What Can I Do?

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This is a frequent question asked by almost all patients.  Most Doctors wish they had a “magic pill” to fix everything.  The reality is we don’t.  This section is focused on the patient responsibilities to have a successful outcome for treatment of your condition.  For more detailed information on “What Can I Do” consult the physicians at Kidney and Hypertension Institute of Utah.

It is your health:  Kidney disease may be difficult to detect.  If you follow some simple guidelines you can aide your doctor in getting an early diagnosis and treatment plan.  Determine your risk by asking yourself if you have any of the following: 1. Diabetes 2. High Blood Pressure 3. Family History of Kidney Disease  4. Heart Disease 5. Are you a US ethnic minority of Hispanic or African American?  If you answered yes to any of these question and you have not already been screened, ask your doctor or call the Kidney and Hypertension Institute of Utah to be screened for kidney disease or high blood pressure.  The screening is very simple and requires three simple tests; a urine specimen, blood pressure measurement, and blood draw for the serum creatinine to determine your Glomerular Filtration Rate (GFR).  If any of these screening tests are abnormal discuss with your doctor or one of our doctors to determine the next step in diagnosing and treating your conditions.

High Blood Pressure/Hypertension:  Treatment of most kidney disease is focused around treatment of the condition that caused the Kidney Disease.  About 30-40% of kidney failure in the United States is a result of high blood pressure.  If high blood pressure is the reason for your kidney disease it is very important that you work with your doctor to achieve appropriate blood pressure control.  It is advised to purchase an arm blood pressure monitor and check your blood pressure at home and record the pressure at a frequency of 2-3 times per week.  Make sure the average blood pressures are adequate for you and your doctor’s goal of therapy.  Underlying kidney disease may also cause high blood pressure; if you have high blood pressure it is important to have your kidneys and urine checked.

Medications:  Your doctor will prescribe certain medications to control diabetes, high blood pressure, kidney disease, or to treat the complications of kidney disease such as bone disease, anemia, heart disease, and high blood pressure.  It is important that you are on disease specific medications for this.  A kidney doctor is the best person to get you on the correct medications.  It is important that you take your medications as prescribed and call your doctor for refills when the medications run out if appropriate.  Some prescription and over-the-counter medications may harm your kidneys, always check with your doctor or pharmacist to see if the medications need a dose adjustment or are harmful to your kidneys.  Please see Dos/Don’ts with OTC Medications. If you are a current patient of the Kidney & Hypertension Institute, please advise us of all new medications that are prescribed to you.

Diet:  This is a very difficult subject to explain to patients because of multiple diets needed for associated conditions.  In other words, do I have to follow a kidney or diabetic diet if I have diabetic kidney problems?  To give a general diet for all patients with kidney disease would be impossible, however due to the fluid accumulation associated with kidney disease it is advisable to limit salt and fluid consumption.  This will help prevent fluid accumulation in your lungs, ankles and feet.  As kidney disease advances you might be asked to go on a low potassium, phosphorus, or protein diet.  Only do this under the advice of your kidney doctor.

Diabetes:  This is an extremely long and difficult topic.  The best advice is to work with your primary doctor and/or diabetic doctor (endocrinologist) to ensure your blood sugars are treated to the recommended goals by the American Diabetes Association.  Tight blood sugar control will slow the progression of diabetic kidney disease.

Your Doctors:  Doctors are your friends.  It is important to tell them you have kidney disease or risk factors for kidney disease.  Patients with Chronic Kidney Disease are at risk for certain things that should be evaluated.  Kidney patients are a special group of individuals that require different blood pressure goals and treatment parameters than the general population.  Please tell your doctor if  you have kidney disease or at risk.  If you have risk factors of Diabetes, High Blood Pressure, or Heart Disease see  your doctor to be screened for kidney disease. Doctor’s at the Kidney and Hypertension Institute of Utah are more than happy to personally discuss your individual case with your doctor to see if further evaluation or treatment is needed.  We strive to bridge the communication between patient, specialist, and primary care provider.

Exercise:  Walking and most types of exercise are a very effective therapy for your health.  Exercise is one of the “biggest bangs for the buck” you can do for your health.  Exercise has been shown to improve almost every aspect of your health.  It lowers your blood pressure, decrease chance of heart disease, improves control of Diabetes, and a multitude of other benefits.  It is important to start slow, but stick with it and slowly advance to your exercise comfort level. Exercise is cheaper than a months’ supply of medications for Diabetes and High Blood Pressure. It makes economic sense to exercise.

Smoking:  If you smoke and have kidney disease, your kidney disease progresses to dialysis at a faster rate regardless of other concurrent treatments for your kidney disease.  Please don’t smoke and if you smoke try to quit and ask your physician for help.  There are effective medications, seminars, and over the counter medications to aide in your cessation of smoking.

Alcohol: Please ask your physician or kidney doctor the specific benefits and detriments of alcohol to your health. 

Diagnosis:  The success of your outcome heavily relies on the accuracy of the diagnosis.  The focus of delaying the progression of kidney disease relies on the treatment of the underlying cause and early intervention.  70-80% of kidney failure in the United States is due to Diabetes or High Blood Pressure.  That means around 30% of kidney disease is related to something else.  Most all patients with advanced kidney disease have high blood pressure, not all patients with high blood pressure get kidney disease.  The Kidney and Hypertensive Institute Physicians strive to give you an accurate diagnosis for your condition.  Ask your doctor to be screened for kidney disease if you are at risk and contact us if indicated.