How much fluid should I drink to keep my kidneys healthy?  What type of fluid is best?
The human body needs water to replenish the blood and fluids in order to work properly. Water regulates the body’s temperature through perspiration, removes waste via urine and carries nutrients and other substances throughout the body. It has been recommended and promoted that we all need to drink around 6-8 glasses of water each day, however there is no evidence to support this. The best way of knowing how much to drink is to drink enough to satisfy your thirst.  If you're thirsty drink water instead. It will have a more positive impact on your health. Read our Position Statement providing information on drinking water.

If you have severe kidney disease, you may have a restriction on how much fluid you can drink. Your healthcare team will let you know if you need to limit fluids and how much fluid you can have each day. 

Does alcohol and smoking affect my kidneys?
It’s important to be smart about your alcohol intake. While there are some studies that show that alcohol causes no direct harm on the kidneys, it may be dangerous if you already have kidney problems. Alcohol makes your kidneys produce more urine than normal and excessive drinking can have a negative impact on other parts of the body that may contribute to kidney damage, such as the liver. There have also been studies that show that heavy drinking may contribute to high blood pressure and heart disease. Over time, this may contribute to kidney disease. Alcohol also has a high sugar content and may cause weight gain, so heavy drinking may lead to diabetes – another high risk factor for kidney disease.

It’s well known that smoking harms your health. 
Smoking causes a narrowing of the arteries, including the small vessels in the filtering section of your kidney. This reduces the kidney’s ability to work properly. Smoking has also been linked to cancer of the bladder and the ureter (the small tubes that run from your kidneys to your bladder). The message is clear: don’t smoke. If you do smoke, giving up is one of the best things you can do to keep your kidneys healthy. QUIT Ring 137848 and ask for free Quit Pack

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Chronic Kidney Disease

Can Kidney Health Australia refer me to a nephrologist?
Kidney Health Australia cannot refer you to a specific nephrologist. If you need a referral a nephrologist, you will need to see your local doctor who can assist you. See Making the most of your visit to the doctor - You're in Charge: Self-management Health Booklet - Chronic Kidney Disease  

What type of exercise should someone with kidney disease be doing?
Exercise helps you stay healthy by:

• Reducing your risk of heart problems
• Helping to maintain body weight
• Helping to control blood pressure and blood sugar
• Lifting your mood and fighting depression
• Improving your sleep

There are lots of ways to keep fit when you have kidney failure. Some people find strenuous sport or activities too tiring so enjoy exercises such as walking, yoga and Tai Chi. Others throw themselves enthusiastically into fitness programs and compete nationally and internationally in the Transplant Games. Some contact sports need to be avoided, particularly after a transplant. If you are on peritoneal dialysis, you need to protect your catheter while exercising. If you have advanced kidney disease but not yet on dialysis or had a transplant, you may find it difficult to improve your fitness – do as much as comfortable. See MeasureUp and CKD this site.  IMPORTANT: Talk to your health care team and ask for advice before starting a new exercise program, particularly if you are not very fit. 

Do you know your heart and stroke risk score?

In the past, CVD risk was measured and treated by looking at  one risk factor, such as blood pressure or cholesterol, at a time. We now know that your individual combination of risk factors is more important. Risk factors work together to increase or decrease your overall chance of getting CVD. The new method of measuring your risk gives you an overall picture of your personal risk level, to help you and your doctor to identify the most important steps that you should take to reduce your risk and improve your health. 

Do everyday drug therapy affect the kidneys?
The kidneys clear many medicines from the body. Patients whose kidneys are not working properly may be unable to clear some medicines. They may need to take a lower dose of the medicine so that it does not build up inside the body. Some medicines can damage the kidneys if  the dose is too high.The elderly and people with diabetes or heart disease may be more at risk of kidney damage. Many commonly used medicines, such as pain killers or treatments for blood pressure, can affect the kidneys. As people get older their kidneys do not work so well.

