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Being a teenager can be tough with or without kidney disease. But having kidney disease can make it even harder. The good news? Learning to cope with your feelings can help. It can make the extra challenge of living with kidney disease easier.

Why are my emotions all over the place?

There can be many different reasons why you may feel the way you feel. Understanding the connection between your kidney disease and feelings of depression, anxiety and other emotions is the first step toward coping. Here's what you should know:

A chronic illness can affect your mental health. When you have a chronic illness like kidney disease, you have a lot more to think about, which can lead to feelings of anxiety, anger, worry, and stress. Living with the seriousness of kidney disease, day in and day out, can lead to a more negative view of life. You may not understand everything that is happening with your body, your treatment, and how you feel from one day to the next. All of this can make you feel confused and leave you feeling down.

The physical challenges of kidney disease are hard. Maybe some of the medications you take have physical side effects, like steroids, which can cause you to bloat and not look or feel like yourself. You may feel more self-conscious of how you look and how you feel. Some days you may be too tired to go to school, and other days you may not want to see anyone because you do not like the way you look. These feelings can be hard for you to understand and maybe harder to explain to others.

Kidney disease can affect your personal life. In addition to physical problems, you might find yourself making lifestyle changes - not because you want to, but because you feel you have no choice. Living with kidney disease might mean having to cancel plans with friends when symptoms flare up. As a result, you may end up spending more time alone.

How do I manage all these emotions?

Talk: Find someone you trust and talk to them. Maybe that person is a friend, your social worker, school counselor, or maybe even your parents. Don't be afraid to tell others what you are feeling and to ask for help and support when needed.

Share: Part of being a teenager is thinking that you are the only one who has problems. Everyone you know has something that they are dealing with. Your something is kidney disease. Don't be afraid to share your feelings with one or two close friends. If you share your concerns with each other, you will all feel better.

Don't be so hard on yourself: Sometimes bad days or bad things happen. These things can create stress. Your emotions might already be scattered because of hormones and physical changes. Add the stress of living with kidney disease and you have a lot to manage. Be prepared for this by finding ways to relax. Maybe keep a journal, call a friend up, exercise, read, or listen to music.

Find a routine: As a teen, keeping up with high school, daily activities, and medical visits can be a lot. Create a routine just for you for those times when things feel too difficult. Some ideas are watching your favorite TV show, playing your favorite game, taking a walk, or reading a good magazine or book.

Take charge: Living with kidney disease doesn't mean you should give up on your goals and dreams. You may just need to change how you accomplish them. You can move toward goals one small step at a time. Meeting with your guidance counselor or teacher can help you reach your goals at school.

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Managing Your Emotions While Living with Kidney Disease

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Being a teenager can be tough with or without kidney disease. But having kidney disease can make it even harder. The good news? Learning to cope with your feelings can help. It can make the extra challenge of living with kidney disease easier. Why are my emotions all over the place?

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We all experience stress. It's part of life. But too much stress can contribute to poor health, increasing our blood pressure and damaging our kidneys. By learning how stress impacts our health and finding ways to manage it, we can keep our kidneys healthier and live a healthier life overall.

What is stress?
Stress is anything that can upset or disturb your equilibrium or balance. Stress can be physiological (infection, injury, disease), or psychological (anxiety, argument, conflict, threats to personal safety or well-being). Living with a chronic illness, such as kidney disease, or learning for the first time that you have a chronic illness can be a significant source of stress.

Psychological stress is something that we contend with every day. It can be a result of positive life events, such as marriage and children, or it can come from more emotionally challenging events, such as the loss of a loved one, divorce and personal or financial problems.

Stress is normal, and your physical response to stress, including faster breathing and heart rate, a spike in blood pressure, dilated pupils, tense muscles, is a natural and normal process. The levels of fats and sugars in your blood can also increase. The body's response to stress is commonly known as "fight or flight." Although it is a natural process to help us survive immediate dangers, these reactions from too much or constant stress can eventually take their toll on your health.

How can stress impact my health and kidneys?
Not only does your body's reaction to stress help you with immediate dangers or crises, it can also serve as a positive motivator while handling life's challenges-when channeled properly. However, when your body is under high levels of stress for sustained periods of time, these physical reactions, if left unchecked, can eventually harm your health. The combined impacts of increased blood pressure, faster heart rate, and higher fats and sugar in your blood can contribute to a number of health problems, including high blood pressure, diabetes, and heart disease (also known as cardiovascular disease).

Stress and uncontrolled reactions to stress can also lead to kidney damage. As the blood filtering units of your body, your kidneys are prone to problems with blood circulation and blood vessels. High blood pressure and high blood sugar can place an additional strain or burden on your kidneys. People with high blood pressure and diabetes are at a higher risk for kidney disease. People with kidney disease are at higher risk for heart and blood vessel disease. If you already have heart and blood vessel disease and kidney disease, then the body's reactions to stress can become more and more dangerous. Therefore, whether your goal is to prevent heart and/or kidney disease, or improve your health while living with heart and/or kidney disease, managing stress is an important part of maintaining your overall health.

What can I do to manage my stress?
It is very difficult, if not impossible, to completely get rid of stress, or to never have any physical reactions to stress. However, there are steps you can take to manage stress and help control your body's response to stress. Some simple ways to reduce stress include:

Eat healthier foods

Limit salt and caffeine (especially if you have high blood pressure)

Limit sugar (especially if you have diabetes), and fats (especially if you are at risk for heart and blood vessel disease)

Set aside time to relax

Relaxation techniques (yoga, meditation, etc.)

Prayer

Talk to a friend, loved one, spiritual leader, or healthcare professional

Write down your problems and think about the best solution for each of them. A list can help you evaluate and prioritize what issues need to be addressed.

Set realistic goals and expectations

Get enough sleep and maintain a regular sleep schedule

Maintain a positive attitude and outlook

Vacation

Regular exercise and more physical activity

This list does not include all of the ways you can manage stress. Improvements in diet and more physical activity are things everyone should attempt. Talk to a healthcare professional to discuss which dietary and lifestyle changes might be best for you. Other methods to manage stress will depend on your personal preferences. You might prefer music, while someone else prefers a relaxation technique or massage. No matter the technique, managing your stress can help you feel better and live a healthier life.

