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Draft: not yet reviewed by a clinician

Use this page to prepare questions for your care team. It does not replace their advice. Your own targets and doses come from your nephrologist, diabetes team and renal dietitian.

Kidney Health Handbook

For people living with chronic kidney disease (CKD) and type 1 diabetes, at any stage, and for the family and friends who help them. It explains what each stage means day to day, what to eat, how to read your lab results, and when to get help, with real numbers and the source for every one.

What this handbook is not

It is not your care team's advice and it never replaces it. Your nephrologist, diabetes team and renal dietitian set your own targets and doses. This handbook never gives insulin or medicine doses. Use it to understand your care and to prepare questions. KDIGO asks for education that also involves care partners (KDIGO 2024, practice point 5.3.2): bring a family member.

In an emergency, call 911 (or your local number). The Get help now link is at the top of every page.

Five things to know today

  1. Never skip treating a low. Under 70 mg/dL (3.9 mmol/L), take 15 g of fast sugar straight away, best as 4 glucose tablets; if juice or regular soda is what you have, drink 4 oz (½ cup). Recheck in 15 minutes and repeat if still low. Potassium never delays treatment (Treating a low; ADA 2026 §6; NIDDK).
  2. Have a written sick-day plan from your team, including when to pause medicines and when to restart them (Sick days; KDIGO 2024, practice point 4.3.2).
  3. Know your own potassium and fluid rules, if you have them, from your latest blood tests and your dialysis unit (Potassium; Fluid).
  4. Star fruit is never allowed at any stage of kidney disease (NKF; de Oliveira 2015).
  5. Bring questions to every visit. Each page ends with "Ask your care team", and there is a printable list on Questions to ask.

Find your stage

If… Start with
eGFR 60 or more, with albumin in the urine Stages G1 and G2
eGFR 45–59 Stage G3a
eGFR 30–44 Stage G3b
eGFR 15–29 Stage G4
eGFR under 15, not on dialysis Stage G5 without dialysis
Hemodialysis at a center In-center hemodialysis
Hemodialysis at home Home hemodialysis
Peritoneal dialysis Peritoneal dialysis
Waiting for, or living with, a transplant Before a transplant · After a transplant
Not sure, or just diagnosed What CKD is, then CKD stages

eGFR is in mL/min/1.73 m² on your lab report (KDIGO 2024, Table 2). Stages are labels for risk and planning, not a countdown. Diabetes and high blood pressure are the most common causes of CKD in adults (NIDDK). Most people in the early stages feel nothing, which is why the yearly blood and urine tests matter (NIDDK).

If you help someone with CKD

Where your numbers come from

  • Your lab report: eGFR, urine albumin (UACR), potassium, phosphate and more. Your lab's reference range wins over any typical range here (Lab results).
  • Your care team: your targets for potassium, phosphorus, sodium, protein, fluid and carbohydrate.
  • The app: "Suggest targets" gives starting points from the same tables as this handbook, labeled "discuss with your care team" (Targets and warnings). When the app shows a warning, it links to the page here that explains it.

How to read this handbook

  • Units: pages with lab numbers have US units and International tabs. Pick one and every page follows. Try it:

    A glucose under 70 mg/dL is a low. Treat it now (ADA 2026 §6).

    A glucose under 3.9 mmol/L is a low. Treat it now (ADA 2026 §6).

    To convert any result yourself, see Units and conversions.

  • Draft banner: every page says "Draft: not yet reviewed by a clinician" until a named clinician has reviewed it. The line at the bottom of each page shows when its facts were last checked (About this handbook).

  • Sources: each page ends with its sources; all sources are listed with their links and the date they were checked.
  • Words: hover over or tap an abbreviation such as eGFR to see what it means, or open the Glossary.
  • Printing: pages print cleanly. Useful ones to print are Get help now, the wallet cards, Questions to ask and the grocery lists.

Who should see a specialist first

This handbook is written for adults.

  • Children and teenagers with CKD need a pediatric kidney team; KDIGO gives them separate advice (KDIGO 2024, pediatric considerations).
  • Pregnancy, or planning one, with CKD and type 1 diabetes needs a nephrologist and a maternal-fetal medicine team before you try, because some kidney medicines must be changed first (UK Kidney Association 2019; ADA 2026 §15; Sex, fertility and pregnancy).

Using the handbook with the app

The app is a food log for kidney disease and type 1 diabetes. It does not give doses and is not a medical device (About the app).

Outside the US

Use your local emergency number (112 across the EU, 999 in the UK, 000 in Australia). Your lab may use international units; the tabs on each page show both. Benefits and services differ by country; your national kidney charity can tell you what is available.

Sources

Not yet reviewed by a clinician. Facts and sources last checked 2026-10-06.