6 / 16
A AMC MAGA Z I N E | S P R I NG
Learn more about taking care of your kidneys at AAMC’s monthly Kidney
class. Register at
AAMCevents.org
or call
- -
.
Chronic kidney disease (CKD), which
gradually makes it harder for your
kidneys to lter waste from the blood,
can cause anemia, bone disease, heart
disease, and other health problems.
Proper care often includes seeing several
specialists. Even with careful treatment,
it can get worse and may lead to the
need for dialysis or a kidney transplant.
Choosing the right care for CKD can
be a challenge. How do you know if a
treatment, test or procedure is the right
choice for you? Here are some things
to consider:
Anemia drugs
Anemia is common in people with
CKD. Drugs called erythropoiesis-
stimulating agents (ESAs) can help the
body make new red blood cells. You
should generally consider ESAs only
when you have symptoms of anemia,
including breathlessness and fatigue.
Dialysis treatment
e decision to start long-term dialysis
should be part of an individualized,
shared decision-making process between
you, your family and other caregivers and
Protect your kidneys
These steps can slow the
progress of kidney disease and
prevent complications:
›
Control blood pressure.
Keep blood
pressure below
/ mm/Hg, or
even lower if you have protein in your
urine. Two kinds of drugs stand out
for protecting kidneys: ACE inhibitors,
such as lisinopril (Prinivil, Zestril and
generic) and enalapril (Vasotec and
generic), and ARBs—blockers such as
candesartan (Atacand) and losartan
(Cozaar and generic).
›
Control diabetes.
Aim for an A C level,
a marker of long-term blood sugar
control, of seven percent or less.
›
Limit potassium intake.
Diseased
kidneys have a hard time excreting the
mineral. Talk with a registered dietitian
for advice on a healthy, appetizing,
low-potassium diet.
›
Exercise.
That can lower your blood
pressure, control diabetes and prevent
weight gain.
›
Avoid certain drugs and supplements.
Many can injure kidneys, including
certain antidepressants, antibiotics,
antivirals, pain relievers, statins,
proton-pump inhibitors, and
supplements containing aristolochia or
wild ginger. Talk with a doctor to see if
any medicine or supplement you use is
unsafe for you.
›
Quit smoking.
The habit can double
the rate of progression to end-stage
renal failure.
Source: Choosing Wisely
®
is a national initiative
of the ABIM Foundation that encourages patients
and doctors to have important conversations about
the necessity of tests and treatments. Developed
in cooperation with
Consumer Reports
and the
American Society of Nephrology (ASN).
To learnmore, visit
askAAMC.org/
ChoosingWisely
.
CHRONIC KIDNEY DISEASE
Making
hard choices
Choosing Wisely
your doctor. Ask for a full explanation of the
bene ts and risks of dialysis. Discuss how the
treatment ts with your desires and what to
expect if you decide not to pursue dialysis.
Intravenous catheters
Some medical circumstances can require
doctors to place a peripherally inserted
central venous catheter (PICC) in your arm.
But if your kidney disease has advanced to
stage 3 or higher and a doctor says you need
a PICC line, ask for a second opinion from
a kidney-disease specialist. If you eventually
need to be treated with dialysis, it will be
important to have your arm veins available
for dialysis catheters. In many cases, it is
possible to place the PICC line in veins in
your neck instead.
Cancer screening
Screening for cancer can save lives, but
many people on hemodialysis might
prefer focusing on more pressing health
problems. at’s because those other health
problems pose a much greater, and more
immediate, risk to most people on dialysis.
Talk with your doctor about routine
screening based on your cancer risk factors,
symptoms and expected survival on dialysis.