Questions to Ask Your Kidney Care Team

Education - education, kidney care - August 31, 2026

Finding out you have kidney disease can be overwhelming. Kidney disease is often called a “silent disease” because it can have very few noticeable symptoms, and early warning signs can easily be mistaken for other health issues. As a result, many people don’t discover they have kidney problems until the disease has progressed.

While a kidney disease diagnosis can feel scary, there are lifestyle changes and treatment options that can help you preserve kidney function, feel better, and potentially slow the progression of the disease.

One of the best ways to take an active role in your kidney health is to understand your treatment options and know what questions to ask your care team. In this guide, we’ll share important questions to ask your kidney care team so you can feel more informed and confident about your care.

1. What stage of kidney disease do I have?

The stage of kidney disease you have will determine how your doctor recommends treating it. Stage one indicates a small amount of kidney damage, and stage five occurs when your kidneys have failed. Your stage of kidney disease depends on your GFR number, which you can learn more about here. Talk to your kidney care team to learn what stage you’re at now and ask what you can do to try to prevent your kidney disease from progressing further.

Kidney disease stage	GFR	About your kidney function
1	>90	Normal GFR. Other signs of kidney injury, such as blood or protein in the urine, may still exist and indicate a slight loss of kidney function.
2	60-89	Mild GFR decrease from the normal rate. This could be normal for your age or indicate early kidney disease.
3	30-59	Kidney function is low. See a nephrologist to learn about treatments you can do now and lifestyle changes you can make to prevent further damage.
4	15-29	Severe kidney disease. See a nephrologist – a kidney doctor – regularly to learn how to protect your remaining kidney function, prepare for dialysis or find out more about a kidney transplant.
5	0-14	End-stage renal disease. Dialysis or kidney transplant is necessary to prolong life.

2. What can I do to slow the progression of kidney disease?

Lifestyle changes can play a big role in slowing the progression of kidney disease. Quit smoking, manage your blood pressure and your blood sugar, and work with a dietitian to help you follow a kidney-friendly diet. Limiting sodium, for example, can help manage blood pressure and reduce the risk of complications. Regular exercise can also help preserve kidney function and help with potential complications like heart disease or diabetes. Make sure to take recommended medications but avoid those that can damage the kidneys, like NSAID pain relievers such as ibuprofen, unless your doctor tells you they are safe for you. You can also ask your doctor to help you put together a nutrition and exercise plan to try to slow the progression of your kidney disease.

3. What treatment options are available to me?

The treatment options available to you depend on the stage of kidney disease that you have. Changing your lifestyle, following a low-sodium diet, managing your blood pressure and blood sugar, and exercising regularly can help in the early stages of kidney disease. If your kidney disease reaches stage 5, you will need dialysis or a kidney transplant to stay alive. Many clinics offer dialysis treatments in a center, which are usually for about four to five hours at a time, three times a week. Some clinics also offer home dialysis, training you to do dialysis in the comfort of your own home. A kidney transplant, although not a cure, is another treatment option that can offer the best quality of life for people with kidney failure. Ask your doctor which treatment options are available so you can decide what’s best for you.

4. Who is part of my kidney care team, and what does each person do?

Your care team will likely be made up of a nephrologist (kidney doctor), a nurse, dialysis technician, dietitian, social worker, and a member of our benefits and billing team. Each person on your care team has a special role. Your nephrologist will oversee your health and care, while a nurse and dialysis technician will be looking after you in the dialysis clinic. Our dietitians are experts in kidney disease and are there to support you with the kidney diet, helping you understand the foods that are best for you as well as the ones you should avoid. The entire team is there to support you throughout your journey with kidney disease.

5. What should I know about eating well with kidney disease?

The kidney diet can seem overwhelming at first, which is why we have specialized renal dietitians as part of our team. These dietitians understand the kidney diet inside and out and are an incredible resource to you. They will meet with you regularly, and you are encouraged to reach out if you want to talk about the kidney diet at any stage. What you eat specifically will depend on the type of treatment and the stage of kidney disease you are in. People who are in stage 3, for example, will follow a different diet from those in stage 5 and on dialysis. Rest assured, you don’t need to have all the answers now. Your dietitian will meet with you to go over the specific foods that are OK for you.

