Symptom Management
Kidney disease can have a variety of complications. They range from uncomfortable to damaging and even life-threatening. Managing these complications can help stop further damage to your kidneys and help you stay as healthy as possible. Here are some common symptoms and how they may be treated:
Anemia
Red blood cells carry oxygen, giving you energy and keeping your heart healthy. A hormone called erythropoietin (EPO) tells your bone marrow to make red blood cells. With kidney disease, your kidneys make less EPO and your body makes fewer red blood cells. This leads to anemia. This can be treated with synthetic EPO. Your doctor may also prescribe iron supplements.
High Blood Pressure
High blood pressure, or hypertension, is a condition where the force of blood in your blood vessels is higher than it should be, making your heart work harder. Uncontrolled high blood pressure can damage many organs in your body, including your kidneys.
Healthy kidneys create an enzyme called renin that helps control blood pressure. When your kidneys are not working as well as they should, they will make less renin, and your blood pressure may rise. Because uncontrolled high blood pressure can damage blood vessels, it becomes harder for your kidneys to get rid of wastes. This can cause even more kidney damage.
Your doctor will make a treatment plan that may include advice to:
- Cut down on sodium (salt) in your diet. Sodium can raise blood pressure in some people.
- Lose weight if you are overweight, and begin to exercise at least three times a week (just walking can help). Weight loss and exercise can help lower your blood pressure.
- Quit smoking. If you need help, ask your doctor for advice.
- Take blood pressure medication.
Bone Disease
Phosphorus is a mineral in most food we eat. Normally, extra phosphorus is removed from your blood by your kidneys. If your kidneys are not working well, phosphorus can build up in your body and cause a loss of calcium from your bones. Calcium is a mineral that builds strong bones and helps your body send nerve signals. It’s found in many foods—mainly milk and other dairy products. When the calcium level in your blood drops, 4 small parathyroid glands in your neck make Parathyroid Hormone (PTH), which pulls calcium out of your bones. Too much PTH in your blood will pull too much calcium from your bones, making them weaker over time. To help prevent these problems, your doctor may recommend:
- Calcium supplements.
- Activated vitamin D supplements (pills or injections) which help in the absorption of calcium.
- Lowering the phosphorus in your diet (some foods high in phosphorus include dairy products, nuts, beans, chocolate, cola, and beer).
- Taking a phosphate binder to reduce the amount of phosphorus you absorb from your food.
- Making changes in your dialysis treatment—nocturnal hemodialysis, for example, removes more phosphorus than regular dialysis, which can help your bones stay healthy.
- Starting a doctor-approved exercise routine.
- Having surgery to remove some of your parathyroid glands.
Muscle Cramps
Muscle cramps, especially leg cramps, are common in people with kidney disease. They are thought to be caused by an imbalance of fluids and electrolytes (sodium, potassium, or chloride) in your body. Your doctor will probably suggest that you stretch and massage the muscle that is cramping. Also, wearing comfortable shoes may help.
Itching
Itching can be due to dry skin (caused by less fluid intake or other reasons) or high levels of phosphorus in your blood. Your doctor will work with you to try to find out why you are itching. Lotions may help dry skin. If your itching is due to high levels of phosphorus in your body, your doctor may prescribe a medication called a phosphate binder that pulls extra phosphorus out of your food.
