Perhaps you are like most people when they find out they have kidney disease – overwhelmed and unsure. This is a very stressful time and your diagnosis of kidney failure may have come out of left field. You need to understand what is happening (whether you are pre-dialysis or already started dialysis) so you can get past the scared and flustered state that happened when you found out about your diagnosis.
Consider this your top list of things to understand about kidney disease and kidney failure, so that you can get in the right frame of mind and realize you are not going to die tomorrow. As a matter of fact, kidney disease is quite manageable with a few changes to your life.
You are a person with kidney disease. You are not kidney disease and it is not the only thing that defines you.
You might feel that way sometimes when it’s all you talk about, but understand that you are a person first and you have a condition that needs to be managed.
Your intrinsic value is not in whether or not you are healthy. You have a story, a life, a legacy to hand down. Your life doesn’t stop because you have kidney disease, it is just another chapter. You are not going to die from it tomorrow, you can live quite well, but only once you realize it is a condition. It didn’t pick you to be spiteful, as a matter of fact, you may or may not have contributed to your condition. Whether you did or not does not change the reality of today. So accept your condition and accept yourself. You are a person who has kidney disease, not kidney disease itself.
You are responsible for taking the actions needed to reduce the side effects and improve your treatments. This goes for you whether or not you are on dialysis. If you are not on dialysis (in Stage 1 – 5), there are specific things you can do to slow down the progression of kidney disease and failure. No magical cure exists for kidney disease, regardless of how many people try to convince you otherwise. If you are on dialysis, you can choose from many different ways to dialyze, but it is something that you will need to do based on your doctor’s prescription.
One important way you can take control of your condition is to know your lab values. Your lab values will be checked many times, and your doctor may or may not discuss them with you. You should make a point of getting the information and reviewing it for changes over time. Then ask your doctor or dietitian what you should do to change the value of those that are too high or too low.
The big lab value is eGFR and it usually provides your doctor with information about the stage of kidney disease you have. Combined with creatinine values and urine protein amounts, you can tell if you are on the fast track to dialysis or if you are controlling your disease. You should also ask about potassium and phosphorus levels, and understand if you need to restrict them in your diet.
It is important to understand how intimately related lab values and diet are. What you put into your body is broken down and goes into your bloodstream for your body to process. Much of that processing produces waste products. Many of your waste products are removed from your body by your kidneys. As they become damaged, your ability to remove the waste is limited, so you must control what you put into your body.
Knowing what is a problem, whether it’s potassium, phosphorus, calcium, protein or sodium is key to understanding what to limit in your diet.
Speaking of diet, you need to follow the right diet based on your condition.
What is the right diet? Based on the answer to #2 of the 7 things you need to know about kidney disease, you should know what stage of kidney failure you are in. Then proceed to address your dietary needs related to your labs and stage of kidney disease. General guidelines are as follows, your specific condition questions should be answered by your doctor.
If you are pre-dialysis and are in an early stage, such as 1 – 3, you need to control your related conditions. You have little need to limit your protein, and should aim to increase fruits, vegetables, and whole grains. Eating less sugar and salt will help control diabetes and high blood pressure. The diet that most doctors recommend is the DASH diet (Dietary Approaches To Stopping Hypertension) which research has shown is very effective in reducing blood pressure levels.
If you are in a later stage of kidney failure but not on dialysis, you will limit protein and salt at first, then potassium and phosphorus as your condition and labs reveal. Protein is usually limited to .6 – .8 grams of protein per kilogram of body weight per day. One kilogram is equal to 2.2 pounds. So a 200 pound man would weigh 90.9 kilograms and eat 54 – 73 grams of protein per day.
To put that in ounces, you have 7 grams of protein per ounce of meat (beef, chicken, fish, pork). So he could eat between 7 – 10 ounces of meat per day. About 2 ounces at breakfast and 4 ounces at lunch and supper.