Some medicines and some illnesses can also affect the kidneys. If a person's kidneys are not working normally they may not be able to get rid of doses of medicine. This could increase the side effects of the medicine. In people with reduced kidney function some medicines should not be used. Other medicines require a lower dose or a bigger gap between doses. You need to tell your doctor or pharmacist if you have had kidney problems when they ask you to take a new medication.

What about alternative and complementary therapies?
Complementary therapies include a wide range of healing approaches. They may have a supportive approach that can improve well-being and quality of life for people with chronic conditions or terminal illness. These therapies may include meditation, massage, visualisation, aromatherapy, acupuncture or herbs to name a few. Some health professionals see these therapies as useful. However, many of them have not been tested in clinical trials in relation to kidney disease. 

Herbal treatments sometimes claim that they may cure or slow down the disease progression but some are harmful to people with kidney disease. Again, few clinical trials have been undertaken to prove claims although this is slowly changing. Always speak with the health care team managing your condition before using any herbal remedies, over-the-counter-medicines or supplements. It is important to let your health care team know you are using complimentary or herbal therapies. When deciding on complementary or herbal treatments it is very important to gather as much information as possible. It is also a good idea to ask as many questions as possible so that you are able to clearly understand the treatments and possible outcomes in relation to kidney disease.

Medicine Line 1300 888763 - Independant pharmacist advice (9am to 6pm Mon-Frid) on your prescriptions, over-the-counter, and complementary (herbal/natural/vitamin/mineral) medicines.

I have restless legs – what can I do about them?
Restless leg syndrome (RLS) is a common movement problem of the nervous system. Your legs feel as if they want to exercise or move when you are trying to rest.  It can make it hard to sleep and relax. It is more common in women and older people. Some people have described RLS as a crawling, creeping, prickly, tingling, itching, burning, pulling or shock like sensation. The problem can vary from a minor irritation to a severe condition.  You may find that your arms are also affected.

The cause of RLS is not clear but there appears to be a problem with the function of a chemical in the central nervous system. It is not related to exercise. However it is sometimes linked to kidney failure, iron deficiency, anaemia, diabetes, hypothyroidism or the regular use of certain medications for nausea, depression, seizures and allergy treatment. It can be distressing but is often treatable with a mixture of medication and self-help methods. Talk to your doctor who may be able to prescribe medication, review your medications or adjust your dialysis treatment.

• Restless Legs Syndrome - Just the Facts also in Spanish
• Restless Legs Syndrome Australia  Info on RLS - diagnosis, treatment, and support
• Restless Legs Syndrome Foundation (USA)

What if I need dialysis and I have a fear of needles?
Many people have a fear of needles, which can also be known as needle phobia. A person with needle phobia can often experience feelings such as anxiety and fear or have a physiological reaction such as fainting, shock or dizziness. These reactions can be caused by exposure to needles, or even the thought of needles or sharp objects. See Access for dialysis.

If you have a fear of needles, speak to a member of your healthcare team.There are some treatments available for people who have a fear of needles:

• Using topical creams (anaesthetics) to prevent pain from needles and reduce anxiety
• Raising your legs or lying down to help increase blood circulation around your body
• Learning techniques to control your breathing and reduce panic-like symptoms
• Considering another form of treatment like peritoneal dialysis

Does Kidney Health Australia provide financial assistance?
Kidney Health Australia does not directly provide financial assistance. However, you may be able to contact a social worker or other health professional at your local hospital or community health centre for further info about financial assistance available in your community. Sometimes local renal support groups may be able to assist and other community groups such as Rotary or Lions Clubs may be helpful.

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Travelling with Kidney Disease

How do I organise a holiday within Australia whilst on dialysis?
Kidney failure can make travelling difficult but not impossible. You may be able to attend work and social events or enjoy a great holiday with careful planning. If you are thinking about travel, it is important to first speak to your health care team about the effect that this might have on your health. If you are well enough, a holiday can be a great boost to your confidence and well being. Read Taking your Kidneys on Holidays and Dialysis Konnections which offer practical suggestions to arrange this.

