Discharge Instructions for Chronic Kidney Disease (CKD)

The job of the kidneys is to remove waste products and extra water from the blood. When the kidneys don't work as they should, waste products start to build up in the blood. This is called chronic kidney disease (CKD). 

CKD means that you have kidney damage or a decrease in kidney function lasting at least 3 months. CKD allows extra water, waste, and toxins to build up in the body. This can become life-threatening over time. You might need dialysis or a kidney transplant to stay alive. This most severe form is called end-stage renal disease.

Chronic kidney disease can happen because of many things. These include:

• Infections

• Diabetes

• High blood pressure

• Kidney stones

• Circulation problems

• Reactions to medicine

Having kidney disease means making many changes in your life. Learn as much as you can about it so that you can better adjust to these changes. It's important to remember that the main goal of treatment is to stop CKD from progressing to kidney failure. Treatments may vary based on the progression of CKD. Always follow your healthcare provider's directions on how to manage your condition.

Below are some things you can do to help you manage CKD.

Changes to what you eat and drink

When you have CKD, your body can’t process certain things as well. You need to make changes to what you eat and drink. Eat small meals often that are high in fiber and calories. You may be told to limit how much fluid you drink.

Talk with your healthcare provider before making any changes to what you eat and drink. Any kind of dietary change can feel overwhelming and confusing. You can ask your provider to refer you to a registered dietitian. This person can help you plan and manage the changes to your diet.

Reduce your salt (sodium)

You may be told to have 1,500 mg or less of sodium daily. This section will help you make that happen.

When shopping for foods:

• Buy fresh meats and fish, and fresh vegetables and fruits. These don’t have added sodium.

• Don’t buy processed foods. These include frozen and pre-made meals, canned meat and fish, and lunch meats.

• Don’t buy salty foods such as cheese, pickled foods, or salty snacks.

• Read all food labels to check sodium levels.

• Don’t eat fast food. It's often high in sodium.

When cooking at home:

• Don't add salt to your food while cooking or before eating at the table.

• Season foods with fresh herbs, garlic, onions, citrus, and flavored vinegar. Use salt-free spice blends.

• Don't use salt substitutes that are high in potassium. Ask your healthcare provider or a dietitian which salt substitutes to use.

Other sources of hidden sodium include:

• Softened water. Don’t drink water that has been through a water softener. It has sodium in it.

• Bottled water. Some types of mineral water have sodium. Make sure to read labels.

• Some medicines. Some over-the-counter (OTC) medicines that have sodium bicarbonate or sodium carbonate. Read labels carefully. If you aren't certain about a medicine, talk with the pharmacist before using it.

Watch your potassium  

You may be told to eat less than 1,500 mg to 2,700 mg of potassium daily. To stay on target:

• Check all food labels to see how much potassium is in the product.

• Always drain canned foods before serving. This includes canned vegetables, fruits, and meats.

• Don't eat whole-grain bread, wheat bran, or granola.

• Don't eat milk, buttermilk, or yogurt.

• Don't eat nuts, seeds, peanut butter, dried beans, or peas.

• Don't eat fig cookies, chocolate, or molasses.

• Don't use salt substitutes that are high in potassium. Ask your healthcare provider or a dietitian which salt substitutes to use.

Limit your protein

Based on your condition, your healthcare provider will talk with you about why you should limit protein in your diet. To do this:

• Eat less meat, milk products, yogurt, eggs, and cheese.

• Check all food labels to see how much protein is in the product.

Avoid phosphorus

When you have CKD, your kidneys can’t remove phosphorus from your blood very well. High phosphorus levels can cause damage to your body and make your bones weak. To avoid phosphorus in your diet:

• Don't drink beer, cocoa, dark colas, ale, chocolate drinks, or canned ice teas.

• Don't eat cheese, milk, ice cream, pudding, yogurt, or caramel.

• Don't eat liver (beef, chicken), organ meats, oysters, crayfish, or sardines.

• Don't eat beans (soy, kidney, black, garbanzo, and northern), peas (chick and split), bran cereals, or nuts.

General home care

• Try not to wear yourself out or get too tired.

• Get plenty of rest and get more sleep at night.

• Bend and move your legs often. This helps to prevent blood clots when you rest for a long time.

• Weigh yourself every day. Do this at the same time of day and in the same kind of clothes. Keep a record of your daily weights.

• Take your medicines exactly as directed.

• Keep all medical appointments.

• Take steps to control high blood pressure or diabetes. Talk with your healthcare provider for advice.

• Talk with your provider about dialysis. This procedure may help if your chronic kidney disease is progressing to end stage renal disease.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to call your healthcare provider

Call your provider right away if you have any of these:

• Trouble eating or drinking

• Weight loss of more than  2 pounds in  24 hours or more than  5 pounds in  7 days

• Weight gain of more than 3 pounds in 2 days or 5 pounds in 3 days

• Little or no urine output

• Trouble breathing

• Muscle aches

• Fever of  100.4°F ( 38°C) or higher, or as advised by your provider

• Blood in your urine or stool

• Bloody fluid leaking from your nose, mouth, or ears

• Severe headache or a seizure

• Vomiting

• Swollen legs or ankles

• Feeling depressed or anxious

Call 911

Call 911 right away if you have:

• Chest pain