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Managing Multiple Health Conditions While on Dialysis

Many people treating end stage renal disease (ESRD) with dialysis also have other health issues, including heart disease, diabetes, high blood pressure. Once you start dialysis treatment, your doctor may need to modify your diet or medications to ensure you’re addressing all of your conditions properly. Your care team will work with you to make sure your Care Plan encompasses all aspects of your health.

Eating for optimal health.

Eating for optimal health

Your nephrologist (kidney doctor) and dietitian will work with you to create a diet plan that addresses all of your nutritional needs. If you’re on dialysis and living with diabetes, you’ll still need to control your blood sugar and test your levels at least twice daily. If you have high blood pressure, you’ll need to focus on fresh fruits and vegetables, watch your saturated fat intake and of course avoid salt—which is an important step for anyone on dialysis. Your dietitian will help explain how what you eat and drink affects all of your conditions and your treatments. Your nephrologist will also recommend vitamins and supplements.
Medications for CKD.

Your medications matter

Taking commonly prescribed blood pressure medications such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may also be part of your therapy to protect your kidney function. As always, be sure to take the medications that have been prescribed by your doctor.
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Conditions to monitor

  1. Learn about diabetes and CKD.

    Diabetes - Diabetes is the  leading cause of chronic kidney disease (CKD). 1 in 3 adults with diabetes may have chronic kidney disease*. Diabetes—especially type 2 diabetes—is also the number one cause of kidney failure in the US. If you’re living with diabetes and kidney disease, it’s important to stay in control of both conditions by eating well, managing medications and following your prescribed care plan.

  2. Learn about high blood pressure and CKD.

    High blood pressure (hypertension) - High blood presure is the second leading cause of chronic kidney disease (CKD). 1 in 5 adults with high blood pressure may have chronic kidney disease*. If you have high blood pressure, it’s important to maintain a healthy lifestyle and take medications, as prescribed by your doctor. High blood pressure weakens blood vessels, which can contribute to loss of kidney function.

  3. Closeup of red blood cells
    Anemia - Having CKD affects your body’s ability to make red blood cells, which carry oxygen to your organs. Having too few red blood cells is called anemia and can make you feel tired or weak. Taking iron supplements and a medicine called ESA (erythropoiesis-stimulating agents) will help your body make more red blood cells, which helps increase the flow of oxygen.
  4. Renal diet foods to avoid
    High cholesterol - Many people with chronic kidney disease also have high cholesterol—which causes a narrowing of the arteries and restricts blood flow. Your doctor may recommend dietary changes, exercise and, possibly, special medications to help lower your cholesterol.
  5. Bone and mineral disease.
    Bone and mineral disease - When your kidneys aren’t working properly, they can’t filter out extra phosphorus in your blood or help your body retain vitamin D. This imbalance of minerals causes your bones to become weaker and more likely to break. Your doctor will likely ask you to take phosphate binders (medicines that remove phosphate from your blood) and vitamin D.
  6. Smoking on dialysis
    Smoking - If you smoke or use smokeless tobacco, you should consider quitting. When you have CKD, tobacco puts more stress on your heart and other organs, which is extremely dangerous. Some sweet versions of smokeless tabacco also contain molasses, which has high potassium levels and should be avoided.
Need help understanding your medications?

FreseniusRx has renal-trained pharmacists who can answer questions about your kidney medications and explain any interactions with medications you may be taking for another condition.

Learn about FreseniusRx
Talk to your dietitian.
Wondering exactly what to eat?

Ask your doctor or dietitian for help creating a kidney-friendly meal plan that can help you thrive.

Learn the basics