General kidney care (general nephrology)

Our general nephrology clinics provide treatment for all forms of kidney problems, including:

• chronic kidney disease 
• kidney failure 
• diabetic kidney disease 
• congenital kidney disease 

As part of your outpatient appointment or inpatient stay you may have some of the following tests and investigations. 

Outpatient clinic investigations:

• blood tests 
• kidney function tests 
• scans or x-rays
• urine collections 

Hospital admission investigations: 

• creation of an AV fistula 
• insertion of a peritoneal dialysis catheter 
• insertion of a permacath 
• kidney biopsy

Patient education sessions

Patient education is key to good kidney health and we run a programme of patient education sessions – please speak to one of the clinical nurse specialists for further information.

Healthcare professional information

Explore Hounslow CCG's Living with a health condition website for professional guidance on kidney disease and management of chronic kidney disease.

What is Chronic Kidney Disease (CKD)?

Chronic kidney disease or CKD is a medical term used to describe a wide range of conditions that has resulted in damage to your kidneys.

‘Chronic’ means it is long term and ‘disease’ means that the kidneys are damaged and are not working properly. It is important to know that even if you are given this diagnosis, only a few people go on to develop complete kidney failure.

What do the kidneys do?

Most people have two kidneys, and their role is to:

take away waste products from your body
balance the amount of water in your body
help control blood pressure
help produce red blood cells (to stop you getting anaemic)
help to keep your bones healthy

What causes kidney disease?

There are many causes of kidney disease, but the commonest causes are:

• high blood pressure
• diabetes
• ·vascular disease (narrowed or blocked arteries)
• having a family history of a kidney disease

How does diabetes affect my kidneys?

Your kidneys contain millions of small blood vessels that can be damaged by high blood sugar levels this is called diabetic nephropathy.

The most important way to prevent further damage is to have good blood glucose control.

Visit our diabetes page for more information

How is chronic kidney disease diagnosed?

There are several ways to diagnose the condition; these are:

• a simple blood test
• a urine sample
• a kidney ultrasound
• Sometimes your doctor will arrange a kidney biopsy to determine the cause of your kidney disease.

Will my kidney disease get better?

Your kidney disease is unlikely to improve and the most important thing is to prevent further damage.

How can I look after my kidneys and prevent further damage?

Blood pressure

Good blood pressure control can slow down the progression of kidney disease but also reduces the risk of heart attacks or stroke. You can help lower your blood pressure by exercising regularly and reducing salt in your diet.

Measuring your blood pressure at home is a good way to see how your blood pressure is in daily life, particularly if you get anxious at appointments.

Exercise

Regular exercise not only helps lower your blood pressure, but also helps keep your keep your heart healthy. Exercise also helps to maintain a healthy weight. Aim for 30 minutes at least 3 times a week. This could be something simple like a brisk walk. Try taking the stairs instead of the lift and walking up the escalator.

Healthy diet

A healthy diet which is low in fat and salt can help protect your kidneys. If you are overweight, speak to your GP about weight management programs or find Advice, tips and tools to help you make the best choices about your health and wellbeing here.                  

Stop smoking

Smoking may make your kidneys worse more quickly. For help giving up ask for your local stop smoking service.

Reduce alcohol consumption

If you drink, try to reduce the amount, keeping to the recommended 14 units a week or less as well as trying to have two alcohol free days a week.

Diabetes

if you are diabetic, getting your diabetes under control is essential to help protect your kidneys from further damage. Talk to your diabetic nurse or doctor for advice.

Medication

avoid some painkillers that are known to cause kidney disease such as Brufen, Nurofen and any herbal medications. Ask your pharmacist for advice.

You may be prescribed some medications to help protect your kidneys, particularly to help control your blood pressure. It is essential that you do not miss doses. If you have any unwanted side effects, speak to your doctor because the medication can be changed for one that suits you.

Avoid herbal medication or non-steroidal tablets like ibuprofen and Nurofen (including gels) as these can further damage your kidneys

Can I still go on Holidays?

Having kidney disease should not interfere with holidays, but always check with your doctor. We recommend that you avoid street food and tap water in most countries and keep hydrated in hot countries (bottled water is best). On standard holiday insurance application forms, you should declare your kidney disease as a pre-existing medical condition. This may exclude you from some policies. Contact the National Kidney federation for advice on health Insurance for kidney patients.

Can I still start a family?

If you are hoping to start a family, it is important that you talk to your doctor before getting pregnant so you can plan together for a healthy pregnancy. Fertility in both men and women can be affected in the later stages of kidney disease.

Visit our pregnancy and kidney disease page for more information.

What if I’m unwell?

When you are unwell, particularly if you become dehydrated (e.g. from vomiting or diarrhoea), some medicines can worsen your kidney function or result in side effects.

You may need to temporally miss or reduce doses for the following types of medications tablets:

• Blood pressure pills
• Water pills Always contact your GP for advice.
• Diabetic medications

If you are diabetic and usually monitor your blood sugars at home, you should increase the number of times you measure your blood sugar. If they run too high or too low, you should contact your GP

If you are on insulin, you may need to alter your dose.