• Peritoneal Dialysis - Dialysis supplies in most cases can be delivered to your holiday destination. Talk to your doctor and renal nurse who can help you. Carry medical supplies with you for the whole trip plus extra or arrange for supplies to be delivered ahead of time. If pre-ordering, ensure supplies have arrived at your destination before starting out.  Arrange a clean space to do exchanges and store supplies.  
• Haemodialysis -  Be aware the standard of care may not be the same in all countries. Plan ahead and arrange for back-up medical care.
• Transplantation - If you are on the transplant list you will need to consult with your doctor and inform your transplant coordinator about your travel plans and they can help you to decide whether you will be able to return in time if a kidney becomes available. When on holiday, it is important that your health care team can contact you especially if you are on the transplant waiting list. 

Making travel arrangements – Here are a few tips to help make your travel successful
Talk to your health care team about your travel plans before doing anything else. Your renal unit should help you organise dialysis at another centre. It is important to plan your travel well ahead of time. Decide the times/days you want to dialyse. Most units run on tight schedules so you may need to be flexible about the dates of your visit. Let the renal nurse who is helping with your planning know if you cannot dialyse on some days.

• Ask your health care team where renal units are located or check our Australian Dialysis Unit Guide Resources (the DUG).
• Check with the visiting renal unit as soon as you arrive to confirm your appointment time. You may also want to visit the new unit before dialysis and meet the staff to feel more comfortable. Phone the unit before you visit. 
• A transfer form (ask your renal unit) will be sent to your destination unit and you need to carry a copy with you when travelling. If travelling in an emergency, dialysis details can be faxed ahead.

Can I go on holiday overseas whilst on dialysis?
Kidney failure can make travelling difficult but not impossible. You may be able to attend work and social events or enjoy a great holiday with careful planning. If you are thinking about travelling, it is important to first speak to your health care team about the effect that this might have on your health. If you are well enough, a holiday can be a great boost to your confidence and well being. See Dialysis and Travel - DUG Travel tips for people with kidney failure and note these hints to make your overseas travel successful:

• Talk to your health care team before you do anything else.
• Find out about medical costs in advance - medical payment agreement with Australia via Medicare.  
• Ask your health care team for contact details of doctors or hospital you can contact when travelling for medical help in case of an emergency.
• Travel insurance for people with kidney disease
• Take enough medication with you for the whole trip, with some extra in case of lost luggage or a spillage.  Make sure you put your medications and prescriptions in your carry-on luggage.
• It is a good idea to carry spare written prescriptions with you. You will need to find out if you need a different type of prescription in other countries.
• Remember to stretch for a few minutes every one hour while travelling to increase circulation and reduce the risk of leg swelling and clots.  

I want to visit family interestate for a special event. Can I arrange a 'dialysis chair swap' with a unit interestate?
The demands made by haemodialysis on the patient and family are considerable. The need to access a haemodialysis machine every second or third day dominates all aspects of life, including work, family and recreation. Holidays are an essential ingredient for a quality of life to refresh and re-vitalize the body, mind and spirit - and Kidney Health Australia is here to help.

The Australian Holiday Dialysis Konnections program is Kidney Health Australia's initiative to connect individuals on dialysis in different locations in Australia. You may be able to arrange a break, interstate travel for a special occasion, or a well earned holiday. This program allows you to identify possible travel options - we facilitate the exchange of contact information with another registered AHD Konnectee - you then liaise directly with this person to identify a ‘chair swap’ for the period you request.

How does it work in detail? Kidney Health Australia 'connects' you with a dialysis patient from another public dialysis unit who may wish to discuss direct 'dialysis chair' exchange for an agreed period.

NOTE: Kidney Health Australia undertakes no responsibility for cancelled holiday exchanges or unusual circumstances that evolve around this arrangement. Kidney Health Australia has no responsibility for any financial loss incurred by any cancelled or delayed dialysis exchange.  All Kidney Health Australia will do is to facilitate a safe exchange of contact details between registered AHD Konnectees. The remaining arrangements are up to you. Note our Privacy Policy for your information, which applies to this program.

See Chronic Kidney Disease  -  Kidney Transplantation  -  Australian Dialysis Unit Guide - Holiday Dialysis Konnections