What will happen if I refuse pre-ESRD care?
Refusing pre-ESRD care may result in accelleration of kidney damage and earlier development of or worsening of complications of CKD, such as anemia, loss of appetite and fatigue. In short, progression to ESRD or early death may become inevitable. Cardiovascular complications such as heart enlargement and heart failure may also set in earlier. Hence, refusal may result in more frequent hospitalizations, bigger expenses, emotional trauma, and poor quality of life. Moreover, you may not be prepared well for eventual need for renal replacement therapy, resulting in hasty and risky initiation of dialysis.
What is my role with my Chronic Kidney Disease?
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 and your dietitian to determine individualized dietary guidelines based on lab tests and your stage and type of CKD. Stay active and get plenty of exercise.
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.
What to eat
Should I be on a low protein diet?
Protein, found in meats, fish, poultry, dairy products, nuts, and some grains, helps your body form muscle and tissue. But when your kidneys are not working well, the byproducts of protein breakdown can build up in your blood. This can make your kidneys work harder.
Some studies of low protein diets show that they can slow the progression of kidney failure. But other studies show that such diets do not help. Due to these mixed results, and the need to maintain good nutrition, doctors differ about the need to limit protein for people with chronic kidney disease (CKD). The answer is often moderation.
In all cases, it’s crucial to avoid malnutrition. A blood test for albumin, a form of protein, is a good way to tell if you are getting enough good food. Your albumin level should be 4.0 g/dL or higher. If you notice weight loss, loss of appetite, or other signs of poor nutrition, talk to your doctor.
Should I be on a low phosphorus diet?
Ask your doctor – the answer will often be yes. Phosphorus is a mineral found mostly in dairy products and meats. Your body uses it to form strong bones and teeth. But starting in moderate CKD, your kidneys begin to lose the ability to remove extra phosphorus from your body. Because too much phosphorus can harm your bones, it makes sense to eat less phosphorus. Some experts think 800 to 1,200 mg. of phosphorus per day is a good target. Foods high in protein tend to be high in phosphorus, too.
Should I be on a low potassium diet?
Having the right level of potassium in your body helps all your muscles work smoothly, including your heart. When kidneys fail, they start to lose this ability.Your potassium level should be checked regularly with a blood test. If your levels are too high, your doctor will ask you to start a LOW potassium diet. Many foods have potassium, but some like avocados, dried fruits like raisins, apricots and prunes, potatoes, oranges, bananas and salt substitutes are very high in potassium.
What can I do about loss of appetite?
Poor appetite is a common symptom of advanced kidney disease. Even if you are not hungry, it is important to eat and keep good nutrition. As kidney function drops, you may notice that protein foods, such as eggs, meat, chicken and fish lose their appeal. You need calories and quality protein to feel your best. To get good nutrition try to:
- Eat more bland, starchy foods or whatever appeals to you
- Eat small portions of protein foods.
- Try a liquid nutritional drink like Nepro® once a day
- Graze all day—have several small meals instead of three large ones
- Boost the protein content of your meals by adding egg whites, egg white powder or protein powder
- Get help from a renal dietitian, if lack of appetite continues.
Finally, if you are in Stage 5 CKD and your appetite or nutritional well-being does not improve, this may be a sign that you should start dialysis. Many people find their appetite improve after some time on dialysis.
What are the treatment options for end-stage renal disease (ESRD)?
There are three types of treatment for kdiney failure: hemodialysis, peritoneal dialysis and transplantation. Dialysis is a medical term that means cleaning the blood by artificial means. During dialysis, wastes and extra fluid that build up due to kidney failure are removed from the blood using a dialyzer (artificial kidney) or your own abdomen (peritoneal membrane). Kidney transplantation involves receiving a kidney transplant from another person (donor) through surgery. The new kidney (graft) is placed in your abdomen and will do the work your damaged kidneys did.
» data courtesy of Philippine Society of Nephrology «
Article by Julius
Julius is a blogger and a freelance graphics artist undergoing dialysis treatment since 2003. An enthusiastic person by nature, he loves to write, blog, cook, read books, tinker around, listen to rock music, and do research.
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