Kidney disease: getting expert help 

Effective treatment of kidney disease can stop this potentially deadly problem from getting worse. An expert gives practical advice about how to manage the condition.

Learn more about kidney disease

Transcript of Kidney disease: getting expert help

(Chris Steele) As a kidney specialist nurse,

Nicola Thomas regularly talks to patients who have been newly diagnosed.

As we've heard already, every patient is different,

but Nicola has some good practical advice

about how to approach ongoing management of CKD.

I think the wording chronic kidney disease itself is very difficult

because when you hear the words chronic and disease

you imagine something terrible is about to happen.

So having that label is quite difficult.

You've come in today for the results of your recent blood test.

OK. Well, I've been through them and everything's fine

except for one of your kidney function tests,

which is a little bit lower than what we would like them to be.

OK?

You won't have any signs or symptoms

of anything untoward because this is really early stages.

To make sure we've got the right results we need to repeat the blood test. OK?

And we also need to check your blood pressure.

People are quite often shocked

when they hear they might have something wrong with their kidneys

because they feel quite healthy.

Some people are very upset

because they imagine they'll have to go into hospital

or see doctors quite often, which they're not used to.

I suppose a lot of people are very bewildered

because they've never heard the term before

and don't really know what the kidneys do.

So all these things come together and that's what makes it very difficult.

We'll check your blood pressure.

Slip your arm through there.

I just want you to sit back in the chair and be nice and relaxed. OK?

Nice slow breathing, slow, deep breathing

and we'll check this blood pressure.

Monitoring your blood pressure is the most important thing.

For people who have high blood pressure in their family,

it's worth going to your GP or practice nurse for a regular check.

If you've known in the past that you've had high blood pressure,

it's worth monitoring it at home.

Some of the blood pressure machines you can buy from the chemist are about �40.

Maybe just monitoring that once a month

will give you an indication of whether you're at risk.

We're looking at a blood pressure of less than 130 being the top figure

and 80 being the bottom figure.

If you come back and see me in about a week's time, OK?

And you'll bring your blood pressure monitor back with you

with the list of all your readings.

OK, let's go and get you a monitor.

Usually the GP or maybe a hospital doctor

will prescribe blood pressure tablets.

It's all very well having a prescription for the tablets

but really it's advisable to understand the link

between high blood pressure and kidney damage.

A lot of people don't quite realise that if they don't take the tablets,

the kidney damage will get worse.

My advice would be if you're prescribed the tablets,

try and understand exactly when to take them, why you're taking them,

and ask about side effects

because sometimes people have specific side effects.

Some of them give you a troublesome cough,

or maybe you have a headache or feel light-headed.

Go back immediately and report the problems

because you might be prescribed something different

which might suit you better.

Something that people with kidney damage have to watch out for

is that some of the tablets you can buy over the counter

can damage the kidneys further.

I think if you've been told you've got some type of kidney damage

that when you buy over-the-counter medicines

you always tell the pharmacist before you buy them

that you might be at risk of kidney disease.

If you're in a high-risk group,

then there are very specific things that you might have to do.

For diabetes, for example, the extra things would be

trying to keep your blood sugar level under control,

certainly trying to keep your blood pressure under control

and having a yearly urine sample sent off

to see whether any protein is leaking from the kidneys into the urine.

So there are very specific things for certain at-risk groups.

It's very difficult for some people to take formal exercise.

The sort of things I say to people is,

"Assess how much exercise you do at the moment and try and do a bit more."

Let's say, for example, you work in an office up on the second floor.

Take the stairs rather than the lift.

If you live half a mile from the bus stop,

try and walk briskly to the bus stop rather than taking your time.

And if you can feel that maybe three times a week

your heart is pumping a little bit, that you've actually exercised,

then that's some way in reducing cardiovascular risk,

the chance of having a heart attack or stroke in the future.

And finally, if your kidney function does seem to be getting worse

and you are referred to a specialist at the hospital,

please don't panic about that.

It's important that you go to the appointments

and you're able to talk with specialists who know about kidney disease,

and they may be able to slow down the kidney damage even further,

because what we're really trying to stop

is anybody needing dialysis or a kidney transplant.

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