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We all experience stress. It's part of life. But too much stress can contribute to poor health, increasing our blood pressure and damaging our kidneys. By learning how stress impacts our health and finding ways to manage it, we can keep our kidneys healthier and live a healthier life overall.

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Helpful Mobile Apps - NephCure Kidney International ®

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There are many mobile apps available to assist with tracking diet, medications, and kidney health on-the-go. Here are some we've found helpful: Diet and Nutrition Apps KidneyDiet allows you to search foods to determine their nutritional values, and add your diet to a diary to track your nutrient and fluid intake.

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FIRST30: What to Expect When Starting Dialysis

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August 12, 2014, 10:06am EDT

You may experience certain symptoms commonly reported by people on dialysis. However, there are ways you can help manage these symptoms by following your treatment plan and notifying your healthcare team of any sudden changes in symptoms. Here are some common issues for people on dialysis, along with advice on how to deal with them.

Symptoms related to low blood pressure can include dizziness, lightheadedness or fatigue. Low blood pressure can have different causes, including excess fluid weight between sessions and having a weak heart. You should be aware of these symptoms, and let your healthcare team know if you are experiencing any of these symptoms. Your healthcare team might adjust your dialyzing time or frequency, and recommend restrictions of fluid intake. Salty foods that can increase thirst should also be avoided.

Nausea and vomiting can be caused by uremia (buildup of toxins in the blood) or other factors. If you experience nausea or vomiting, speak with your healthcare team. They can help figure out the cause and recommend possible treatments.

Dry or itchy skin can be experienced by many patients receiving dialysis and can have different causes, such as too much or too little dialysis or skin allergies. Sensitivity to cold and dry weather can also help cause dry and itchy skin. Unmanaged phosphorous can be another possible cause of dry and itchy skin. You should avoid lotions with fragrances because these may irritate sensitive skin. You can also use soaps that don't dry out skin as much and use plain moisturizers. You should also talk to your healthcare team if you have dry or itchy skin.

Symptoms related to restless leg syndrome (RLS) can also be experienced by people receiving dialysis. People with RLS keep moving their legs because the leg nerves and muscles create uncomfortable sensations such as crawly, prickly or itchy feelings. RLS usually happens while sitting or lying down and can disrupt sleep. RLS can have multiple causes, such as some forms of kidney disease, uremia, iron deficiency, or neuropathy (nerve damage). Therefore, it's important to speak to your healthcare team for a diagnosis and a prescription which will help address the specific cause.

Muscle cramping can cause discomfort for people receiving dialysis. The exact cause is unknown, but it is believed to have something to do with fluid removal toward the end of a dialysis session. Treatment might include stretching the cramped muscle, applying hot packs to the affected area to help increase circulation, or certain medications that can provide relief. Speak with your healthcare team if you experience muscle cramping, so they can look into a possible cause and recommend the right treatments for you. Monitoring fluid intake to avoid large fluid gains between dialysis treatments might also help.

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You may experience certain symptoms commonly reported by people on dialysis. However, there are ways you can help manage these symptoms by following your treatment plan and notifying your healthcare team of any sudden changes in symptoms. Here are some common issues for people on dialysis, along with advice on how to deal with them.

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If you are on dialysis, your vascular access allows you to get the treatment you need. It is important to take care of it. Learn about the different kinds of vascular access and how to keep them working well.

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If you are on dialysis, your vascular access allows you to get the treatment you need. It is important to take care of it. Learn about the different kinds of vascular access and how to keep them working well.

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How Your Access Works A hemodialysis access, or vascular access, is a way to reach the blood for hemodialysis. The access allows blood to travel through soft tubes to the dialysis machine where it is cleaned as it passes through a special filter, called a dialyzer. An access is placed by a minor sur…

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What is home haemodialysis (Home HD)? | Baxter Empowers

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This site is for patients, caregivers and healthcare professionals.

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What Is In-Centre Haemodialysis (In-Centre HD)? | Baxter Empowers

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This site is for patients, caregivers and healthcare professionals.

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This site is for patients, caregivers and healthcare professionals.

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Explore your Treatment Options | Baxter Empowers

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This site is for patients, caregivers and healthcare professionals.

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PRINE welcomes you to Kidney Care First! (Qualified Medicare members only)

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PRINE welcomes you to Kidney Care First! (Qualified Medicare members only)

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PRINEd Choices 2: Kidney Transplant and Medical Management

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Paired Exchange Programs

Sometimes a loved one may want to donate a kidney but their blood type is incompatible. Some transplant centers will help incompatible pairs of recipient/donors through a process called paired exchange, which involves two living donors and two recipients.

If the recipient from one pair is compatible with the donor from the other pair, and vice versa- the transplant center may arrange for a "swap"-for two simultaneous transplants to take place. This allows two transplant candidates to receive organs and two donors to give organs though the original recipient/donor pairs were unable to do so with each other.

Figure 1: In paired exchange, an incompatible donor/ recipient pair (such as a mother and son that don't have compatible blood types) are matched with another incompatible donor/recipient pair for a "swap". Each donor gives a kidney to the other person's intended recipient.

Both donors and candidates are carefully evaluated and tested medically and psychologically to assure that the benefits outweigh the risks. It is important for both surgeries to be scheduled for the same time in case either donor changes their mind at the time of surgery. Surgeries can take place at the same or different hospitals. It can be advantageous if the surgeries take place at the same hospital though this may mean extra costs of travel and housing for one couple.

Never Ending Altruistic Donor (NEAD) chain

A NEAD™ chain (Never Ending Altruistic Donor chain) begins with one non-directed (altruistic) potential donor. In this program, the non-directed donor gives to a person waiting for a transplant, and that recipient's willing - but incompatible - donor gives to another person waiting, and so on.

Each living donor in this system gives to a stranger, and the chain of donors is kept going as long as possible.

Figure 2: In A NEAD™ chain, a non-directed potential donor is matched up with a recipient who has a willing, but incompatible donor. Then that recipient's incompatible donor then gives to another incompatible pair, and so on.
For More Information

If you are interested in one of these exchange programs:

Talk with your transplant hospital. If you're already working with a transplant hospital: Talk to them about your options. Ask them if any of these programs are an option for your situation, and if so, does that hospital offer them?

