The 5 Best Tips for People with Chronic Kidney Disease

Chronic kidney disease (CKD) affects millions of people worldwide and can progress to kidney failure (end-stage kidney disease), at which point dialysis or transplantation becomes necessary. While dialysis can be life-saving, it also imposes major lifestyle changes, health risks, and emotional and financial burdens. The good news: many patients with CKD can significantly slow disease progression and delay, sometimes avoid, dialysis through evidence-based medical care and lifestyle measures. This professional guide lists five of the most effective strategies, explains why they work, and gives practical steps you can discuss with your healthcare team.

Quick overview: When is dialysis considered?

Dialysis is generally considered when kidney function is so low that the body cannot maintain fluid, electrolyte, or waste product balance, or when life-threatening complications of kidney failure appear (severe hyperkalemia, refractory fluid overload, uremic symptoms such as nausea, confusion, or pericarditis). Decisions are based on symptoms and labs (e.g., falling eGFR, rising creatinine, uncontrolled potassium), not a single numeric threshold for every patient. Early action and sustained management can often delay the need for dialysis by years.

Tip 1: Control blood pressure aggressively and appropriately

Why it matters High blood pressure (hypertension) is both a primary cause and a major accelerator of CKD. Elevated pressure damages the kidney’s small blood vessels and increases protein leaking into the urine (proteinuria), which fuels further damage. Tight and appropriately individualized blood pressure control slows CKD progression and lowers cardiovascular risk.

What to do (practical steps)

• Work with your nephrologist to set an individualized blood pressure target. Many patients with CKD and albuminuria are managed toward targets near or below 130/80 mmHg, but targets vary by age, frailty, and other conditions.
• First-line medicines: ACE inhibitors (e.g., lisinopril, enalapril) or ARBs (e.g., losartan, valsartan) are preferred for people with CKD and proteinuria because they reduce intraglomerular pressure and proteinuria beyond blood pressure lowering alone.
• Monitor at home: Invest in a validated home blood pressure cuff and keep a log for clinic review.
• Lifestyle: Reduce dietary sodium (see Tip 3), maintain a healthy weight, limit alcohol, and increase physical activity as recommended.

Monitoring and safety

• Check kidney function (serum creatinine/eGFR) and potassium shortly after starting or increasing ACEi/ARB dose. A modest creatinine increase (~up to 30%) may be acceptable; larger rises require evaluation.
• Avoid combining ACEi + ARB because of increased risk of hyperkalemia and acute kidney injury.

Tip 2: Optimize blood sugar control (if you have diabetes)

Why it matters Diabetic kidney disease is the most common cause of CKD worldwide. Good glycemic control reduces the risk of kidney function declining and lowers the chance of complications that can precipitate dialysis.

What to do (practical steps)

• Know your HbA1c target and the individualized plan with your clinician. Typical targets are around 7% for many adults, but your team may adjust this up or down depending on age, hypoglycemia risk, and comorbidities.
• Medications that reduce kidney risk: SGLT2 inhibitors (dapagliflozin, empagliflozin, canagliflozin) have strong evidence for slowing CKD progression in people with and sometimes without diabetes. GLP-1 receptor agonists (semaglutide, liraglutide) also reduce cardiovascular risk and albuminuria in many patients with diabetes.
• Lifestyle: Balanced diet, consistent exercise, and weight management improve glucose control and overall kidney health.

Monitoring and safety

• Some diabetes medicines require dose adjustments in reduced kidney function — always consult your provider.
• Expect a modest initial eGFR dip when starting SGLT2 inhibitors; this often stabilizes and is not a sign to stop without medical guidance.

Tip 3: Reduce proteinuria and follow kidney-healthy dietary guidance

Why it matters Proteinuria (particularly albuminuria) is both a sign and driver of kidney damage. Reducing proteinuria slows progression of CKD. Diet also affects blood pressure, fluid balance, and electrolyte control.

