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Medical Author:

Pranay Kathuria, MD, FACP, FASN, FNKF

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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

• There are, however, several important dietary rules one can follow to help slow the progression of kidney disease and decrease the likelihood of complications.
• This is a complex process and must be individualized, generally with the help of a 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 one determine the appropriate amount of protein.
• Salt restriction: Limit to 2 to 4grams 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, the 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, avocados, 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 a patient can take include:

• carefully follow prescribed regimens to control 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 Phospho-Soda enemas because of their high content of phosphorus
• Laxatives and antacids containing magnesium and aluminum such as magnesium hydroxide (Milk of Magnesia) and magnesium and aluminum hydroxide (Mylanta)
• Ulcer medication H2-receptor antagonists: cimetidine (Tagamet) and ranitidine (Zantac) (decreased dosage with kidney disease)
• Decongestants such as pseudoephedrine (Sudafed) and phenylpropanolamine (Rhindecon) especially if the patient has high blood pressure
• Alka Seltzer, since this contains large amounts of sodium
• Herbal medications

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

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