If not: contact transplant hospitals (in the recipient's area) to ask. To find a transplant center in your area click here. Select "transplant center by organ," then select "kidney," and then select your state.

Contact a transplant hospital that has an exchange program. It's always a good idea to check with your transplant hospital, or hospitals nearby.

Contact other organizations which might help. Following are links to other organizations which help to facilitate exchanges.(Note: these organizations and their websites are not under the control of the NKF, and NKF assumes no responsibility for their content or services. These links are provided for information purposes only, and should not be considered an endorsement or recommendation by the National Kidney Foundation.)

OPTN/UNOS Kidney Paired Donation Program The vision of the OPTN/UNOS Kidney Paired Donation Program is that every kidney transplant candidate with an incompatible but willing and approved living donor receives a living donor kidney transplant. The mission is to develop a successful Kidney Paired Donation (KPD) program with universal access to all UNOS/OPTN members that prioritizes the medical and psychosocial safety of living donors and candidates.

Alliance for Paired Donation The mission of the Alliance for Paired Donation™ is to save lives by significantly reducing the wait time for a kidney transplant through kidney paired donation.

National Kidney Registry The mission of the National Kidney Registry is to save and improve the lives of people facing kidney failure by increasing the quality, speed, and number of living donor transplants in the world.

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Programs for Donor/Recipient Pairs with Incompatible Blood Types

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Paired Exchange Programs Sometimes a loved one may want to donate a kidney but their blood type is incompatible. Some transplant centers will help incompatible pairs of recipient/donors through a process called paired exchange, which involves two living donors and two recipients.

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NY Advanced Directive Planning/Living Will

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NY Advanced Directive Planning/Living Will

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VIDEO: PRINE Care's Lead Care Manager, Colette Boroch interviews a PRINE Health kidney transplant patient.

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VIDEO: PRINE Care's Lead Care Manager, Colette Boroch interviews a PRINE Health kidney transplant patient.

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Interview with PRINE kidney transplantation patient, Terrence Perry

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WHICH DIALYSIS TREATMENT IS BEST FOR YOU?

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WHICH DIALYSIS TREATMENT IS BEST FOR YOU?

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Track your mineral intake through micronutrients 

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Track your mineral intake through micronutrients 

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Cronometer: Track nutrition & count calories

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A web app for counting calories and tracking your diet and health metrics.

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SSM Health Saint Louis University Hospital

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What will recovery be like after a kidney transplant?

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Patient Testimonial: Ron Corbin’s kidney transplant story

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Tracey's Journey on Home Dialysis with Tablo

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7 Foods to Limit with Late Stage Kidney Disease

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Peer Mentoring: 855.NKF.PEERS (855.653.7337)/NKFpeers@kidney.org

NKF Cares Patient Help Line, toll-free 855.653.2273 or email nkfcares@kidney.org.

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Welcome to the National Kidney Foundation’s Transplant Community! Whether you have had a transplant, are waiting for a transplant, or are a family/friend/caregiver, here you will find a safe and supportive space where you can share your experiences, ask questions, and get answers that are accurate…

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Welcome to the National Kidney Foundation Dialysis! In this community you will find a safe and supportive space where you can share your experiences, ask questions, and get answers that are accurate and up to date. Fueled by passion and urgency, NKF is a lifeline for all people affected by kidney disease.

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You have many dialysis treatment options, one of which is in-center hemodialysis. With this treatment, you schedule three four-hour treatments per week at a kidney dialysis center that's fully staffed by a personalized care team. Some people prefer to go to a dialysis center for treatment because:

Treatment is administered by trained kidney care professionals.

They enjoy social interactions with fellow dialysis patients and staff.

Dialysis is only three times a week, leaving four free days.

After talking with your nephrologist, you may determine that in-center hemodialysis is right for your lifestyle.

How does in-center hemodialysis work?

Once you arrive at the dialysis center, the healthcare team-from the nurse to the facility administrator-will take care of all aspects of treatment.

First, your access area will be washed by a patient care technician (PCT). Once that's complete, you will be weighed and escorted to your dialysis chair. Your standing and sitting blood pressure will be taken and a dialysis nurse will check your vitals before connecting you to the dialysis machine.

The typical dialysis session is four hours. During that time your care team will monitor your blood pressure and the dialysis machine's performance. When the dialysis treatment time is up, they will disconnect you from the dialysis machine and record your vital signs again.

What can I do while I dialyze at a center?

You are free to read, watch television, work or play on your laptop, talk to other patients and care team members, sleep-whatever activity you can do from the dialysis chair. All DaVita® dialysis centers offer free Wi-Fi for people who want to be online during in-center treatments.

Who is taking care of me at the dialysis center?

You spend a lot of time-and place a lot of trust-with the people who care for you. A supportive kidney health care team can help make your experience more pleasant. At DaVita®, you'll receive personal care and attention from a highly trained team of professionals that wants to help you maximize your quality of life.

Mason, an in-center hemodialysis patient, says he sees the dialysis care team as an extension of his family.

"The dialysis center plays such an important role in our lives that I don't think many of the team members realize the full extent of the influence they have in our lives," he says. "The smiles, the jokes and laughter give us strength to go on."
What is in-center nocturnal dialysis?
Nocturnal dialysis is similar to in-center hemodialysis, but done overnight. For patients on nocturnal dialysis, they typically arrive at the dialysis center in the evening and receive approximately eight hours of dialysis treatment during the night. Patients sleep at the center three nights a week while they are attached to the dialysis machine. On nights when they dialyze, patients usually get into the center around 7:00 p.m. and are hooked up to the dialysis machine. They are able to bring their dinner, watch television, read a book, listen to music, chat with their health care team or each other, or any other activity they can do at dialysis.

Patients are asked to bring their pillow, blanket, toothbrush and other items to make them feel "at home." At about 11:00 p.m. the lights are turned down. At that time people either fall asleep, or quietly continue their activities as not to disturb each other. After lights out, patients normally only have about four to five hours of treatment left. Treatment is usually over before 5:00 a.m. Patients are taken off dialysis and able to go home and start their days, usually before early-morning traffic.

The care team report that the nocturnal dialysis setting is more peaceful and relaxed than the daytime. The health care team and patients are able to spend more time talking to each other, building a good support system.

Is there a dialysis center near me?

