Understood Care
Kidney disease is very common in health care today. In the United States, chronic kidney disease affects more than 1 in 7 adults, or about 35 million people, and many do not know they have it because early stages often cause few or no symptoms.
Your kidneys have an important job. They help:
Chronic kidney disease (CKD) means your kidneys are damaged or not working the way they should over at least three months. NIDDK This damage usually happens slowly over time. Common causes include:
In the early stages of CKD, you may feel completely fine. Many people only find out they have kidney disease after routine blood or urine tests. Symptoms such as swelling in your legs, changes in urination, tiredness, or shortness of breath most often appear later as kidney function worsens.
If you are living with kidney disease, you are not alone, and there are many steps you can take with your health care team to protect your kidneys and overall health.
In the video that goes with this article, one of our clinicians talks about how often kidney disease shows up in everyday care and how closely doctors have to watch lab tests and medicines. If you have kidney disease, your doctor is likely very careful about:
Two of the most common blood tests related to kidney function are:
BUN measures the amount of urea nitrogen in your blood, a waste product made when your body breaks down protein. Higher levels can suggest your kidneys are not clearing waste well, but BUN can also go up and down with dehydration, diet, or certain medicines.
Creatinine is a waste product from normal muscle use. When kidneys are not working well, creatinine builds up in the blood.
Your health care team often uses your creatinine level along with your age, sex, and sometimes race to calculate an estimated glomerular filtration rate (eGFR). eGFR is one of the main numbers used to understand how well your kidneys filter blood and to help stage chronic kidney disease.
In the video, we mention that BUN and creatinine help determine what stage you are in. Clinically, eGFR calculated from creatinine is the main test used to stage CKD, with BUN and other labs giving added context.
A simple urine test can look for albumin, a type of protein. Healthy kidneys typically keep most protein in your bloodstream and out of your urine. Finding extra albumin can be an early sign of kidney damage, even when eGFR is still normal.
Your clinician may order a urine albumin to creatinine ratio (uACR) to track changes over time. This is a key number for understanding how stressed your kidneys are and how well treatments are working.
There are five main stages of CKD, based largely on your eGFR:
Your stage does not define you, but it helps your care team decide:
Many people worry when they see a single high BUN or creatinine result. It is understandable to feel anxious. At the same time, your doctor will usually look at trends over time rather than one lab value. Hydration, recent illness, and certain medications can all temporarily affect your numbers.
There are also preventable things you can do to improve or stabilize these numbers. This is a key message from the video. By working with your care team on blood pressure, blood sugar, lifestyle habits, and medication choices, many people slow the progression of kidney disease and sometimes see lab values improve.
The good news is that you can take many practical steps, starting today, to protect your kidneys. National kidney and diabetes experts highlight several core strategies.
For many people, controlling blood pressure is the single most important step in treating kidney disease. High blood pressure can damage the tiny blood vessels in your kidneys over time.
You can support healthy blood pressure by:
Diabetes is one of the most common causes of kidney disease. If you have diabetes, keeping your blood glucose and A1C near your target range is critical to protect your kidneys.
Your care team may suggest:
What you eat and drink can help you:
A kidney friendly eating plan often focuses on:
Because kidney nutrition can be complex, especially in stages 3 to 5 or on dialysis, a registered dietitian who understands CKD can help build a plan that fits your culture, preferences, and lab results.
Regular physical activity, even gentle walking, can improve energy, mood, blood pressure, and blood sugar. Aim for about 30 minutes on most days if your clinician says it is safe.
Other habits that protect your kidneys and heart include:
These lifestyle steps also support your immune system and emotional health, both of which matter when you are managing a long term condition.
If you have kidney disease, your doctor is likely very careful about which medications you use and at what dose. This is another key point from the video.
As kidney function declines, some medicines can build up in your body or put extra strain on your kidneys. Others are especially helpful, such as certain blood pressure medicines that protect kidney function.
For many people, managing kidney disease means taking several daily medicines, such as:
Two types of blood pressure medicines, ACE inhibitors and ARBs, have been shown to slow kidney disease and delay kidney failure, even in people without high blood pressure.
It is very important to:
In the video, we emphasize that staying on prescribed medicines is not something you want to leave to chance. Getting timely refills and knowing exactly how to take each medicine helps keep you stable.
Some over the counter pain and cold medicines, especially nonsteroidal anti inflammatory drugs (NSAIDs) like ibuprofen and naproxen, can harm the kidneys or trigger acute kidney injury, particularly when you already have CKD, diabetes, or high blood pressure.
If you live with kidney disease:
As CKD progresses, your kidneys may not clear medicines as well. Your doctor or pharmacist may:
This does not mean you have done anything wrong. It simply reflects how your kidneys are working now. Keeping an updated medication list and sharing it at every visit helps your team keep you safe.
If kidney disease continues to get worse, some people eventually reach kidney failure, also called end stage kidney disease. At this point, kidneys can no longer keep up with clearing waste and extra fluid on their own.
Treatment options for kidney failure include:
In the video, we talk about helping whether you are at stage 1 or stage 4, and even if you are already on dialysis. That includes very practical support:
If you are getting close to kidney failure, your team may refer you to a nephrologist (kidney specialist) to plan ahead. Planning early can give you more options and time to prepare.
Managing kidney disease is not just about lab numbers. It is also about getting to every appointment, understanding your plan, and keeping your life as steady as possible.
In the video, we share that “there is a lot we can do to help you manage your disease so you can stay as healthy as possible.” That support can include:
Kidney disease often involves several clinicians, such as:
Care advocates can help you keep all of these visits and recommendations organized. You can learn more about care coordination at Understood Care’s Care Coordination page.
If you are going to lab draws, nephrology visits, or dialysis several times a week, transportation can become a major stress point. Advocates can:
You can read more about appointment and transportation help on Understood Care’s Appointments page and Kidney Disease Support.
As you heard in the video, running out of medicines is something you want to avoid, especially with kidney disease. An advocate can help you:
Living with CKD can bring fatigue, worry, or frustration. Understood Care advocates can check in between visits, help you prepare questions for your providers, and support you in making sense of your results and next steps.
For most people, the most impactful step is keeping blood pressure under good control. This often means taking blood pressure medicines consistently, limiting salt, staying active, and not smoking. If you have diabetes, reaching your blood sugar and A1C goals is just as important.
Other key steps include:
Ask your clinician which specific numbers, such as blood pressure, A1C, and eGFR, you should track most closely.
Some causes of sudden kidney injury can improve with treatment, but chronic kidney disease often cannot be fully reversed. In many cases, though, CKD can be slowed significantly, and some people see their eGFR stabilize or improve when underlying causes are treated and healthy habits are in place.
Even if your kidney disease cannot be cured, there is a lot you can do with your team to protect the kidney function you have and feel as well as possible.
Common numbers your team may ask you to watch include:
Your doctor can explain which numbers are most important for you and how often they should be checked.
How often you need blood tests depends on your CKD stage and overall health. In earlier stages, your clinician might order kidney labs every few months. In later stages or if your numbers change quickly, they may check more often. If you are on dialysis, these tests are typically checked monthly.
Ask your health care team for a schedule that fits your situation and which warning signs should trigger earlier testing.
Dialysis is usually considered when:
Your nephrologist will talk with you well before this point so you can learn about options, prepare access for dialysis if needed, or explore transplant evaluation.
Your care team may ask you to:
Always ask your doctor or pharmacist before starting any new medication or supplement.
If you are a caregiver, you can play a powerful role by:
Caregivers can also work with an advocate to share information, coordinate transportation, and support healthy routines at home.
This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.
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