Your kidney care team is there to support you, so don’t hesitate to reach out to them with any questions you have.

Managing Stress When You Have Kidney Disease

Education - kidney care, kidney health tips - February 3, 2026

Stress can arise at any point in your journey with kidney disease. Receiving an initial diagnosis can be overwhelming, especially when it comes with changes like adjusting your diet or preparing to start treatment. Stress can also build over time. Dialysis treatments multiple times a week can be physically and emotionally demanding, and managing a chronic condition year after year can take a toll.

Recognizing that stress may be part of your kidney disease journey is an important first step. Finding strategies that work for you to manage that stress can help support your overall well-being and quality of life. Below are four approaches you can try.

1. Mindfulness and Relaxation Techniques

Mindfulness is the practice of paying attention to the present moment. Research shows it can reduce stress, improve your mood and even help with sleep and pain management.

Simple ways to practice mindfulness include:

Deep breathing: Try slow, steady breaths — inhaling through your nose and exhaling through your mouth — for a few minutes each day.

Guided meditation: Apps, videos or audio recordings can guide you through meditation and help you relax, even if you’re new to the practice.

Body awareness: Noticing physical sensations, such as your feet on the floor or your hands resting in your lap, can help ground you when stress feels intense.

Even a few minutes a day can make a meaningful difference.

2. The Power of Support Groups

Kidney disease can feel isolating but you are absolutely not alone. In fact, one in seven adult Americans has kidney disease. Support groups — both in person and online — offer a space to connect with others who truly understand what you’re experiencing. Sharing your story and hearing from others can reduce feelings of loneliness and provide encouragement, practical tips and hope.

Talk to your care team at Puget Sound Kidney Centers about finding a support group that works for you.

3. Counseling and Professional Mental Health Support

Sometimes stress, anxiety or depression can feel too heavy to manage on your own — and that’s okay. Speaking with a mental health professional, such as a counselor, psychologist, or social worker, can be incredibly helpful.

Counseling can provide coping strategies for anxiety or depression and help you adjust to the emotional challenges that often come with kidney disease. If you’re interested in counseling or mental health services, talk to your social worker about available options.

4. Make Time for Self-Care

Self-care doesn’t have to be complicated or time-consuming. Small, consistent habits can help lower stress and improve overall well-being. This might include maintaining routines that give your day structure and a sense of normalcy, staying connected with friends and family, or making time for activities you enjoy.

Whether it’s reading, listening to music, gentle exercise, gardening, or spending time outdoors, doing things that bring you comfort and enjoyment matters. Self-care also includes getting enough rest, which can sometimes be challenging. If sleep is difficult, talk with your care team for support and guidance.

The bottom line: self-care is not selfish — it’s an essential part of managing a chronic condition.

Being diagnosed with kidney disease can come as a shock. Symptoms are often silent or easy to miss, so many people learn they have kidney disease only after it has progressed. Having to make dietary changes to slow the disease or begin thinking about treatment soon after diagnosis can be stressful.

Acknowledging these challenges and trying one or more of the strategies above can help you manage stress, support your mental health and feel more empowered as you move forward.

CKD Prevention & Education: Reflecting on a decade of impact

Community, Education - December 24, 2025

After ten years, PSKC has made the difficult decision to sunset the CKD Education program. Reflecting on the past decade, what an incredible journey it has been!

