The secrets to living well with kidney disease

Regular visits to your PCP and following your treatment plan puts you in the driver’s seat to slowing chronic kidney disease. Taking your blood pressure medications and controlling your A1C (blood sugar) are important along with eating a healthy diet, exercising, and caring for your emotional well-being. Your kidneys are about the size of a fist, but they have a big job: They filter waste products and extra water out of the blood to keep them from building up in the body. For the 37 million Americans with chronic kidney disease (CKD), though, these mighty organs aren’t up to the task. That means some of those “extras” stay in the body, which is why CKD can affect you from head to toe. It’s also why taking a total-body approach can help people with CKD slow the progress of the disease and increase their treatment options, both of which can lead to a better quality of life.

“I’ve had patients who have led a really good life with kidney disease because they’ve taken care of themselves, and they’ve asked for help when they need it,” says Aparna Sharma, MD, a kidney specialist at the University of Arkansas for Medical Sciences. “The patients that follow their doctor’s advice in a disciplined fashion end up with the most benefits.”

Here, Dr. Sharma offers some strategies to build the everyday habits that will serve you well for the rest of your life.

Check in with your emotions

Emotional well-being can have a big effect on every aspect of life, including how well your care plan works. If you’ve had lots of emotions bubble up after learning about your CKD, you’re not alone. Depression is two to three times more common in people with CKD than in those with other health issues, and CKD patients are twice as likely to have anxiety, compared with the average adult.

“There are two proven ways to help address these problems,” says Dr. Sharma. “One is medication, and the other is psychotherapy. And what we know is that the combination of the two works best.” If your kidney doctor doesn’t ask about your mood, don’t be shy about speaking up if you need help.

Signs of depression include feelings of hopelessness and a loss of interest in things you once enjoyed (you can ask your doctor for a behavioral health survey to learn more). Depending on the results, they can refer you to a therapist and make sure you’re given medicines that won’t tax your kidneys. Right now, SSRIs (selective serotonin reuptake inhibitors) are the top pick for depression and anxiety in CKD patients. Do-it-yourself stress relievers like deep breathing, muscle relaxation, and positive self-talk were also shown to boost mood in as little as four weeks.

Eat whole foods

“Making changes to their diet is the number-one step people with CKD can take to improve their health,” says Dr. Sharma. Recent studies indicate that eating a diet rich in fiber, fruits, and vegetables can promote the growth of healthy gut bacteria that contribute to kidney health. Whole foods may also be easier on the kidneys. “Whole” foods are those that are natural — not “processed” (manufactured, packaged, or premade at the grocery store). Prepared foods often contain lots of salt, food dyes, and compounds such as potassium, phosphates, and benzoate, all of which the kidneys must filter out.

Animal proteins, including beef and cheese, also cause more work for the kidneys, so Dr. Sharma advises cutting back or cutting them out. Since this can feel like a lot at first, she suggests working with a registered dietitian or nutritionist. Your kidney care team may have one on staff, or they can help you find one who understands CKD. You can also look for an online or in-person cooking class for people with kidney disease.

“It may help to know that you don’t have to make these changes all at once,” adds Dr. Sharma. “You can go slowly and make smaller changes stepwise.”

Move more

In a recent study of people with kidney disease, those who did the recommended amount of exercise per week (or more) had the best health two years later. Just how much is that? The World Health Organization recommends at least 150 minutes of moderate-intensity exercise (like walking) per week. People who work out harder (like joggers and runners) only need to do 75 minutes per week. A combo of the two also works, with the minutes per week falling somewhere in between. As with diet switches, you can (and should) work up to this if you’re not exercising much now.

Regular aerobic exercise also plays a huge role in heart health, which is even more important for people with end-stage renal disease. “Anything you can do to improve your heart health will tie in to living longer with CKD,” says Dr. Sharma. “That also includes following a healthy diet, stopping smoking, and taking medicines like statins to lower your cholesterol if it’s high.”

All of these changes may help you get your weight in check and can also help slow progression of kidney disease if you need dialysis. And, if needed, these changes can help you qualify for a kidney transplant.

Ask for help

Many behavioral health pros working with dialysis patients believe that support plays a leading role in their patients’ well-being. Providers of support can include family, friends, caregivers, the health care team, community groups, and support groups online. “There are services that can provide help, even if you don’t have loved ones nearby,” says Dr. Sharma.

If family or friends are around, however, don’t be afraid to ask for help. They can motivate you to stick to your care plan, and they can help keep an eye on how you’re doing. After all, it’s not always easy to notice when your own health is changing. Dr. Sharma recommends cluing in your closest contacts on signs that mean it’s time to call a doctor. This includes anything beyond what’s normal for you, such as new or worse leg swelling, loss of appetite and/or weight, nausea or vomiting, shortness of breath, and sleeping more than usual.

Helping you out may even be good for their health, adds Dr. Sharma. “Exercise, diet, mental well-being: They have proven benefits beyond kidney health,” she says. “They’re important for everyone.”