DaVita has a number of outpatient dialysis centers located throughout the United States. As the largest independent provider of dialysis services in the United States, chances are good there will be a DaVita dialysis center near your home or work. Call DaVita Guest Services at 1-800-424-6589 or go to Find a Dialysis Center to locate a center near you.

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In-Center Hemodialysis: Dialysis Care Day or Night

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You have many dialysis treatment options, one of which is in-center hemodialysis. With this treatment, you schedule three four-hour treatments per week at a kidney dialysis center that's fully staffed by a personalized care team. Some people prefer to go to a dialysis center for treatment because: Treatment is administered by trained kidney care professionals.

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WHICH TYPE OF DIALYSIS ARE YOU COMPATABLE WITH?

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WHICH TYPE OF DIALYSIS ARE YOU COMPATABLE WITH?

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Intro to transplant handout 2019 (002) revised EA

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Offered by some local home hemodialysis programs on Long Island.

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Home hemodialysis (HHD) gives you the freedom to do treatments at home and create a treatment schedule that works with your lifestyle.

99% of home dialysis patients are satisfied with the quality of care they receive at DaVita.

Learn more

Learn to manage your kidney health.

Get your questions answered in a no-cost Kidney Smart ® class.

Find a Home Dialysis Program

Call 1-800-424-6589 now to talk to one of our placement specialists or start a search.

Find a Home Hemodialysis Program

Search for a DaVita home dialysis center near you.

Use the forums on myDaVita to connect with other home dialysis patients and learn more about their experience.

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Home hemodialysis (HHD) gives you the freedom to do treatments at home and create a treatment schedule that works with your lifestyle. 99% of home dialysis patients are satisfied with the quality of care they receive at DaVita. Learn more Learn to manage your kidney health.

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An essential online resource for renal healthcare professionals and patients living with chronic kidney disease (CKD). This interactive site features a wealth of information about kidney disease and treatment options, and offers visitors a variety of educational tools. Patients should see their doctor to discuss their health condition.

Benefits of Peritoneal Dialysis (PD)

Peritoneal dialysis (PD) may be the right treatment for you if you work, study or travel regularly and if it suits your lifestyle and medical and physical condition. Doing peritoneal dialysis (PD) at home increases the flexibility and independence of your life on dialysis. It can save you frequent trips to the hospital or clinic and gives you more freedom to do the activities you love.

How peritoneal dialysis works

Learn how peritoneal dialysis works.

What is CKD and how is it treated?

Increase your understanding of kidneys and CKD, and learn how to manage your life with CKD, work with your healthcare team, and review CKD treatment options and the types of dialysis.

Preparing for, and doing your PD treatment

Familiarize yourself with the daily process: from preparation, to hand washing, to connection and disconnection.

Living well as a patient on PD

Gain more control over your life with information on managing peritoneal dialysis, including details on fluid management, exit-site care and home delivery services.

Knowledge center

Look up valuable information related to living with CKD: treatment options, managing fluids, understanding dietary requirements, and more.

Get support in your kidney disease

Discover organizations that help people with kidney disease and their loved ones; whether you are seeking information, tools or just someone to talk to.

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Welcome to Baxter Empowers | Baxter Empowers

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An essential online resource for renal healthcare professionals and patients living with chronic kidney disease (CKD). This interactive site features a wealth of information about kidney disease and treatment options, and offers visitors a variety of educational tools. Patients should see their doctor to discuss their health condition.

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#1 Talk with your doctor

Even if you are currently receiving dialysis treatment in-center, home dialysis could still be an option for you. Speak with your doctor candidly about your interest in home dialysis. Ask about the potential benefits and any medical risks, as well as your treatment options and how your choice could affect your lifestyle and overall health. If you are currently treating on dialysis, learn more here.

#2 Start home dialysis training

Once you and your doctor decide that home dialysis is right for you, you and your care partner (a friend or family member) will start a comprehensive safety and training program with your care team. Training is customized to meet your specific needs, and will provide you the education, tools and support needed to stay healthy and safe.

#3 Get your home ready

Because you'll perform treatments from home, you'll need to make room to store equipment and supplies. Although the equipment and supplies you need vary based on your choice of treatment, it's essential to make sure you have a comfortable and sanitary environment dedicated for your treatments.

#4 Receive ongoing care

Even though you do not have to treat at a center, it's important to understand that you're never alone when you do home dialysis. You will maintain regular contact with your doctor and dialysis nurses who will closely monitor and track your care. In most cases, you'll also make a monthly visit to meet with your health care team and talk regularly by phone about any issues or concerns.

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Even if you are currently receiving dialysis treatment in-center, home dialysis could still be an option for you. Speak with your doctor candidly about your interest in home dialysis. Ask about the potential benefits and any medical risks, as well as your treatment options and how your choice could affect your lifestyle and overall health.

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AFTER YOUR KIDNEY TRANSPLANT

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Schedule regular healthcare visits

Take all your medications every day and at the same time as instructed

Discuss any medication concerns or side effects with your transplant team

Eat healthy

Get regular exercise

Keep a healthy weight

Ask how you can lower your chances for high blood pressure, diabetes, cancer, or infection Become an active member of your healthcare team

Most people with a kidney transplant have few dietary restrictions, but it's important to eat a healthy diet. In general, you should eat a heart- healthy diet (low fat, low salt) and drink plenty of fluids. If you have diabetes or other health problems, you may still have some dietary restrictions. A dietitian can help you plan meals that are right for you.

It is important to take care of your overall health with your transplant. Having routine health screenings will help guide your care. You will also need regular blood tests to help find out how well your kidney is working, and to watch the levels of immunosuppressive medications. This will also help find any possible problems early, when treatment works best.

You and Your Healthcare Team

Good healthcare is always a team effort-especially when you have a transplant. The people on your healthcare team help you most when you work with them as part of the team. You do that by sharing your concerns, asking questions, and by learning as much as you can about your transplant. Remember, you are the most important part of the team!

