Renal (Kidney) Insufficiency

Your kidneys remove waste products and extra water from your body. When your kidneys don't work as they should, waste products build up in your blood. The early stage of this process is called renal insufficiency. If renal insufficiency gets worse, you can develop chronic renal failure. This allows extra water, waste, and toxic substances to build up in your body. This can become life-threatening. You may need dialysis or a kidney transplant. The most serious form of renal insufficiency is end-stage renal disease.

Diabetes is the main cause of renal insufficiency. Other causes include:

• High blood pressure.
• Hardening of the arteries.
• Lupus.
• Inflammation of the blood vessels (vasculitis).
• Viral or bacterial infection.

Some over-the-counter (OTC) pain medicines can cause renal failure if you take them for a long time. These include aspirin, ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs (NSAIDs).

Follow these tips when caring for yourself at home:

• If you have diabetes, talk with your doctor about controlling your blood sugar. Ask if you need to make any changes to your diet, lifestyle, or medicines.
• If you have high blood pressure:
  • Take your prescribed medicine. Your goal is to lower your blood pressure to less than 130/80, or as recommended by your doctor.
  • Start a regular exercise program that you enjoy. Check with your doctor to be sure your planned exercise program is right for you.
  • Cut back on the amount of salt (sodium) you eat. Your doctor can tell you how much salt each day is safe for you.
  • Monitor and record your blood pressure at home on a regular schedule. Ask your doctor to teach you how to correctly check your blood pressure. Bring the blood pressure records with you to your appointments.
• If you are at a higher weight, talk with your doctor about a weight loss plan.
• If you smoke, quit. Smoking makes kidney disease worse. Talk with your doctor about ways to help you quit. Here are some resources that may help.
  • Clearing the Air: Quit Smoking Today, a booklet from the National Cancer Institute, at smokefree.gov/sites/default/files/pdf/clearing-the-air-accessible.pdf
  • Tools, tips, and articles on quitting at www.smokefree.gov
  • The American Cancer Society's guide to quitting smoking at www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/
• Talk with your doctor about any restrictions you should make in your diet. In general, you should limit the amount of protein, salt, potassium, and phosphorus. Don't drink too many fluids. Ask your doctor for the amount of daily fluid intake that is safe for your condition. Don't add salt at the table and stay away from salty foods. You may need a calcium supplement to help prevent osteoporosis.
• If you or your family feel overwhelmed by the dietary restrictions, ask for a referral to a registered dietitian. This person can help you understand and plan your diet.
• Talk with your doctor about any medicines you are currently taking to find out if they need to be reduced or stopped.
• Before starting any over-the-counter (OTC) medicines, herbal supplements, or vitamins, talk with your doctor or pharmacist. You need to be certain they won't harm your kidneys or interact with other medicines you take.
• Don't take the following OTC medicines, unless your doctor says it is okay:
  • Aspirin, ibuprofen, naproxen, and other NSAIDs. You may be able to use these for a short time to help with fever or pain.
  • Laxatives and antacids with magnesium or aluminum
  • Phospho-soda enemas with phosphorus
  • Certain stomach acid-blocking medicine, such as cimetidine or ranitidine
  • Decongestants with pseudoephedrine
  • Herbal supplements

Follow up with your doctor, or as advised. Contact one of the groups below for more information:

• American Association of Kidney Patients at www.aakp.org
• National Kidney Foundation at www.kidney.org
• American Kidney Fund at www.kidneyfund.org
• National Kidney Disease Education Program at www.nkdep.nih.gov

Call 911 if you have:

• Severe weakness, dizziness, fainting, drowsiness, or confusion.
• Chest pain or shortness of breath.
• A fast, slow, or irregular heartbeat.

Contact your doctor right away if you:

• Have an upset stomach (nausea) or vomiting.
• Have a fever of 100.4°F (38°C) or higher, or as advised by your doctor.
• Have unexpected weight gain or swelling in the legs, ankles, or around your eyes.
• Don't urinate as much as normal, or you aren't able to urinate.
• Have new symptoms.