Living with Chronic Kidney Disease: 5 Essential Do’s and Don’ts

Living with Chronic Kidney Disease: 5 Essential Do’s and Don’ts

Managing Chronic Kidney Disease (CKD) can feel overwhelming because the advice changes depending on your stage. A 27-year-old with Stage 1 CKD (normal function with protein leakage) requires a different strategy than an 87-year-old with Stage 5 (kidney failure).

CKD is categorised into five stages based on your Glomerular Filtration Rate (eGFR)—a measure of how well your kidneys filter blood.

While every patient is unique, the following “Golden Rules” apply to almost everyone living with CKD to help stabilize kidney function and prevent progression.

5 Essential “Do’s” for CKD Patients

1. Optimise Your Blood Pressure (The #1 Priority)

High blood pressure is both a cause and a result of kidney disease. Controlling it is the single most effective way to protect your kidneys.

• Target: Aim for <130/80 mmHg (or <120/70 mmHg if you have diabetes).

• Medication: Ask your doctor about ACE inhibitors (e.g. Ramipril) or ARBs (e.g. Losartan). These specifically protect the kidney’s filters.

2. Know Your Numbers (eGFR, Creatinine and Potassium)

Don’t be a passive patient. Access your blood results via the NHS App or Patients Know Best (PKB).

• Monitor: Track your eGFR, Creatinine, and Potassium levels.

• Advanced Stages: If you are Stage 4 or 5, you must also monitor Calcium, Phosphate, PTH, and Bicarbonate to prevent bone disease and acidity.

3. Embrace “Kidney-Friendly” Lifestyle Changes

CKD significantly increases your cardiovascular risk. Protecting your heart protects your kidneys.

• Stop Smoking: Smoking narrows blood vessels and accelerates kidney scarring.

• Exercise: Aim for 30 minutes of moderate activity 5 days a week.

• Weight: Maintaining a healthy BMI reduces the “hyperfiltration” strain on your kidneys.

4. Fine-Tune Your Nutrition

As CKD progresses, your kidneys struggle to process certain minerals.

• Salt: Reduce sodium to lower blood pressure.

• Specialist Diet: Depending on your blood tests, a renal dietitian may advise you to limit Potassium (found in bananas/potatoes) or Phosphate (found in dairy/processed foods).

5. Review and Reconcile Your Medications

Many drugs are cleared by the kidneys. If your eGFR drops, the “normal” dose of a drug may become toxic.

• Dose Adjustments: Ensure your GP reviews your repeat prescriptions annually to check if doses need to be lowered based on your current eGFR.

5 Critical “Don’ts” for CKD Patients

1. Don’t Use NSAID Painkillers

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen (Advil/Nurofen), Naproxen, or high-dose Aspirin can be “nephrotoxic.”

• The Risk: These drugs restrict blood flow to the kidneys and can cause Acute Kidney Injury (AKI).

• Alternative: Use Paracetamol for pain management unless otherwise directed by a specialist.

2. Don’t Assume a New Prescription is “Kidney-Safe”

Even if a doctor prescribes a new medication, they may not have your most recent eGFR on file.

• The Habit: Always ask: “Is this drug safe for my kidneys, and is the dose correct for my current eGFR?” ### 3. Don’t Ignore Cardiovascular Risks

  Most patients with CKD don’t actually progress to dialysis; they are more at risk of heart disease.

• The Action: Don’t skip your statins or blood pressure pills. Managing cholesterol and blood sugar is vital to long-term survival with CKD.

4. Don’t Miss Your Specialist Appointments

CKD is often a “silent” disease. You may feel perfectly fine while your kidney function is dropping.

• Be “The Glue”: NHS systems don’t always talk to each other. Don’t assume your consultant’s notes have reached your GP. Bring a list of your latest results and medications to every appointment.

5. Don’t Wait for a Transplant Referral

If you reach Stage 4 or 5, don’t assume you are automatically on “the list.”

• Be Proactive: Ask your team specifically about “transplant workup.”

• The Conversation: Discuss living donation with healthy friends or relatives early. A pre-emptive transplant (before starting dialysis) offers the best long-term outcomes.

Summary Checklist

Patient Tip: Recovery is possible. While scarred kidney tissue doesn’t “regrow,” function can stabilize or even improve if the underlying cause (like high blood pressure or diabetes) is aggressively managed.