Your Daily Medication Schedule

Living with daily medications often means creating new habits so you can remember to take your medications in a way that fits into your routine. Talk to your transplant team if you are having difficulty sticking to your medication schedule. In addition, here are some common barriers to taking medication and ways to overcome them:

I forget to take my medication, especially if:

I am busy doing other things

I can't remember whether I've taken them already

I fall asleep or oversleep

Something interrupts my routine like a phone call or visit

It is a holiday or celebration

Nobody reminds me

It's hard for me to take my medications:

On time

When others can notice me taking them

When it is inconvenient to do so

I forget to bring them with me when I leave home

Post a medication calendar in sight showing the days/times to take them

Use a pillbox, app, mobile phone, or watch with an alarm

Place medications where they are visible (but out of reach of children or pets)

Schedule your medications at the same time as regular daily routines

Keep a small supply of medication in your purse or briefcase, at your desk at work, or other helpful places

Common Immunosuppressants

Avoid grapefruit juice because it affects how the medication is broken down by the liver

Best to take with food to avoid stomach upset

Mycophenolate mofetil (MMF)

Take by mouth on an empty stomach, 1 hour before or 2 hours after meals.

Available as an IV infusion only

Dosing schedule depends on time after transplant but are usually given every four weeks

Note: Different tacrolimis, cyclosporine, and mycophenolate products are not interchangeable.

Learn More

The more you learn about your transplant, the better choices you can make about your health. Ask your transplant team for more information. You can also visit the National Kidney Foundation's website at www.kidney.org/transplantation or call NKF Cares toll-free at 855.653.2273.

The National Kidney Foundation has many free educational resources:

THE NKF CARES PATIENT HELPLINE at 855.653.2273 is a toll-free number that you can call for information. A trained professional will listen to your concerns and help answer your questions. Ask for any of our free educational booklets on kidney transplantation or visit: www.kidney.org/transplantation.

CARE AFTER KIDNEY TRANSPLANT is a SmartPhone app that helps you learn how to stay healthy with a kidney transplant. It provides answers to frequently asked questions, and why it is important to follow all of the instructions and recommendations from your transplant team.

TRANSPLANT CHRONICLES is an e-newsletter from the National Kidney Foundation that provides information and resources for transplant recipients and families. Subscribe here

Additional Resources:

TRANSPLANT CAFE allows individuals in the transplant community to connect online to create friendships, get and give support, increase awareness through advocacy, and much more. Visit www.transplantcafe.com

TRANSPLANT LIVING has information and resources that help you and your family make the best possible decisions about your post-transplant treatment. View their list of support groups to see if there is one in your area. "Transplant Living"
is part of The United Network for Organ Sharing (UNOS), which manages the waiting list for a transplant in the U.S. and matches donors to recipients. Visitwww.transplantliving.org

Date Reviewed: 02-06-2017

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Schedule regular healthcare visits Take all your medications every day and at the same time as instructed Discuss any medication concerns or side effects with your transplant team Eat healthy Get regular exercise Keep a healthy weight Ask how you can lower your chances for high blood pressure, diabetes, cancer, or infection Become an active member of your healthcare team Eating Healthy Most people with a kidney transplant have few dietary restrictions, but it's important to eat a healthy diet.

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LIVING DONOR SEARCH

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If you need a kidney transplant, you must first be evaluated for a transplant by a transplant center (a hospital that does transplants - not every hospital does them). The evaluation is used to make sure you're a good candidate for a transplant. This must happen before any potential living donors can be considered. If you have not been evaluated for a transplant yet, you can:

Ask your doctor for a referral to a transplant center

OR

You can also find and contact U.S. transplant centers near you
Call and ask for the "Kidney Transplant Coordinator", who will be a registered nurse who can help.

Then, talk to your transplant center about living and deceased donation options. Make sure that you are active on the waiting list for a transplant from a deceased donor, even if you prefer to get a kidney from a living donor.

I have a living donor. What do they need to do?

Any family members or friends who are interested in donating to you can contact your transplant center (ask for the "Transplant Coordinator") for information and to begin the evaluation process.

How can I ask someone to be my living donor?

Talk to your friends and family about your kidney failure and need for a donor. While you might not be comfortable asking people to donate, it may be helpful to make people aware of your need for a donor. That way, if someone is interested in pursuing donation, they can ask for more information.

Some people also decide to share their story and tell co-workers, community organizations, social groups, people who belong to their place of worship, or local newspapers or magazines that they need a transplant. Many people are also turning to social media to share their story.

Educate your family and friends about kidney transplantation and donation. You can contact NKF Cares, our Patient Help Line, at toll-free 855.653.2273 or email nkfcares@kidney.org to request free educational brochures about donation to share with your friends or family members.

What if I don't have a living donor?

You will need to work through your transplant center to discuss other options which might be available. If you are trying to find a kidney donor, the best way to do this is to have interested family members and friends tested for potential compatibility. If you cannot find a donor this way and you are a suitable transplant candidate, you will be placed on the transplant waiting list by the transplant center.

If you have any questions, you can also contact NKF Cares, our Patient Help Line, at toll-free 855.653.2273 or email nkfcares@kidney.org.

A CONVERSATION CAN SAVE A LIFE.

Need help getting the conversation started?

About NKF Cares

NKF Cares is a free, confidential hotline with trained professionals ready to answer your questions or concerns. Our peer-mentoring program, NKF PEERS, connects anyone affected by kidney disease with an informed and supportive mentor who has already been through the process.

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If you need a kidney transplant, you must first be evaluated for a transplant by a transplant center (a hospital that does transplants - not every hospital does them). The evaluation is used to make sure you're a good candidate for a transplant. This must happen before any potential living donors can be considered.

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Giving up salt does not mean giving up flavor. Learn to season your food with herbs and spices. Be creative and experiment for a new and exciting flavor. What kinds of spices and herbs should I use instead of salt to add flavor? Try the following spices with the foods listed. Allspice - Use with bee…

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Cholesterol, Fats, and Heart Disease: What You Need to Know

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Cholesterol is a fat-like substance found in your blood. Your body needs cholesterol in certain amounts. Your body can make cholesterol as well as get it from eating meats and other animal food products. Too much cholesterol in the blood is bad.

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PROTEIN

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We all need protein in our diet every day. Proteins, carbohydrates and fats are the three fuel sources (calories) in the foods we eat. Protein is used to build muscle and fight infection.