How It All Started

With the generous support of a three-year seed grant from the Verdant Health Commission, the program was created with the goals of raising community awareness about CKD, promoting kidney health, and empowering patients. The founding CKD Education team included Dan Blatnik (Director of Social Services), Kathy Harvey (Director of Renal Nutritional Services), and Pam Keech (Chief Medical Officer), as well as Michelle Rowlett (Social Work Supervisor) and Sara Prato (Renal Dietitian) who co-led the initiative. Recognizing that the voice of patients matters, they invited mentors like Bob Crabtree, Mary Beth Walsh, and Don Criscaden to help shape the program, fostering a community-centered, interdisciplinary approach that became a cornerstone for the program.

Growing With Our Community

With the inaugural Survive & Thrive class series launching February 11, 2015, more than 100 people benefited from CKD educational efforts that first year. As interest grew, so did our outreach throughout the region. By listening closely to community needs, we improved patient access with additional class times, offering teaching materials in multiple languages, and strengthening partnerships with local organizations including senior centers, the YMCA, faith-based groups, cultural organizations, and regional health fairs. We are deeply grateful for the meaningful partnership we share with the Tulalip Tribes and inspiration they provided in shaping the program.

The Pandemic

When the COVID-19 pandemic began, the CKD team acted quickly to ensure education remained accessible by pivoting to a virtual platform to allowing people to continue learning safely from home. Recognizing that many families lacked reliable internet access, with support from partners like Union Bank, we created “Kidney Healthy Eating Packets” for distribution through regional food banks and senior meal programs. These packets—available in English, Spanish, and Russian—included kidney-healthy tips and salt-free spice blends. Between 2021 and 2023, more than 7,700 packets reached households coping with food insecurity and limited access to health education.

In 2023, we were thrilled to welcome participants back to the classroom and introducing a hybrid model for delivery of kidney health education, making it easier for everyone to participate and improving access. With our Chief Medical Officer, Dr. Durvasula, being named Executive Sponsor of our CKD program in 2024, the curriculum was updated to reflect the newly released KDIGO guidelines, ensuring the program remained current and relevant. We also worked to expand our reach beyond the nephrology community, marketing to health care systems and primary care providers throughout the region.

A Decade of Impact

Through the generous support of grant partners including Verdant, the Tulalip Charitable Fund, Molina Healthcare, Union Bank, and many others who recognize the importance of early kidney health education, our efforts around CKD prevention have reached almost 21,000 people. We have heard countless personal anecdotes from patients and family members about how CKD education has helped them along their health journey and with clinical decision-making. Beyond stories of empowerment, we have seen that high-risk patients who participated in our CKD classes were better prepared for the transition to end stage kidney disease. Work of the CKD Education team has been recognized both locally and nationally with awards from the Verdant Health Commission (2016), as well as the National Kidney Foundation (2022). Additionally, members of our CKD team have presented at local, state, and national conferences, sharing insights and contributing to the broader conversation on CKD care.

The future of CKD Education

What began from humble beginnings evolved into a decade-long commitment to raise awareness about kidney disease, support early diagnosis, and empower patients. Unfortunately, in the face of mounting financial constraints, the PSKC leadership team has made the difficult decision to dissolve the CKD Education program. This was a painful choice, but ultimately necessary to ensure that PSKC continues fulfilling its essential duty to the countless patients who depend on the organization for providing life-sustaining dialysis care. While this chapter may be closing, our commitment to our mission remains strong – we will continue to find new and different ways to support kidney health and well-being in the communities we serve.

We are grateful to our community, partners, and participants for an incredible ten years and thank you for your understanding.

Dialysis treatment time—every minute counts! A message from our CMO.

Education - dialysis, kidney care - September 18, 2023

For most in-center patients, hemodialysis means three treatments per week, each four hours in duration. The weekly total of 12 hours represents a small fraction (less than 10%) of the round-the-clock work normally performed by healthy kidneys to continuously clean the blood. Removing the toxins and excess fluid that accumulate in-between treatments requires maximizing every minute of your treatment time.

It is not uncommon that patients may wish to come off dialysis early for a variety of reasons—fatigue, muscle cramping, even boredom, to name a few. While they may not feel any immediate symptoms, shortening treatment time can have a negative long-term impact on overall health. Coming off early once can easily become a recurring pattern of behavior.

