Protecting Your Kidneys
| Action | Why It Matters |
|---|---|
| Control blood pressure (<130/80) | Hypertension is the #1 driver of CKD progression |
| Control blood glucose (HbA1c <53) | Diabetic nephropathy is the most common cause of end-stage kidney disease |
| Take ACE inhibitors/ARBs if proteinuric | Reduce intraglomerular pressure and proteinuria — slow progression |
| Start SGLT2 inhibitor if CKD + T2DM or proteinuria | Empagliflozin/dapagliflozin — most effective CKD drugs discovered in decades |
| Stay hydrated | Dehydration concentrates toxins and promotes stone formation |
| Avoid NSAIDs | Reduce renal blood flow — particularly harmful in CKD, elderly, heart failure |
| Avoid aminoglycosides (if possible) | Directly nephrotoxic — adjust dose or avoid in CKD |
| Stop smoking | Independent risk factor for CKD progression and cardiovascular events in CKD |
High-Risk Groups Who Need Regular eGFR Monitoring
- Diabetes (type 1 and 2) — annual eGFR + ACR
- Hypertension — annual eGFR
- Family history of CKD or polycystic kidney disease
- Previous AKI (acute kidney injury)
- Regular NSAID use
- Myeloma or recurrent UTIs
- Any known CKD — frequency depends on stage and rate of decline
The Sick Day Rules for CKDDuring acute illness (diarrhoea, vomiting, fever): temporarily STOP ACE inhibitors, ARBs, NSAIDs, and diuretics ('SARD' drugs) — they can precipitate acute kidney injury when dehydrated. Resume 24–48 hours after recovery when drinking normally.
What is polycystic kidney disease?
An inherited condition (PKD1 or PKD2 gene mutation) causing multiple fluid-filled cysts throughout both kidneys. Progressive — 50% reach kidney failure by age 50–70. Tolvaptan (a vasopressin antagonist) slows cyst growth. Monitor BP and renal function regularly.
Can a kidney recover after AKI?
Often yes — AKI (acute kidney injury from dehydration, drugs, or obstruction) frequently resolves with treatment. However, repeated AKI episodes each cause permanent scarring and hasten CKD progression. Preventing AKI is critical.
Is low potassium diet needed for CKD?
Only in advanced CKD (G4–5) when potassium clearance is impaired and serum K is elevated. Unnecessarily restricting potassium in earlier CKD reduces beneficial plant food intake. Dietitian assessment is essential — blanket restriction is not recommended.
What is dialysis?
Dialysis replaces kidney filtration function. Haemodialysis: blood filtered through a machine 3× per week (4 hours per session). Peritoneal dialysis: fluid instilled into the peritoneal cavity absorbs toxins — done at home daily. Neither replicates all kidney functions (hormonal, immune).
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.