How do you know how much protein you need daily? Protein needs vary based on your age, sex and overall general health. The Recommended Dietary Allowance (RDA) for protein in healthy adults is 0.8 grams of protein per kilogram of desirable body weight a day. So, for a 150 pound person (divide by 2.2 to get 68 kilograms then multiply by 0.8), that is 55 grams of protein a day. For someone who weighs 120 pounds, that would be 44 grams of protein a day. If we eat more protein than what our bodies can use in a day, it becomes a source of excess calories, which can cause weight gain. Protein byproducts are removed from the body by the kidneys, which filter it out in the urine.

For someone with declining kidney function, the byproducts of protein breakdown in the body can build up in the blood instead of being cleared out. Many studies suggest that limiting the amount of protein in the diet may slow the loss of kidney function. It is important that a kidney doctor (nephrologist) and a renal dietitian help plan the amount and type of protein sources to be provided in your diet, at even the earliest stages of kidney disease, so that kidney function can be monitored closely for any necessary diet and medicine changes.

Protein sources in our diet come from animal sources and plant sources. Animal sources of protein are considered "complete" or "high quality" protein as they provide all the essential amino acids (the building blocks of protein). Animal sources of protein vary in their amount of fat, with fatty cuts of red meat and whole-milk dairy products and eggs being the highest in saturated fat (less healthy for the heart). Fish, poultry, and low-fat or fat-free dairy products are lowest in saturated fat.

An "incomplete" or "lower quality" protein source is one that is low in one or more of the essential amino acids. Plant sources such as beans, lentils, nuts, peanut butter, seeds and whole grains are examples of incomplete proteins. The good news is that if you eat a combination of these incomplete proteins in the same day, they can provide adequate amounts of all the essential amino acids. Vegetarians can meet their protein needs with careful planning. For example, combining red beans and rice or peanut butter on whole grain bread together make a complete protein. Another bonus with plant proteins is that they are low in saturated fat and high in fiber.

Examples of the amount of protein in the typical serving sizes of the major protein foods:

1 whole egg or 1/4 cup frozen egg substitute = 7 grams

3 ounces cooked meat (size of a deck of cards) = 21-24 grams (leaner meats are higher in protein per oz.)

8 ounces milk (whole, 2%, skim, soy) = 8 grams

8 ounces yogurt or 1 ounce cheese = 8 grams

1 cup cooked beans (navy, pinto, kidney, black-eyed peas, split peas) = 14-16 grams

1 ounce of dry roasted peanuts = 7 grams
Total protein from above sources = 65-70 grams
Other foods such as breads and cereals, pasta and rice, fruits, and other vegetables provide smaller amounts of protein, but provide lots of other nutrients as well.

We all need protein every day to meet our body's needs but moderation and variety is the key to an overall healthy lifestyle. For special dietary concerns, it is best to seek professional assistance.

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News - Protein in Our Diet - Variety and Moderation is the Key

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By Linda M. Ulerich, RD We all need protein in our diet every day. Proteins, carbohydrates and fats are the three fuel sources (calories) in the foods we eat. Protein is used to build muscle and fight infection. How do you know how much protein you need daily?

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A DaVita Dietitian’s Top 15 Healthy Foods for People with Kidney Disease

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Some of the healthiest foods for people with kidney disease on a renal diet or kidney diet are fruits and vegetables low in sodium, potassium and phosphorus.

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GENERAL KIDNEY NUTRITION

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Learn the basics!

Most patients in the early stages of kidney disease need to limit the amount of sodium in their diet. Some patients may be told to limit protein in their diet as well. The DASH diet is often recommended for patients with kidney disease. Be sure to talk with your healthcare provider about your specific nutrition needs.

If your kidney disease gets worse, you may also need to limit potassium or phosphorus in your diet. Talk with your healthcare provider about your specific nutrition needs.

Here are some additional resources to help you stay healthy with kidney disease through your diet:

Looking for nutrition guidance? Contact a CKD dietitian in your area.

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Nutrition and Kidney Disease, Stages 1-4

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Learn the basics! Nutrition and Chronic Kidney Disease Nutrition for Children with Chronic Kidney Disease Most patients in the early stages of kidney disease need to limit the amount of sodium in their diet. Some patients may be told to limit protein in their diet as well.

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NKF CKD Comminity

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Welcome to the National Kidney Foundation's Community for people affected by Chronic Kidney Disease (CKD)! In this community you will find a safe and supportive space where you can share your experiences, ask questions, and get answers that are accurate and up to date.

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What Is a Peer Mentor?

A peer mentor is a person from any background or experience level who shares his/her experiences with kidney disease to help his/her peer feel less alone in facing the challenges of kidney disease. Peer mentors can motivate a peer to stay active in his/her care.

What Is Peer Mentoring?

Peer mentoring is a relationship between a mentor and mentee. The peer mentor shares his/her knowledge, experiences, and skills. This helps a mentee progress toward his/her goals.

Who Can Be a Peer Mentor in the End Stage Renal Disease (ESRD) Peer Mentoring Program?

If you would like to be a peer mentor, talk to your ESRD Network Peer Mentor Champion.

Who Is a Peer Mentee?

A peer mentee is a person who:

Is looking to make a connection with a peer who is thriving despite kidney disease.

Wants more knowledge from someone who also has kidney disease.

Who Can Be a Mentee in the ESRD Peer Mentoring Program?

If you would like to be paired with a peer mentor, talk to your ESRD Network.

How Do I Sign Up for the Peer Mentoring Education Program?

Reach out to your ESRD Network Peer Mentor Champion to let them know that you want to be part of the Peer Mentoring Education Program.

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Patients: Peer Mentoring Education Program

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A peer mentor is a person from any background or experience level who shares his/her experiences with kidney disease to help his/her peer feel less alone in facing the challenges of kidney disease. Peer mentors can motivate a peer to stay active in his/her care. Peer mentoring is a relationship between a mentor and mentee.

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You are here

Home " A to Z " Estimated Glomerular Filtration Rate (eGFR)

Types

Measuring and estimating GFR

Getting an accurate GFR level is challenging because measured GFR (mGFR) is a complicated and lengthy process. This makes it impractical for both clinicians and patients. It is for this reason that healthcare professionals use a formula to estimate GFR. Often, CKD does not have any symptoms until the later stages of the disease. This is the reason why reliable estimates of GFR are so important for identifying CKD as early as possible.

The standard way to estimate GFR is with a simple blood test that measures your creatinine levels. Creatinine is a waste product that comes from the digestion of dietary protein and the normal breakdown of muscle tissue. Aside from CKD, creatinine levels can be affected by other factors including diet; muscle(weight of your muscles); malnutrition; and other chronic illnesses.

