DNA Patient Guide: Get the Most From A Visit With Your Kidney Doctor

Know Your Kidney Numbers

Your two most important labs are the estimated Glomerular Filtration Rate (eGFR) and the urine Albumin-to-Creatinine Ratio (uACR).

The eGFR is a blood test that measures how well your kidneys clean your blood. A normal eGFR is 90 or higher. As CKD worsens, the eGFR declines. A lower number means your kidneys are having a harder time cleaning your blood.

A second test is a urine test called the albumin-to-creatinine ratio (ACR). This test checks your urine for a protein called albumin. Healthy kidneys don’t leak protein into the urine, but damaged kidneys do. You usually won’t notice this, because it doesn’t hurt or change how you feel. A urine test is the best way to test for this type of damage.

These are your main kidney numbers, eGFR, and ACR. They tell the story of how your kidneys are doing. Keep track of them to know if your kidneys are staying the same, getting better, or worse.

At your visit, ask:

• What other labs should I be following to look for problems related to CKD?
• What is my eGFR?
• What stage of kidney disease am I in?
• Do I have protein in my urine? What is my uACR?
• Have my numbers changed since my last appointment?

There are no bad questions. The more you know, the better you can protect your kidneys.

Keep Your Appointments

Kidney disease often progresses quietly without any warning signs, especially early on. The good news is that even if you feel fine, your check-ups and labs can show how well your kidneys are working. To know how you are doing, you will need regular visits and lab tests. So, keep all your doctor visits and get regular blood and urine tests to catch changes early, before you feel sick.

Bring an Updated Medication List To Your Visit

Many patients with CKD have three or more doctors. Each one may be adding or changing your medicines. Since your kidneys filter and process many medicines, even small changes can impact your lab results.

Please bring:

• All prescription medicines
• Over-the-counter medicines (especially pain relievers like ibuprofen or naproxen)
• Vitamins, supplements, and herbal products

If possible, bring the actual bottles or a printed list from the pharmacy.

Write Down Symptoms or Concerns

Keep a “Health Journal” to track how you are feeling. Before your appointment, take a few minutes

to jot down:

• Swelling in your legs or feet
• Changes in urination
• Tiredness or weakness
• Shortness of breath
• Dizziness
• Medication side effects

These details help your doctor adjust your care plan to your needs.

Be a Partner in Your Care

Your kidney care team is here to support you. Before you leave your appointment, make sure you understand your doctor’s instructions. Ask if you need any labs or tests done before you come back, and if so, get them and your follow-up appointment scheduled. If other services have been ordered, such as CKD education or a nutritional consult, ask to be scheduled before you leave. Together, you and your healthcare team can work towards a healthier, brighter future.

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Today’s Focus: Medicines called SGLT2 inhibitors

SGLT2 inhibitors are a group of medications that help protect your kidneys and heart. They were first used for diabetes, but we now know they benefit many patients, even those without diabetes. Most SGLT2 inhibitors end in “-flozin”.

Common examples include:

• Jardiance® (empagliflozin)
• Farxiga® (dapagliflozin)
• Invokana® (canagliflozin)
• And others

How do they work?

These medications help your body remove extra sugar and salt through your urine. This lowers blood sugar (if you have diabetes), reduces strain on the kidneys, and can help protect your heart.

Why might your doctor recommend one?

• Protects kidney function by slowing kidney disease progression
• Reduces the risk of heart problems and heart failure
• Helps manage blood sugar (if you have diabetes)

What should you know?

• You may urinate more often at first
• Staying well hydrated is important
• Report symptoms like dizziness, dehydration, or signs of infection

CKD Education Department

Empowering Patients Through Kidney Disease Education

Learning about Chronic Kidney Disease (CKD) can help reduce stress and build confidence in managing your health. Since 2015, DNA has been committed to providing kidney disease education through classes and workshops designed to support patients at every stage of CKD.

Our complimentary group class, “CKD and Me,” is available at most DNA clinics and provides a strong foundation for understanding CKD and managing your health. For patients with Stage 4 CKD, we offer “My Kidneys. My Options. My Life.” workshops, which focus on slowing down CKD, managing CKD problems, and exploring treatment options such as dialysis, transplant, and active medical care.

We also offer our CKD Treatment Options Education Clinic, a hands-on experience that helps patients compare dialysis options, prepare in advance, and choose the treatment path that best fits their lifestyle and goals.

In addition, a variety of patient handouts are available on topics such as high blood pressure, important kidney medicines, and diet changes to help you stay informed between visits. Ask your doctor which resources are right for you.

Early education gives you the knowledge, confidence, and time to make informed decisions. Talk with your doctor about your options and schedule your session today.