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Discharge instructions for chronic kidney disease

Dr. Himadri Shankar, MBBS, MD (General Medicine), DNB Nephrology (Gold Medalist), Consultant Nephrologist and Renal Transplant Physician, Ex Registrar Max Hospital, New Delhi, Ex Associate Consultant R N Tagore, Kolkata

Published: Dec 5, 2022 04:57:58 PM IST
Updated: Dec 6, 2022 11:36:52 AM IST

Discharge instructions for chronic kidney disease
Chronic Kidney Disease can (CKD) 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.

Here are some instructions for you to follow as you recover.

Home Care
•    Follow any instructions for eating and drinking given to you by your healthcare provider.
    – Drink less fluid, if instructed by your healthcare provider.
    – Keep a record of everything you eat and drink.
•    Measure the amount of urine and stool you have each day.
•    Weigh yourself every day, at the same time of day, and in the same kind of clothes. Keep a daily record of your daily weights.
•    Take your temperature every day. Keep a record of the results.
•    Learn to take your blood pressure (BP). Your healthcare provider can teach you how to correctly measure your BP. Keep a record of your results. Bring the record to your follow-up appointments. Ask your healthcare provider when you should seek emergency medical attention. Your provider will tell you what blood pressure reading is dangerous.
•    Stay away from people who have infections. This includes people with colds, bronchitis, or skin conditions.
•    Practice good personal hygiene. Wash your hands often. This is especially important if you have a catheter in place when you leave the hospital. Doing so helps keep you safe from infection.
•    Take your medicines exactly as directed.
•    You may need frequent blood and urine tests. These are done to monitor your kidney function.

Diet Changes
Always discuss your diet with your healthcare provider before making any changes.

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 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
•    Avoiding drinking softened water, because of the sodium content. Make sure to read the label on bottled water for sodium content.
•    Avoid over-the-counter medicines that contain sodium bicarbonate or sodium carbonate. Read labels carefully.

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.
•    Avoid whole-grain bread, wheat bran, and granola.
•    Avoid milk, buttermilk, and yogurt.
•    Avoid nuts, seeds, peanut butter, dried beans, and peas.
•    Avoid fig cookies, chocolate, and molasses.
•    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
•    Cut back on protein. Eat less meat, milk products, yogurt, eggs, and cheese.

Phosphorus in your diet
•    Avoid beer, cocoa, dark colas, ale, chocolate drinks, and canned ice teas.
•    Avoid cheese, milk, ice cream, pudding, and yogurt.
•    Avoid liver (beef, chicken), organ meats, oysters, crayfish, and sardines.
•    Avoid 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.

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