Differences between eGFR and mGFR

Estimated GFR (eGFR)

Measured GFR (mGFR)

How it works

A calculation used to estimate how well your kidneys are filtering certain agents produced by your body, such as:

creatinine (a waste product that comes from the normal wear and tear on muscles)

cystatin C (a protein that slows down the breakdown of other protein cells)

A measurement of how well your kidneys are filtering certain agents not produced by your body, such as:

inulin (a kind of fiber that is found in some plant foods)

iohexol (contrast agent used in imaging tests)

Availability

Widely available

Not widely available

Cost

Less expensive

More expensive

Time to complete the test

Less time needed

More time consuming

Accuracy

Possible inaccurate estimates of GFR, especially in early stages of kidney disease (stages 1 and 2)*

Accurate measures of GFR, including early stages of kidney disease (stages 1 and 2)

Precision

Can miss early GFR changes, such as a rapid decrease in levels, which may be a sign of diabetic kidney disease

Can identify early GFR changes, such as a rapid decrease in levels, which may be a sign of diabetic kidney disease

*Other factors that can affect eGFR include: pregnancy, being over the age of 70, unusual muscle mass, cirrhosis (a disease caused by scarring in the liver), nephrotic syndrome (a condition caused by having too much protein in your urine), a past solid organ transplant, and some medications.

Purpose

Why eGFR testing is done

Early-stage CKD doesn't usually cause symptoms, but your doctor may recommend an eGFR test if you are at higher risk of developing the disease. CKD risk factors include:

Usually, developing CKD is not due to any single reason, but because of a combination of physical, environmental, and social factors.

Later stage CKD does cause symptoms. So you may need an eGFR test if you have any of the following symptoms:

Urinating more often or less often than usual

Itching

Feeling tired

Swelling in your arms, legs, or feet

Muscle cramps

Nausea and vomiting

Loss of appetite

Results

eGFR of 90 or higher is in the normal range

eGFR of 60 -89 may mean early-stage kidney disease

eGFR of 15 -59 may mean kidney disease

eGFR below 15 may mean kidney failure

What is a normal eGFR number?

In adults, the normal eGFR number is usually more than 90. eGFR declines with age, even in people without kidney disease. See chart below for average estimated eGFR based on age.

Age (years)

Average eGFR

20-29

116

30-39

107

40-49

99

50-59

93

60-69

85

70+

75

Understanding your results

There are five stages of kidney disease. Your healthcare professional determines your stage of kidney disease based on the amount of kidney damage shown by your eGFR or mGFR. Now that your know your eGFR, find out your kidney disease stage using the table below.

What are the stages of chronic kidney disease (CKD)?

Stage

Description

eGFR

Kidney Function

What to do next

If you have any of the CKD risk factors listed above, ask your healthcare professional to order an eGFR lab test.

Questions for your healthcare team

Now that you know your eGFR and your stage of kidney disease, use this table to find questions to ask your healthcare professional at your appointments.

If your kidney disease is in stage...

Ask your healthcare professional if you should...

1

2

3a

3b

4

5

✔

✔

✔

✔

✔

✔

Test your urine for albumin to have a complete picture of your overall kidney health

✔

✔

✔

✔

✔

✔

Repeat your eGFR test in 3 months to check if your eGFR remains lower than 90

✔

✔

✔

✔

✔

✔

Take medication that may help slow progression of kidney disease (such as ACE inhibitors, ARBs, SGLT2 inhibitors, or nonsteroidal mineralocorticoid receptor antagonists)

✔

✔

✔

✔

✔

✔

Adjust any current medications due to reduced kidney function

✔

✔

✔

✔

✔

✔

Get nutritional and dietary counseling to help support kidney function and overall health

✔

✔

✔

✔

✔

✔

Start seeing a kidney specialist (nephrologist)

✔

✔

✔

✔

✔

✔

Learn more about end-stage kidney disease and treatment options

✔

✔

✔

✔

✔

✔

Be evaluated for a kidney transplant and be placed on a kidney transplant list

Download the NKF Fact Sheet: eGFR

Kidney Numbers and the CKD Heat Map

Download a printable resource that explains what kidney numbers are and how your healthcare professional uses them to diagnose CKD.

This content is provided for informational use only and is not intended as medical advice or as a substitute for the medical advice of a healthcare professional.

Last Reviewed: 09/23/2021

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Estimated Glomerular Filtration Rate (eGFR)

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Home " A to Z " Estimated Glomerular Filtration Rate (eGFR) Types Getting an accurate GFR level is challenging because measured GFR (mGFR) is a complicated and lengthy process. This makes it impractical for both clinicians and patients. It is for this reason that healthcare professionals use a formula to estimate GFR.

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People who develop chronic kidney disease may have some or all of the following tests and measurements. If you have kidney disease ask your doctor which tests you will have and how often they will be done. Speak to your doctor about your results. If your numbers are not in the normal range, ask how to improve them.

Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor should use the results of your serum creatinine test to calculate your GFR.

Glomerular Filtration Rate (GFR): Your GFR tells how much kidney function you have. It may be estimated from your blood level of creatinine. If your GFR falls below 30 you will need to see a kidney disease specialist (called a nephrologist), Your kidney doctor will speak to you about treatments for kidney failure like dialysis or kidney transplant. A GFR below 15 indicates that you need to start one of these treatments.

Blood Urea Nitrogen (BUN): Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from the foods you eat and from your body metabolism. It is normally removed from your blood by your kidneys, but when kidney function slows down, the BUN level rises. BUN can also rise if you eat more protein, and it can fall if you eat less protein.

Urine Protein: When your kidneys are damaged, protein leaks into your urine. A simple test can be done to detect protein in your urine. Persistent protein in the urine is an early sign of chronic kidney disease.

Microalbuminuria: This is a sensitive test that can detect a small amount of protein in the urine.

Urine Creatinine: This test estimates the concentration of your urine and helps to give an accurate protein result. Protein-to-Creatinine Ratio: This estimates the amount of protein you excrete in your urine in a day and avoids the need to collect a 24-hour sample of your urine.

