Chronic Kidney Disease

General education. Dietary limits, fluid intake, medication dosing, and laboratory follow-up must be individualized according to CKD stage, potassium level, urine protein, blood pressure, diabetes, heart disease, and dialysis status.

Chronic Kidney Disease (CKD): Patient Education

Chronic kidney disease means the kidneys have been damaged or are not filtering the blood as well as they should. CKD may remain stable for years, especially when blood pressure, diabetes, medications, and diet are carefully managed. Most patients do not experience symptoms during the early stages.

Protect Your Kidneys

• Take medications exactly as prescribed. Do not stop blood-pressure or kidney-protective medications without speaking with your clinician.
• Check blood pressure at home and bring the readings to each visit.
• If you have diabetes, monitor blood sugar and follow the treatment plan.
• Keep all appointments and complete the ordered blood and urine tests. Important results include creatinine, eGFR, potassium, bicarbonate, and urine protein or albumin.
• Avoid smoking and remain physically active as tolerated.
• Maintain a healthy weight.

Medicines and Supplements

Avoid NSAID pain relievers unless specifically approved by your clinician. These include:

• Ibuprofen: Advil or Motrin
• Naproxen: Aleve
• Meloxicam: Mobic
• Celecoxib: Celebrex
• Diclofenac tablets
• Indomethacin

NSAIDs can reduce blood flow to the kidneys and may worsen kidney function, blood pressure, and swelling. Acetaminophen is generally safer for the kidneys when used at the recommended dose, but confirm this with your clinician. kidney.org

Before starting vitamins, herbal products, protein or creatine supplements, antacids, laxatives, or over-the-counter medicines, ask your clinician or pharmacist. Remind every healthcare professional that you have CKD, especially before receiving contrast dye or starting an antibiotic.

Eating With CKD

• Limit sodium to approximately 2,000 mg daily. Avoid adding salt and reduce processed meats, canned soups, frozen meals, fast food, chips, and salty seasonings.
• Choose fresh foods and more plant-based, minimally processed meals.
• Avoid very high-protein diets and unnecessary protein supplements. Many adults with CKD stages 3–5 are advised to consume approximately 0.8 gram of protein per kilogram of body weight daily, but the correct amount should be individualized.
• Potassium and phosphorus do not need to be restricted automatically. Restrict them only when laboratory results or the kidney clinician indicate this.
• Do not use potassium-containing salt substitutes unless approved.
• Fluid restriction is not required for every patient. Follow the individualized fluid instructions, particularly if there is swelling, heart failure, low sodium, or advanced kidney failure. kdigo.org

During Vomiting, Diarrhea, or Poor Intake

Dehydration can suddenly worsen kidney function. Contact the medical team if vomiting, diarrhea, fever, or poor intake persists. Ask whether any medications should be temporarily held; do not stop them independently.

Call the Clinic Promptly for

Increasing leg swelling, rapid weight gain, reduced urine output, persistent nausea or vomiting, worsening fatigue, uncontrolled blood pressure, muscle weakness, or new medication concerns.

Seek Emergency Care for

Severe shortness of breath, chest pain, confusion, fainting, inability to urinate, severe weakness, or a very high blood pressure accompanied by neurologic or cardiac symptoms.