About Chronic Kidney Disease Medications and Vitamins

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If you are diagnosed with chronic kidney disease (CKD), your doctor may prescribe certain medications and vitamins to help you stay your healthiest and feel your best. These medications, vitamins, and supplements for kidney disease can help you maintain balance in your body when your kidneys aren’t working as well as they should.

Which chronic kidney disease medications your doctor prescribes may depend on several personal health factors, including your level of kidney function, which of the kidney disease stages you’re in, and whether you’re managing any other health conditions that could affect your kidney health.


6 common chronic kidney disease medications

Your doctor will work closely with you and your care team to prescribe the right medications to help protect your health. With any new medication, it’s important to understand what it does and how to take it. If you have questions about your medications, ask your nurse or talk to your pharmacist.

  1. Erythropoietin—is a hormone that’s naturally produced by healthy kidneys to stimulate the production of red blood cells. When there’s not enough oxygen in your blood, healthy kidneys produce more erythropoietin, With CKD, kidneys may not produce enough of this hormone, which can lead to anemia (low red blood cell count). Your doctor may prescribe synthetic erythropoietin as an injection to help keep your blood healthy. 
  2. Diuretics—are medications that help rid your body of excess fluid. Having too much fluid in your body can raise your blood pressure to unhealthy levels. Some people living with CKD experience swelling (edema) when their kidneys aren’t removing enough fluid—and swelling can increase as CKD progresses. Taking diuretics can help reduce your fluid levels and lower your blood pressure. Diuretics may also be prescribed to help control your potassium level if your labs show elevated potassium levels (hyperkalemia). 
  3. Blood pressure medications—are taken to help lower your blood pressure and slow the progression of kidney disease. High blood pressure is the second leading cause of CKD and can damage blood vessels and increase kidney damage, causing a buildup of toxins and excess fluid in your body. There are many types of blood pressure medications, each working in different parts of the body-such as the kidneys, heart, blood vessels, or nervous system—to lower your blood pressure. Your doctor will determine the right medication for you. 
  4. Phosphate binders—also called phosphorus binders, help prevent your body from absorbing phosphorus(PHOS) from the food you eat. With CKD, your kidneys may not be able to remove extra phosphorus from your blood, which can cause a harmful buildup. Your doctor will prescribe the amount of phosphate binders you need to stay your healthiest, based on your level of kidney function.
  5. Sodium bicarbonate—commonly known as the active ingredient in baking soda, may be prescribed in pill form by your doctor to help balance the acid in your blood. Bicarbonate (a form of carbon dioxide) is naturally present in blood and is normally balanced by healthy kidneys. Having bicarbonate levels that are too low can cause kidney disease to progress, and some research shows that taking sodium bicarbonate pills can help slow CKD progression. It’s very important not to take sodium bicarbonate unless your doctor prescribes it.
  6. Cholesterol medication—helps lower cholesterol to prevent blockage in your blood vessels. When too much cholesterol builds up, it can prevent blood from flowing properly to certain parts of your body, including your kidneys. High cholesterol can cause several health issues, including coronary heart disease, a heart attack, a stroke, and progression of CKD that can eventually lead to kidney failure. If your doctor determines you need cholesterol medication, he or she will prescribe one that's safe to take with CKD.

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 Why do I need vitamins and supplements for kidney disease?

Your body needs certain vitamins and minerals to maintain good health, get energy from food, and perform important functions. Chronic kidney disease can change the way your body uses vitamins and minerals—and eating a kidney-friendly diet may also change the amount of vitamins and minerals you’re able to get from the foods you eat. Taking certain vitamins for kidney disease can help ensure that your body is getting what it needs to help you feel your best and thrive. Your doctor will regularly monitor your blood work and prescribe key supplements to help you stay your healthiest.


