people with early kidney disease do not have symptoms. That’s why it’s important to be tested. There are two simple tests to check for kidney disease: •Urine test Your urine will be tested for protein. Your body needs protein. But it should be in the blood, not the urine. Having a small amount of protein in your urine may mean that your kidneys are not filtering your blood well enough. This can be a sign of early kidney disease. Having protein in your urine is called “albuminuria.” •Blood test Your blood will be tested for a waste product called creatinine. Creatinine comes from muscle tissue. When the kidneys are damaged, they have trouble removing creatinine from your blood. But testing for creatinine is only the first step. Next, your creatinine result is used in a math formula with your age, race, and sex to find out your glomerular filtration rate (GFR). Your GFR number tells your healthcare provider how well your kidneys are working. You should also get your blood pressure checked regularly. Having high blood pressure puts you at risk for kidney disease. Regular checkups help your healthcare provider find and treat high blood pressure. This helps lessen your risk for kidney damage. 8 NATIONAL KIDNEY FOUNDATION Does kidney disease have symptoms? Most people with early kidney disease do not have symptoms. That’s why it’s important to be tested. In the later stages of kidney disease, you may: •Feel tired or short of breath •Have trouble thinking clearly •Not feel like eating •Have trouble sleeping •Have dry, itchy skin •Have muscle cramping at night •Need to go to the bathroom more often, especially at night •Have swollen feet and ankles •Have puffiness around your eyes, especially in the morning Can I prevent kidney disease, even if I am at higher risk? Yes. Not everyone who is at risk will get kidney disease. Talk to your healthcare provider about how to lessen your chances of getting kidney disease. You should also: •Have regular checkups by your healthcare provider •Control your blood sugar if you have diabetes •Control your blood pressure if you have high blood pressure •Make healthy food choices •Exercise regularly WWW.KIDNEY.ORG 9 •Lose weight if you are overweight •Stop smoking if you are a smoker •Limit how much alcohol you drink •Use only the medicines, vitamins and supplements that your healthcare provider recommends. Some can harm the kidneys. •Avoid herbal supplements and those used for body building What if my test results show I already have kidney disease? More tests might be done to help understand what caused your kidney disease. This can help in planning your treatment. You may also be asked to see a specialist. Examples of tests that might be done are: •An ultrasound or CT scan to get a picture of your kidneys and urinary system. These pictures show the size of your kidneys, and whether they are too large or too small. They also show whether you have any tumors, kidney stones, or cysts. Some pain relieving drugs can harm the kidneys if they are used for a long time. They are called NSAIDs (nonsteroidal anti-inflammatory drugs). They include aspirin, ibuprofen, and naproxen. Talk to your healthcare provider if you have questions about them. TIP 10 NATIONAL KIDNEY FOUNDATION •A biopsy to remove a tiny piece of kidney tissue for evaluation. The sample is studied under a microscope to: See what kind of kidney damage is happening See how much damage has happened Plan treatment If I have kidney disease, what will my treatment be? Your treatment plan will depend on your stage of kidney disease and other health problems you may have. It may include: •Treatment for high blood pressure High blood pressure can make your kidney disease worse. You may need to take medicine to help control it. You may also need to eat less salt, lose weight if you are overweight, and follow a regular exercise program. •Protecting kidney function by taking ACE inhibitors or ARBs You may be asked to take high blood pressure medicines (called ACE inhibitors or ARBs), even if your blood pressure is normal. Research suggests that these medicines can slow the loss of kidney function in some people—even in people with normal blood pressure. •Controlling blood sugar if you have diabetes The best way to prevent or slow kidney damage is to keep your blood sugar well controlled. This is usually done with diet, exercise, and, if needed, insulin or pills (called hypoglycemic drugs). WWW.KIDNEY.ORG 11 •Controlling high cholesterol with diet and medication Many people with kidney disease have high cholesterol levels in their blood. High blood cholesterol increases your risk for heart disease. Your healthcare provider will check your cholesterol at least once a year. If it is too high, you may need drugs and exercise to help lower it. •Treatment for anemia People with kidney disease often get anemia (low red blood cell count). Why does this happen? Healthy kidneys help your body make red blood cells. If you have kidney disease, your kidneys may not be able to do this very well and you may get anemia. Medicines called ESAs (erythropoiesis-stimulating agents) and iron supplements are used to treat anemia. •Treatment for mineral and bone disorder Many people with kidney disease have mineral and bone disorder. Mineral and bone disorder can make your arteries stiffen and become narrow from the