When To Call a Doctor

Call 911 or other emergency services if you have chronic kidney disease and you develop:

• A very slow heart rate (less than 50 beats a minute).
• A very rapid heart rate (more than 120 beats a minute).
• Chest pain or severe shortness of breath.
• Severe muscle weakness.

For instructions on taking your heart rate, see the instructions for taking a pulse.

Call your doctor immediately if you:

• Develop symptoms of uremic syndrome, such as increasing fatigue, nausea and vomiting, loss of appetite, or inability to sleep.
• Vomit blood or have blood in your stools.

Call your doctor if you:

• Are feeling more tired or weak.
• Develop signs of a serious illness that are not caused by a cold or the flu.
• Have swelling of the arms or feet.
• Have muscle weakness.
• Bruise often or easily.

Call your doctor if you are being treated with dialysis and you:

• Develop signs of a serious illness that are not caused by a cold or the flu.
• Have excessive bleeding or bruising.
• Develop belly pain while being treated with peritoneal dialysis.
• Have signs of infection at your catheter or dialysis access site, such as pus draining from the area.
• Have any other problem that your dialysis instruction manual or nurse's instructions say you should call about.

If you have uncontrolled weight loss, discuss this with your doctor during your next visit.

Watchful Waiting

A wait-and-see approach is not a good idea if you could have chronic kidney disease. See your doctor. If you have been diagnosed with chronic kidney disease, follow your treatment plan, and call your doctor if you notice any new symptoms.

Who To See

Health professionals who can diagnose and treat chronic kidney disease include:

• Family medicine physicians.
• Internists.
• Kidney specialists (nephrologists).
• Pediatricians.
• Nurse practitioners.
• Physician assistants (PA).

Soon after you have been diagnosed with chronic kidney disease, your doctor may refer you to a nephrologist. A nephrologist can treat kidney disease and other conditions that may be contributing to it and help you make other decisions about treatment. Nephrologists also often take over the care of people who have kidney failure when they need dialysis or after they receive a kidney transplant.

If you are to receive dialysis, you will be referred to a surgeon who will prepare a dialysis access. A dialysis access is a site on your body where blood or other fluids can be removed, filtered, and returned to the body during dialysis. You will be referred to a surgeon if you are being considered for a kidney transplant.

You may also be referred to a:

• Dietitian, to help you with meal planning. Because of the many restrictions in your diet, you may find it hard to get enough calories to maintain your weight. A dietitian can help you make wise food choices.
• Psychologist or social worker, to help you and your family with emotional stress or financial issues.

To prepare for your appointment, see the topic Making the Most of Your Appointment.