Serum Albumin: Albumin is a type of body protein made from the protein you eat each day. A low level of albumin in your blood may be caused by not getting enough protein or calories from your diet. A low level of albumin may lead to health problems such as difficulty fighting off infections. Ask your dietitian how to get the right amount of protein and calories from your diet.

nPNA: Your nPNA (normalized protein nitrogen appearance) is a test that may tell if you are eating enough protein. This measurement comes from lab studies that include a urine collection and blood work. Your dietitian may ask for an accurate food record to go with this test.

Subjective Global Assessment (SGA): Your dietitian may use SGA to help check for signs of nutrition problems. The dietitian will ask you some questions about your daily diet and check your weight and the fat and muscle stores in your face, hands, arms, shoulders and legs. Ask your dietitian about your score on the SGA. If your score is too low, ask how to improve it.

Hemoglobin: Hemoglobin is the part of red blood cells that carries oxygen from your lungs to all parts of your body. Your hemoglobin level tells your doctor if you have anemia, which makes you feel tired and have little energy. If you have anemia, you may need treatment with iron supplements and a hormone called erythropoietin (EPO). The goal of anemia treatment is to reach and maintain a hemoglobin level of at least 11 to 12.

Hematocrit: Your hematocrit is a measure of the red blood cells your body is making. A low hematocrit can mean you have anemia and need treatment with iron and EPO. You will feel less tired and have more energy when your hematocrit reaches at least 33 to 36 percent.

TSAT and Serum Ferritin: Your TSAT (pronounced tee-sat) and serum ferritin (pronounced ferry-tin) are measures of iron in your body. Your TSAT should be above 20 percent and your serum ferritin should be above 100. This will help you build red blood cells. Your doctor will recommend iron supplements when needed to reach your target levels.

Parathyroid Hormone (PTH): High levels of parathyroid hormone (PTH) may result from a poor balance of calcium and phosphorus in your body. This can cause bone disease. Ask your doctor if your PTH level is in the right range. Your doctor may order a special prescription form of vitamin D to help lower your PTH. Caution: Do not take over-the-counter vitamin D unless ordered by your doctor.

Calcium: Calcium is a mineral that is important for strong bones. Ask your doctor what your calcium level should be. To help balance the amount of calcium in your blood, your doctor may ask you to take calcium supplements and a special prescription form of vitamin D. Take only the supplements and medications recommended by your doctor.

Phosphorus: A high phosphorus level can lead to weak bones. Ask your doctor what your phosphorus level should be. If your level is too high, your doctor may ask you to reduce your intake of foods that are high in phosphorus and take a type of medication called a phosphate binder with your meals and snacks.

Potassium: Potassium is a mineral in your blood that helps your heart and muscles work properly. A potassium level that is too high or too low may weaken muscles and change your heartbeat. Whether you need to change the amount of high- potassium foods in your diet depends on your stage of kidney disease. Ask your doctor what your potassium level should be. Your dietitian can help you plan your diet to get the right amount of potassium.

Body Weight: Maintaining a healthy weight is important to your overall health. If you are losing weight without even trying, you may not be getting the right nutrition to stay healthy. Your dietitian can suggest how to safely add extra calories to your diet if needed. On the other hand, if you are slowly gaining too much weight, you may need to reduce calories and increase your activity level. A sudden weight gain can also be a problem. If it is accompanied by swelling, shortness of breath and a rise in blood pressure, it may be a sign of too much fluid in your body. Speak to your doctor if your weight changes noticeably.

Blood Pressure: Ask your doctor what your blood pressure should be. If your blood pressure is high, make sure to follow all the steps in your prescribed treatment, which may include taking high blood pressure medications, cutting down on the amount of salt in your diet, losing excess weight and following a regular exercise program.

Total Cholesterol: Cholesterol is a fat-like substance found in your blood. A high cholesterol level may increase your chance of having heart and circulation problems. For many patients, a good level for total cholesterol is below 200. If your cholesterol level is too high, your doctor may ask you to make some changes in your diet and increase your activity level. In some cases, medications are also used.

HDL Cholesterol: HDL cholesterol is a type of "good" cholesterol that protects your heart. For many patients, the target level for HDL cholesterol is above 40.

LDL Cholesterol: LDL cholesterol is a type of "bad" cholesterol. A high LDL level may increase your chance of having heart and circulation problems. For many patients, the target level for LDL cholesterol is below 100. If your LDL level is too high, your doctor may ask you to make some changes in your diet and increase your activity level.

Triglyceride: Triglyceride is a type of fat found in your blood. A high triglyceride level along with high levels of total and LDL cholesterol may increase your chance of heart and circulation problems.

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People who develop chronic kidney disease may have some or all of the following tests and measurements. If you have kidney disease ask your doctor which tests you will have and how often they will be done. Speak to your doctor about your results.

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The RENAL DIET (or KIDNEY DIET) needs to be individualized. Everyone should discuss their particular situation with their nephrologist. However there are some guiding principles to consider.

In early stage CKD (Stage 1-3), dietary restrictions may be quite modest. Generally, lower protein diets are helpful in slowing the progression of kidney disease. As CKD progresses and kidney function worsens, diet becomes even more important. General recommendations for a RENAL DIET are typically:

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Nutrition Consultants - Meal Planning Tailored For You - PRINE Health

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PRINE Nutrition Eat right. Be well. The RENAL DIET (or KIDNEY DIET) needs to be individualized. Everyone should discuss their particular situation with their nephrologist. However there are some guiding principles to consider. In early stage CKD (Stage 1-3), dietary restrictions may be quite modest.

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Learn more about the diet and nutrition information available from DaVita Kidney Care.

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CLICK FOR KIDNEY FRIENDLY RECIPES

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Hemodialysis vs Peritoneal Dialysis

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Learn about how your kidneys work and why they are so important. Find out if you are at risk for kidney disease and what tests you need to check your kidney health.

COVID-19

Nutrition is key to managing kidney disease and your overall health.

Looking for guidance on a kidney-friendly diet? Find a dietitian in your area.

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Learn about how your kidneys work and why they are so important. Find out if you are at risk for kidney disease and what tests you need to check your kidney health. COVID-19 Nutrition is key to managing kidney disease and your overall health. Looking for guidance on a kidney-friendly diet?

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Take away the need to know from our KIDNEY NUTRITION 101 Live Sessions