Chronic Kidney Disease (cont.)
Chronic Kidney Disease Treatment
Chronic Kidney Disease Self-Care at Home
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;
- 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.
Pranay Kathuria, MD, FACP, FASN, FNKF
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