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Key vitamins and supplements for people with chronic kidney disease

VITAMIN WHY YOU MAY NEED IT
Vitamin A Vitamin A promotes cell and tissue development, which is important for maintaining your immune system and protecting against infection. Needing vitamin A isn’t common with CKD—and should only be taken if prescribed by your doctor.
Vitamin D Vitamin D promotes healthy bones by helping to regulate the absorption of calcium and phosphorus1 and supporting your immune system. With CKD, your kidneys are less able to convert vitamin D into its active form for the body to use. Your doctor may prescribe vitamin D based on your lab results.
Vitamin E Vitamin E protects cells from oxidizing and protects them from the effects of free radicals, which may help prevent heart disease and cancer. Your doctor will determine if you’re low on vitamin E and could benefit from taking it.
Vitamin K Vitamin K helps produce blood clotting proteins, which are important for forming healthy bones. If you are often on antibiotics, you may benefit from a vitamin K supplement, as determined by your doctor. Note: taking this vitamin may interfere with blood thinners.
Niacin Niacin helps your body use sugars and fatty acids. It helps your cells produce energy and help enzymes function throughout the body. Research suggests that niacin may improve dyslipidemia (abnormal lipid levels), lower serum phosphorus, and help slow the progression of CKD.
Folate Folate helps produce DNA for new cells and works with vitamin B12 to produce new red blood cells. The manufactured supplement, known as folic acid, can be used to reduce the risk of cardiovascular events for people with CKD.
B-Complex Vitamins Various B vitamins are combined to work together for different purposes in a 8-complex vitamin. Some B vitamins—B6, B2, and folic acid (folate)-work with iron to prevent anemia, and some-thiamine, riboflavin, pantothenic acid, and niacin—help convert food into energy for your body to use. Studies show that B vitamins can also be helpful in managing stress. B vitamins may be prescribed to people with CKD, depending on dietary needs.
Vitamin C Vitamin C helps keep tissues healthy, heal wounds and bruises quickly, and prevent infections. Since some dietary sources of vitamin C are limited for people with CKD due to concerns about potassium1 your doctor may prescribe a vitamin C supplement or multivitamin.
Biotin Biotin helps cells produce energy while breaking down protein, fat, and carbohydrates. People living with CKD and eating a low-protein, kidney-friendly diet may not be getting enough biotin and need a supplement.
Pantothenic Acid Along with biotin, pantothenic acid helps your body produce energy and metabolize protein, fat, and carbohydrates. Your doctor may prescribe this as a supplement if you are living with CKD and limiting protein.
Calcium Calcium helps support strong bones, along with vitamin D, though too much or too little calcium can be harmful. Your doctor will help determine if you need to take calcium, and in what amount. Some phosphorus binder medications prescribed for CKD also contain calcium, so it’s important to follow your doctor’s exact instructions.
Iron Iron helps raise your red blood cell count and produce more hemoglobin—a protein in red blood cells that carries oxygen to the body. Because damaged kidneys produce less erythropoletin, the hormone that stimulates red blood cell production, you may need to take iron, if instructed by your doctor.

It’s important to know that if you go on dialysis, your medication and vitamins needs may be different. Talk to your doctor about any changes you need to make if your care plan changes.


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Talk to your doctor before taking any over-the-counter supplements or medications

Because CKD can change the way your body processes certain substances, it’s important to talk to your doctor about any over-the-counter medication, vitamins, or supplements that you’re taking—whether it’s something new or something you’ve been taking regularly. Certain medications and even herbal substances can be harmful at any stage of CKD. Talking to your doctor can help ensure that you’re protecting your kidney health.


Medications and vitamins to avoid with CKD

There are certain medications that may need to be avoided or adjusted when you’re living with chronic kidney disease. With CKD, your kidneys may not be able to filter some medications or vitamins from your blood, which can cause a harmful buildup of those substances in your body. 

If you are taking any of the following medications, talk to your doctor about how they work with kidney disease. Your doctor may adjust your dosage or change your medication entirely.

  • Statins (cholesterol medication)—may require a dosage adjustment to protect your kidneys
  • Over-the-counter pain medications—including nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antibiotics or anti-fungals—may require changing to a kidney-friendly version
  • Diabetes medications—may need a dosage adjustment to be more kidney-friendly
  • Antacids—which could cause imbalances in your body with CKD

Discuss any vitamins you’re taking with your doctor. Vitamins you may need to avoid include:

  • Fat-soluble vitamins A, D, E, and K—which are more likely to build up in your system. These vitamins should not be taken unless your doctor prescribes them. Vitamin A can be toxic if too much is taken.