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Lifestyle choices

What is my role with my Chronic Kidney Disease?
In most chronic diseases, including Chronic Kidney Disease (CKD), people who learn a lot about their disease and how to take care of themselves stay healthier. The more you know, the more you can help yourself!

There is a lot that can be done early in CKD to keep you feeling well and to maintain your kidney function for as long as possible. You also may be able to help prevent some long-term complications of kidney disease such as bone disease or heart problems by acting early. Your role is to learn all you can and work with your care team to get the best possible care.

Diet and exercise are two areas where you have a lot of control. Talk with your care team to determine individualized dietary guidelines based on lab tests and your stage and type of CKD. Stay active and get plenty of exercise.

It’s possible to have a full and active life with CKD or with kidney failure. For more on your role, see the “20 Tips for a Good Life with CKD”.

I was diagnosed with kidney disease. Should I stop exercising and rest more?
While we all need rest, we need exercise too. It’s been shown that exercise is good for people with kidney disease. So you should try to stay active. If you’ve been sedentary in the past, talk to your doctor about starting a mild exercise program. The key is to start slowly and build up gradually. Getting plenty of exercise is one key to helping yourself feel great, even with kidney disease.

How can smoking affect my CKD?
Smoking is an important risk factor that can make kidney disease worse. Heavy smoking, in particular, will work against you if you are trying to keep your kidney function for as long as possible.

The effects of smoking in diabetic kidney disease are well documented. Diabetics who smoke tend to develop kidney disease earlier and lose kidney function more quickly than diabetics who do not smoke, or who quit smoking. Smoking has also been shown to hasten the progression of other types of kidney disease. In addition, smoking increases high blood pressure and cardiovascular risks, two health problems that often occur along with kidney disease.

You’ll be taking better care of yourself if you can reduce the amount you smoke—or better yet—quit altogether. If you are willing to quit smoking, talk to your doctor about sustained-release buproprion (Zyban®) and nicotine replacement therapy, as well as counseling or support to help you quit.

I have Stage 3 kidney disease. Why am I so tired?
Fatigue is common in people with kidney disease. Most often, it is caused by anemia, a shortage of red blood cells. When you have anemia - you feel tired, weak, cold, and even confused. Anemia occurs with kidney disease because failing kidneys make less of a hormone called erythropoietin, or EPO. EPO tells your body to make red blood cells. Treating anemia will give you more energy and help prevent damage to your heart. Synthetic EPO - called Aranesp®, Procrit®, or Epogen®, and iron supplements are used to treat anemia brought on by kidney disease.

How do I know if I have anemia?
Your doctor can tell if you have anemia through a blood test for hemoglobin or hematocrit. Hemoglobin (Hgb) is the oxygen-carrying pigment that gives red blood cells their color. A normal Hgb level is 12–16 g/dL in women, or 14–18 g/dL in men. Hematocrit (Hct) is the percentage of total blood that is made up of red blood cells. A normal Hct is 37–47% in women, or 42–52% in men. Aranesp®, Procrit®, or Epogen®, and iron supplements are used to treat anemia from kidney disease.

What can I do about muscle cramps?
Cramps—especially leg cramps—are common for those with kidney disease. Cramps are thought to be caused by imbalances in fluid and electrolytes, but may also be caused by nerve damage or blood flow problems. If you experience cramps, here are suggestions that may help:

  • Stretch the muscle
  • Massage
  • A hot shower or bath
  • Drink plenty of water
  • Wear comfortable shoes

    A number of nephrologists prescribe quinine for their patients who are bothered by frequent cramps. Quinine does have potential risks, so be sure it really helps you before taking it for a lengthy period of time.

    What can I do about itching?
    While problems with itching are common for those with kidney disease, it can be difficult to determine the cause. Below are some reasons you may be itching and what may be done to help.

  • Blood levels of phosphorus or parathyroid hormone (PTH) that rise as kidney function drops can lead to itchy skin (and other problems). If you have high phosphorus or PTH levels, your doctor can prescribe a phosphate binder drug for you to take with meals and snacks to get your blood levels into the target range.
  • Itching can be caused by dry skin. Try a good moisturizing cream or lotion.
  • Allergies can cause itching and can happen at any time, even from products you have used for a long time. Think about what you could be sensitive to in your environment such as soaps, lotions, detergents, perfumes, etc.
  • Many people find that getting out in the sun a bit helps with itching, though the reasons for this are unclear.

    Ask your nephrologist and/or dermatologist for tips on how you can deal with stubborn itching.