • Avoid drinks such as beer, cola, and cocoa.
    • Take a medicine called a phosphate binder. A phosphate binder helps control the level of phosphorus in your blood.
    • Take vitamin D and calcium pills.
    • Take medicine to control your parathyroid glands. In some cases, these glands need to be removed by a surgeon.
    • Exercise to strengthen your bones. To make sure that an exercise program is safe for you, talk to your doctor before you begin.
  • If you have renal bone disease, work closely with your doctor, have regular testing, and follow all treatment steps. Your doctor can advise you about how often you need testing. If you are on dialysis, you will probably be tested every 6 months.

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 new or worse nausea and vomiting.
  • You have much less urine than normal, or you have no urine.
  • You are feeling confused or cannot think clearly.
  • You have new or more blood in your urine.
  • You have new swelling.
  • You are dizzy or lightheaded, or feel like you may faint.

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

  • You do not get better as expected.

Where can you learn more?

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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.