Medications and treatments

• ACE inhibitors / ARBs: Foundational drugs for reducing proteinuria in most patients with albuminuria.
• SGLT2 inhibitors: Additive renal protection when combined with ACEi/ARB; reduce albuminuria and slow decline.
• Mineralocorticoid receptor antagonists:
  • Finerenone: a nonsteroidal MRA with evidence in diabetic CKD for reducing albuminuria and renal events; monitor potassium.
  • Spironolactone/eplerenone: can reduce proteinuria but carry higher hyperkalemia risk; used cautiously.
• Disease-specific immunosuppression: If proteinuria is due to an immune-mediated glomerular disease (e.g., minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, IgA nephropathy), targeted immunosuppressive therapies (steroids, calcineurin inhibitors, rituximab, etc.) can be kidney-sparing when appropriate and guided by biopsy and specialist care.
• Supplements to discuss with your doctor: (Shown to possibly reduce protein in your urine and lower creatinine in your blood)
• Chitosan
• Sodium Bicarbonate 
• Alpha-lipoic acid
• Astragalus
• Probiotics
• Coenzyme Q10
• B vitamins
• Resveratrol

Dietary guidance (practical steps)

• Sodium: Limit sodium to reduce blood pressure and fluid retention. Typical targets are individualized but often aim for substantially less than the average intake (work with a renal dietitian).
• Protein: Avoid high-protein diets. Moderate protein intake tailored to CKD stage and nutritional status is recommended to balance kidney benefit and prevention of malnutrition.
• Phosphorus/potassium: Manage based on lab values which includes limiting processed foods with phosphate additives and adjust potassium intake if hyperkalemia risk exists.
• Work with a renal dietitian for individualized meal planning.

Monitoring and safety

• Regularly monitor urine albumin-to-creatinine ratio, serum creatinine/eGFR, potassium, and bicarbonate. Medication choices and doses require coordination to avoid hyperkalemia and other complications.

Tip 4: Avoid nephrotoxins; keep medication lists reviewed and up to date

Why it matters Many commonly used medications and exposures can worsen kidney function acutely or chronically. Avoiding or minimizing these risks preserves remaining kidney function.

What to do (practical steps)

• Avoid chronic or regular NSAID use (ibuprofen, naproxen). Use safer alternatives for pain when appropriate and approved by your clinician.
• Review all prescription, over-the-counter, and herbal/supplement products with your healthcare team as some herbal remedies are nephrotoxic.
• Use iodinated contrast for imaging only when necessary; if required, discuss hydration strategies and alternatives with your doctor.
• Ensure antibiotics and other medications are dosed appropriately for your current eGFR.
• Carry an updated medication list and share it at every medical visit.

Tip 5: Engage in regular monitoring, timely specialist care, and healthy lifestyle habits

Why it matters CKD progression is influenced by many small factors. Consistent surveillance, early nephrology referral, and addressing cardiovascular risk together slow decline and prevent crises that precipitate urgent dialysis starts.

What to do (practical steps)

• Follow-up: Attend scheduled nephrology visits and stick to recommended lab monitoring (eGFR, urine albumin, electrolytes, hemoglobin, bone-mineral parameters).
• Vaccinations: Stay current with flu, pneumococcal, and other recommended vaccines to avoid infections that can destabilize CKD.
• Lifestyle:
  • Smoking cessation is essential — smoking accelerates kidney decline.
  • Regular, moderate exercise improves cardiovascular health and insulin sensitivity.
  • Maintain or achieve a healthy weight.
  • Kidney friendly diet with respect to protein, sodium, phosphorus and potassium.
• Plan ahead: Early education about dialysis modalities, vascular access planning, and transplantation candidacy allows planned transitions if dialysis eventually becomes necessary as unplanned dialysis typically starts with central venous catheters that carry higher risks.

Warning signs: When to seek urgent care

• New or worsening severe shortness of breath, chest pain, persistent vomiting, confusion, sudden large swelling, or very high potassium readings on labs means you should seek urgent medical attention, as these can indicate life-threatening complications.

Final words Delaying or avoiding dialysis is a realistic goal for many people with CKD when evidence-based medical therapies are combined with diet, lifestyle, and careful monitoring. The five pillars outlined here: blood pressure control, optimized diabetes management, targeted reduction of proteinuria with medication and diet, avoidance of nephrotoxins, and proactive monitoring/care coordination, are the most powerful, practical steps you can take. Work closely with your nephrology team to create a personalized plan: the right combination of therapies, monitoring, and lifestyle changes can preserve kidney function, improve quality of life, and delay the need for dialysis.

This information is educational and not a substitute for medical advice. If you have CKD, schedule a review with your nephrologist or primary care clinician to apply these strategies to your situation.