Raghu Durvasula, MD, MHA
Chief Medical Officer

Finishing dialysis even five minutes earlier than prescribed would result in 13 hours of missed dialysis time over the course of the year, the equivalent of more than three skipped treatments!

As a result, wastes inevitably begin to accumulate leading to patients feeling unwell, with reduced energy, poor appetite, chronic nausea, shortness of breath, and worsening blood pressure control.

Furthermore, a reduction in treatment time is known to be associated with increased risk of emergency department visits and hospital admissions, while ultimately reducing long-term survival.

If you are having difficulty completing your full treatment, be sure to discuss it with your care team. It is important to figure out why, then find solutions that could help you get through the entire treatment as prescribed.

Every minute counts, so don’t cut yourself short. Staying well-dialyzed will keep you healthy and energetic, so that you are better able to enjoy those activities and life pursuits that matter most to you!

CKD education program adapts to reach more people with kidney disease

Community, Education - education, kidney health tips, survive and thrive - May 10, 2021

Sara Prato and Michelle Rowlett, members of our CKD team, and Bob Crabtree from The Road Back to Life hold virtual classes to educate members of the community about chronic kidney disease.

Our very popular Chronic Kidney Disease Survive and Thrive program—which reaches people at many stages of CKD as well as those at risk for it—had planned a major expansion to new communities in 2020. But as we began to roll out the program, plans were halted due to the COVID-19 pandemic. Over the next few months, we transitioned Survive and Thrive to an all-virtual format, ensuring that CKD education would be available to those who need it.

Our web-based virtual program went live in June 2020 and became an immediate success. From June to December 2020, we offered 23 classes (two six-week sessions, five check-in classes and six community classes), attended by 214 people from throughout the Puget Sound region. In the classes, we provided extra learning materials—handouts, recipes and giveaways—to foster a sense of connection between instructors, the virtual classroom and participants at home. Class surveys show that attendees are increasing their knowledge of CKD, learning new lifestyle behaviors to protect their kidneys and working to stay as healthy as possible. An incredible 100% of those attending said they would recommend the program to others!

In 2020, our education team also created a series of videos to support online learning. As we move further into 2021, we plan to continue to expand our virtual program. Our hope is to provide in-person classes again when it is safe to do so but also continue with our virtual format, for those who prefer to learn in the comfort of their homes.

It’s easier than ever to learn more about kidney care through one of our online classes. Register for one of our upcoming classes at www.pskc.net/classes. Wondering which one to sign up for? Survive and Thrive is a six-week program for people with chronic kidney disease stages 2 to 4. By focusing on healthy lifestyle behaviors to protect and stabilize kidney function, the goal of this program is to help people learn lifestyle changes they can make now to help protect their kidneys. For people with chronic kidney disease stages 4 to 5, who will soon start treatment, we offer our Healthy Options classes. In this two-week program, you will learn more about treatment options and to feel better prepared when treatment starts. Family and friends are welcome to join you in either of these programs.

Our Community Classes are for anyone who wants to learn more about how kidneys work, healthy eating and other ways to protect your kidney function.

Learn more and register online at www.pskc.net/classes!

March is National Kidney Month!

Education - education, kidney care, kidney friendly eating, kidney health tips - March 25, 2021

One of our free, virtual ‘Survive and Thrive’ classes about chronic kidney disease. Sign up for classes at www.pskc.net/classes.

March is National Kidney Month, a time to raise awareness of kidney disease. Learn more about chronic kidney disease — commonly called CKD — and just how vital your kidneys are in making your body function.

What kidneys do

Kidneys filter blood and remove waste. They also control blood pressure, produce red blood cells, balance electrolytes, and help you maintain healthy bones and a normal pH level.

One fifth of the blood pumped by your heart goes to the kidneys, where it is processed and filtered. Excess water, salt, minerals and waste are sent to the bladder as urine and ‘clean’ blood is returned to circulation. It takes just five minutes for all of your blood to be filtered by the kidney which means in 24 hours, your kidneys will filter all of your blood 288 times!

