9 Steps You Can Take Today to Better Manage CKD
When your kidneys become so damaged over time that they can’t properly do their job—filtering waste from your blood—it can lead to a diagnosis of chronic kidney disease (CKD). And with this diagnosis comes an urgent goal: Protect your kidneys from further damage. Beyond medications and other treatments, managing CKD also involves making some big changes to your lifestyle—but that doesn’t mean you can’t start small. Keep reading for nine steps you can take right away to help stay as healthy as possible with CKD.
A Word About Blood Pressure
“Maintaining a good, well-controlled blood pressure can often slow down progressive kidney damage,” explains Silas Norman, M.D., nephrologist at Michigan Medicine Transplant Clinic in Ann Arbor, MI. This is because of each of your kidneys contains about a million nephrons, which are blood vessels that filter out waste products like potassium and phosphorous, says Dr. Norman. So just like how high blood pressure can damage other blood vessels in your body, it can also damage these filters—that’s why many of the following steps help you target your blood pressure in order to protect your kidneys.
Keep Track of Your Blood Pressure at Home
The top tip to help manage CKD is all about monitoring that blood pressure closely—and that means not just relying on blood pressure checks at the doctor’s office, says Nicole Ali, M.D., transplant nephrologist at NYU Langone’s Transplant Institute in New York City. It’s a good idea to buy a blood pressure cuff so you can be in-the-know at home: “Check your blood pressure every day or couple of days so you have an idea,” Dr. Ali says. And if you notice that numbers are going up, alert your doctor. “Being proactive and involved in your care is important.”
Start Simple With Your Exercise Routine
Exercise is a huge for CKD management since it helps lower blood pressure. The best way to get started? Find small ways to be active that suit your routine: “If it’s easy to walk for five minutes a day, that’s a terrific start,” says Dr. Norman. “Put dinner in the oven then walk [around the house] for the 20 minutes it takes to get cook, or try a simple activity like sitting to standing from a chair during a half-hour program you like.” (If you also have CKD and diabetes, exercise can help you keep your blood glucose levels in check as well, according to the National Institutes of Health.)
Make an Appointment With a Dietitian
Healthy eating habits are also really important when managing CKD, says Dr. Ali. But what does a kidney-friendly diet look like? It can vary somewhat from person to person—which is why it can be helpful to work with a registered dietitian, says Dr. Ali. “Ask to see a nutritionist who specializes in kidney disease so they can help you with tailoring your diet,” she says. In fact, the American Academy of Nutrition and Dietetics strongly recommends anyone with CKD get medical nutrition therapy (MNT), which is more focused on disease management than more typical nutrition counseling. Ask your doctor for a referral, and check with your insurance to see whether MNT is covered.
Use Online Resources for Meal Ideas
Once you’ve learned more about your unique nutritional needs due to CKD, you may find yourself struggling with dietary restrictions. In addition to working with a dietitian, Dr. Ali recommends using the National Kidney Foundation’s website to find recipes and meal ideas that work for you. “It allows patients to put in all their restrictions, and it gives them really good-tasting recipes they can cook at home that could actually work with their diet,” she says. “So it’s really helpful for those patients who have multiple restrictions.”
Learn About Sleep Hygiene
Not getting enough shut-eye? That could be worsening your blood pressure or blood glucose levels, and therefore your CKD, according to the NIH. “Inconsistent sleep has definitely been shown to increase the risk of high blood pressure,” says Dr. Ali. Learning basic sleep hygiene tips is a good place to begin. For example, keeping a consistent bedtime and waketime; cutting off technology an hour before bed; avoiding large meals and alcohol before bed; and keeping your bedroom cool and dark are all tried-and-true ways to improve sleep, the NIH says. Focus on tackling one or two of these changes at a time.
Get on the Path to Quit Smoking
If you smoke, quitting ASAP is vital when you have a diagnosis of CKD, according to the NIH. “Smoking causes damage to blood vessels and contributes to high blood pressure,” Dr. Norman explains. This is especially dangerous when considering that CKD can also increase your risk of heart disease, he says. Quitting smoking can be a challenging task, so beginning with a small, simple step can help. For example, try downloading the CDC’s quitSTART app for support in your journey to stop smoking.
Set Aside Time for Self-Care
Stress is bad for your health—and that includes your CKD. In fact, stress can increase your blood pressure and blood glucose, which both can contribute to kidney damage, per the NIH. That’s why it’s important to prioritize self-care in your life when you have this condition. Try to set aside time each day—even if it’s just a few minutes—to do something you know makes you feel calm and relaxed, like listening to music or meditating. For some people, this might include daily exercise. You can even set an alarm to help hold yourself accountable, suggests Dr. Ali.
Get to Know Your Patient Portal
Of course, managing CKD also means staying close contact with your doctor and being involved in your care, Dr. Ali says. You need to keep up with appointments, of course, but there are other ways to be proactive, too. “Especially with the pandemic, there’s more availability of electronic resources and access to patient portals and records,” says Dr Ali. “I encourage patients to take advantage of those so you can see things like labs for yourself and stay informed.” If you haven’t yet, set aside a time to get to click around in your online portal or checkout other resources your provider offers.
Take Your Medications as Prescribed
Taking medications as prescribed is also a must to help manage CKD, Dr. Ali says. Do some research to get informed about new drugs you’re starting, and let your doctor know right away if any side effects arise, she says. “For example, the top reason why my patients with high blood pressure don’t take their medications is because when their blood pressure comes down to normal, they feel fatigued—and that’s because your brain has gotten used to an unhealthy level of high blood pressure,” she explains. “It’s a matter of your body taking time to get used to normal.”
The Bottom Line on Managing CKD
When you’re diagnosed with CKD, all the test and doctor’s appointments can be stressful. So we get it—thinking about taking even more steps to prevent further kidney damage can seem daunting. But remember: Start with small, manageable actions. “This really is about lifestyle change, and it’s easy to get overwhelmed in trying to do everything at once, but small, steady steps can make an impact,” says Dr. Norman. Working your way up with these bigger lifestyle changes is A-OK—and it can still make a real difference in your health.
Academy of Nutrition and Dietetics CKD Information: Academy of Nutrition and Dietetics. (2020.) “Chronic Kidney Disease (CKD) Guideline.” andeal.org/topic.cfm?cat=3927
CKD Management Information: National Institutes of Health. (2016). “Managing Chronic Kidney Disease.” niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/managing
Sleep Hygiene Information: National Institutes of Health. (2020.) Sleep Deprivation and Deficiency.” nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency