Discharge Instructions for Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) can happen because of many things. These include infections, diabetes, high blood pressure, kidney stones, circulation problems, and reactions to medicine. Having kidney disease means making many changes in your life. Learn as much as you can about it so that you can better adjust to these changes. It's important to remember that the main goal of treatment is to stop CKD from progressing to complete kidney failure. Treatments may vary based on the progression of CKD. Always follow your healthcare provider's directions on how to manage your condition.

Here are some things you can do to help your condition.

Diet changes

Always discuss your diet with your healthcare provider before making any changes. Some people find the needed dietary changes overwhelming and confusing. If it feels like that to you or your family members, ask your provider to meet with a registered dietitian to get help managing the changes to your diet.

Salt (sodium) in your diet

• Based on your condition, you may be told to eat 1,500 mg or less of sodium daily

• Limit processed foods such as:

  • Frozen dinners and packaged meals

  • Canned fish and meats

  • Pickled foods

  • Salted snacks

  • Lunch meats

  • Sauces

  • Most cheeses

  • Fast foods

• Don't add salt to your food while cooking or before eating at the table.

• Eat unprocessed foods to lower the sodium, such as:

  • Fresh turkey and chicken

  • Lean beef

  • Unsalted tuna

  • Fresh fish

  • Fresh vegetables and fruits

• Season foods with fresh herbs, garlic, onions, citrus, flavored vinegar, and sodium-free spice blends instead of salt when cooking.

• Don't use salt substitutes that are high in potassium. Ask your healthcare provider or a registered dietitian which salt substitutes to use.

• Don't drink softened water, because of the sodium content. Make sure to read the label on bottled water for sodium content.

• Check all food labels to see how much sodium is in the product.

• Don't take over-the-counter (OTC) medicines that contain sodium bicarbonate or sodium carbonate. Read labels carefully. If you aren't certain about an OTC medicine, talk with the pharmacist before using it.

Potassium in your diet 

• Based on your condition, you may be told to eat less than 1,500 mg to 2,700 mg of potassium daily.

• Always drain canned foods, such as vegetables, fruits, and meats before serving.

• Don't eat whole-grain breads, wheat bran, and granolas.

• Don't eat milk, buttermilk, and yogurt.

• Don't eat nuts, seeds, peanut butter, dried beans, and peas.

• Don't eat fig cookies, chocolate, and molasses.

• Check all food labels to see how much potassium is in the product.

• Don't use salt substitutes that are high in potassium. Ask your healthcare provider or a registered dietitian which salt substitutes to use.

Protein in your diet

• Based on your condition, your healthcare provider will talk with you about why you should limit protein in your diet.

• Cut back on protein. Eat less meat, milk products, yogurt, eggs, and cheese.

• Check all food labels to see how much protein is in the product.

Phosphorus in your diet

• Don't drink beer, cocoa, dark colas, ale, chocolate drinks, and canned ice teas.

• Don't eat cheese, milk, ice cream, pudding, and yogurt.

• Don't eat liver (beef, chicken), organ meats, oysters, crayfish, and sardines.

• Don't eat beans (soy, kidney, black, garbanzo, and northern), peas (chick and split), bran cereals, nuts, and caramels.

Eat small meals often that are high in fiber and calories. You may be told to limit how much fluid you drink.

Other home care

• Try not to wear yourself out or get overly fatigued (tired).

• Get plenty of rest and get more sleep at night.

• Move around, walk as you can, and bend your legs to prevent getting blood clots when you rest for a long period of time. Spend more time moving around as you start to feel better.

• Weigh yourself every day. Do this at the same time of day and in the same kind of clothes. Keep a record of your daily weights.

• Take your medicines exactly as directed.

• Keep all medical appointments.

• Take steps to control high blood pressure or diabetes. Talk with your healthcare provider for advice.

• Talk with your healthcare provider about dialysis. This procedure may help if your chronic kidney disease is progressing to end stage renal disease.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to call your healthcare provider

Call your healthcare provider right away if any of the following occur:

• Chest pain (call 911)

• Trouble eating or drinking

• Weight loss of more than  2 pounds in  24 hours or more than  5 pounds in  7 days

• Weight gain of more than 3 pounds in 2 days or 5 pounds in 3 days

• Little or no urine output

• Trouble breathing

• Muscle aches

• Fever of  100.4°F ( 38°C) or higher, or as advised by your healthcare provider

• Blood in your urine or stool

• Bloody discharge from your nose, mouth, or ears

• Severe headache or a seizure

• Vomiting

• Swelling of legs or ankles

• Feeling depressed or anxious