Watch the video below to learn more about these incredible organs.

About chronic kidney disease

Chronic kidney disease happens when your kidneys lose function over time. Although chronic kidney disease is irreversible, it can be slowed. If your kidney function drops to a certain level, dialysis or a kidney transplant is necessary.

The two main causes of chronic kidney disease are diabetes and high blood pressure. Other causes of CKD include inherited diseases, inflammatory diseases and infections.

How to keep your kidneys healthy

1. Keep your salt intake to a minimum. Foods high in salt can put a strain on your kidneys. Try to keep your sodium intake to less than 2,000 milligrams per day. Avoid high-sodium restaurant meals and processed foods. Instead, make meals at home, with healthy ingredients.

2. Watch your blood pressure. Controlling your blood pressure is the single most important thing you can do to help prolong the life of your kidneys.

3. Stop smoking. Smoking substantially increases your risk for all kidney-related problems, including heart disease.

4. If you have diabetes, control your blood sugars. For more than 40 percent of people with kidney failure, diabetes is the cause. Work with your doctor to help control your blood sugar.

5. Exercise regularly. Exercise helps you maintain a healthy weight and controls your blood pressure. Walking, light weights, yoga, gardening — all of these are great ways to get exercise.

6. Avoid over-the-counter anti-inflammatories. If you have chronic kidney disease, avoid anti-inflammatory medications like ibuprofen, Advil and Motrin. If you do not have chronic kidney disease, use these medications only as needed.

7. Have your kidneys checked on a regular basis. Kidney disease is often silent, showing no symptoms until you approach the need for dialysis or transplantation. Having your kidneys checked on a regular basis can help identify problems earlier.

Learn more ways to keep your kidneys healthy

Interested in learning more about kidney health? Consider taking one of our free classes! Our virtual classes include one-hour free webinars on kidney health eating, exercising and more. Visit www.pskc.net/classes to sign up for one of our upcoming sessions!

Love your kidneys!

Education, Health - kidney health tips - February 13, 2019

Make simple changes for kidney health

February is all about love and this year, it’s time to spread that love to your kidneys. The truth is, they need it! Kidney disease is serious and one in three adult Americans is at risk for it. When your kidneys fail, you need regular dialysis treatments or a kidney transplant to survive. The good news is, there are many things you can do right now to prevent kidney disease from happening. Follow the tips below to spread the love to your kidneys and help keep them healthy.

1. Follow a low-sodium diet. Eating foods high in sodium can increase your blood pressure and make your kidneys (and your heart) work harder. Keep your sodium intake under 2,000 milligrams a day. Avoid fast foods and packaged foods, and limit eating out as restaurant meals can be full of sodium. Cook at home, choose fresh fruits and vegetables to snack on and flavor foods with spices instead of salt. Check out our tasty low-sodium recipes and work with your dietitian or doctor on a complete meal plan.

2. Monitor your blood pressure. High blood pressure can impact arteries around your heart, making them weak and unable to deliver enough blood to your kidneys. Keep your blood pressure in check to help keep your arteries strong.

3. Exercise regularly. Regular exercise can help you control blood pressure, lose weight, get stronger and sleep better. It can also greatly improve your mood. Start slowly and work up to 30 minutes a day. Check out more fitness tips and work with your doctor to create an exercise plan that’s right for you.

4. Quit smoking. Smoking can slow the blood flow to your kidneys. If you smoke, work with your doctor on a plan to cut back and work towards quitting altogether. Visit smokefree.gov for tips and more information.

5. Control your blood sugar if you have diabetes. High blood sugar can damage blood vessels in your kidneys. Keep your blood sugar at the level your doctor recommends to prevent kidney damage.

Now’s the time to focus on yourself and your health. Don’t put it off! Follow the tips above for a healthier you and let us know how it’s going – share with us on Facebook, Twitter and Instagram!

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