On dialysis, you typically work with a dietitian in the in-center hemodialysis unit to adjust your food based on your lab work. Many times more protein is allowed because your body needs to use it and your dialysis eliminates the waste products so you can eat more. Other minerals, like potassium and phosphorus are important and controlled with both medication and dialysis. You also might have anemia and need additional iron or other medications that help increase your blood cell level.
Your related conditions are still very important to your management of kidney disease.
What are your related conditions? Diabetes and Heart Disease.
Let’s start with Diabetes – If you don’t manage your diabetes well and keep your HgA1c in check, you continue to cause damage to your body. How do you manage your diabetes well? You follow your dietary restrictions, take your meds, exercise, and check your blood sugar. If you have not been to a dietitian, you need to find one who will help you understand how your foods are related to blood sugar levels. If you need more help with figuring out carbohydrate counting, you can check out my book at: www.renaldiethq.com/go/ccdbook
Now, did you know that most people diet of heart related problems and not kidney disease? I don’t know if you are thinking to yourself – not me! Or if you are wondering why me? Either way, many of the tenants of a healthy kidney disease diet go well with a heart healthy diet. Things like eating less salt and balancing your fat and carbohydrate counts are great for eating heart healthy. Realize that if you still have high blood pressure, you should take your medication consistently, monitor your blood pressure, and try to do some exercise (sitting or standing) to improve your heart.
While you should always follow your doctor’s recommendations about your care, using some complementary medicine techniques can be very calming and soothing to your health.
Use of essential oils can relax your body and relieve pain. Some essential oils are harmful for those with kidney failure, so be cautious and listen to the respected advice of people who have studied such practice. Our caregiver guide goes into great detail about how to use aromatherapy and reflexology in your kidney disease care – taking into account the ramifications of kidney failure.
To begin with, it’s nice to use a bit of lavender to soothe you. You might find some wax that can be melted in a warmer that has the scent of lavender. Having this going in your house when you have company or just need to relax can calm the environment. Another essential oil that works well for people with kidney failure is mandarin, which helps with treating exhaustion and fatigue. It appears to stimulate the adrenal glands and helps reduce stress. You can find this essential oil at Amazon: http://www.renaldiethq.com/go/mandarinoil
It’s best to add the oil to warm water, such as a bath, using just a few drops. Or add a few drops to a neutral scented lotion and rub the lotion into your skin several times a day. The work that essential oils do is subtle but effective. Other essential oils you might consider include tea tree for anti bacterial properties, and rosemary which helps with joint pain.
In addition to using some complementary medicine, you should always take your medications that are prescribed.
If you don’t know why you are taking something, then you need to call the doctor and speak with the nurse or leave a message. Many medications can help slow the progression of kidney failure, simply by decreasing the blood pressure and reducing the damage done to the kidneys.
Other medications can cause more harm, namely ibuprofen, which is often taken for pain relief and arthritis. Ask your doctor about medications that can slow the progression of kidney failure, and what medications you should NOT be taking.
If you want to understand more about medications and talking to your doctor about treating your kidney failure, you can read my first book which is highly researched and relevant. Find it at: http://www.renaldiethq.com/go/livingwithchronickidneydisease
I go into great detail about how to manage your diagnosis from the time that you find out to the time you need dialysis.
Last but not least, depression is a subject that I want to discuss.
Depression is real and can be deadly. It’s a reality that the diagnosis and day to day management of your kidney disease can seem overwhelming.
You need to know that there is help out there – whether it’s the social worker in your dialysis unit or your friend’s shoulder. You should talk about your feelings, and know it’s ok to be angry or sad sometimes. But it’s not ok when it takes over your life and starts to become an everyday thing.
Do not allow the sadness to take over your life. It goes back to the first statement I made in the article – kidney disease is not you, you are a person with kidney disease.
Really taking a step back and asking yourself if you are depressed or sad all the time is the first step to getting help. Then ask. People want to help.
You have value regardless of how you might feel at the moment. You have people who love and want to talk to you every day.
With all of that said, it’s great to have a place to start to eat healthier and wiser, right? You can check out our meal plans at: Renal Diet Meal Plans
And feel free to ask questions by sending a note through the contact us page or responding to your emails. I am always listening.
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