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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.

Your medicine list

No doses on this page

This handbook never gives insulin or medicine doses and never tells you to change one. Your prescriber sets every dose and every change, and writes down when to pause a medicine and when to restart it. A low blood glucose is always treated straight away: see Treating a low and Get help now.

In short

People with kidney disease and type 1 diabetes often take many medicines from several doctors. Each doctor may see only part of the picture. Medicine mistakes are common: KDIGO reports studies that found medicine errors or unsuitable prescriptions in up to 37 % of people with kidney disease seen in clinics (KDIGO 2024, chapter 4). One up-to-date list, one pharmacy, and a review at every change in your care are the simplest protection (KDIGO 2024, practice point 4.3.1; NIDDK).

Why the list matters with kidney disease

  • Doses depend on your kidneys. Many medicines leave the body through the kidneys. As your eGFR changes, your prescriber may tell you to take a medicine less often, take less, or switch (KDIGO 2024, practice point 4.2.1; NIDDK). The list is how every doctor sees what you take now.
  • Some medicines harm the kidneys. Each year, about 1 in 5 people with stage G3–G5 kidney disease gets at least one medicine that may harm the kidneys, most often an NSAID pain reliever (KDIGO 2024, chapter 4). See Medicines to avoid.
  • Paused medicines get forgotten. When medicines are paused for an illness, the problem reported most often is a medicine that is never restarted. KDIGO warns this can cause harm, so every pause needs a written restart plan (KDIGO 2024, practice points 4.3.2–4.3.3).
  • You can spot problems early if you know what each medicine is for and which side effects to report (KDIGO 2024, practice point 4.3.1.1).

When to review your list

Moment What to do
Every visit Bring the list, or all your bottles, pens and boxes (NIDDK)
A new prescription from any doctor Ask: "Is this right for my kidney function?"
Going into hospital, and leaving it Compare the discharge list with your own, line by line. Ask about anything new, stopped or paused (KDIGO 2024, practice point 4.3.1)
After a sick day or an operation Check that every paused medicine has been restarted as planned. KDIGO says a medicine review within a month may help (KDIGO 2024, section 4.3)
Starting dialysis, or a transplant Ask for a full review: many medicines change at these points
At least once a year A full review with your pharmacist or kidney team

Make your list

Use this layout, on paper or in your phone. Copy each medicine exactly as it is written on the pharmacy label. Include insulin, glucagon, eye drops, inhalers, creams, vitamins, supplements and anything bought without a prescription.

Medicine (brand and generic name) What it is for How I take it (copy the label) Started Who prescribed it Pause on sick days? Restart rule

Also write down:

  • Allergies and bad reactions, and what happened.
  • Medicines you stopped, and why (for example "stopped because potassium went up"). This stops them being restarted by mistake.
  • Your latest kidney numbers: eGFR, potassium and the date. KDIGO suggests bringing your latest eGFR result to appointments with other doctors (KDIGO 2024, practice point 4.3.1.1).
  • Your sick-day plan with restart dates (Sick days; wallet card).
  • Your pharmacy name and phone number.

What to do

  • Write your list today, and put a copy in your wallet and on your phone (NIDDK).
  • Use one pharmacy or one pharmacy chain, so it can check for interactions (NIDDK).
  • Tell every doctor, dentist and pharmacist: "I have kidney disease, stage ___, and type 1 diabetes" (KDIGO 2024, practice point 4.3.1.1).
  • Ask the pharmacist to check each new medicine against your latest eGFR.
  • Update the list the same day anything changes.
  • Give a copy to the person who would speak for you in an emergency.
  • Bring your questions. AHRQ suggests asking how to spell a new medicine's name, whether it has side effects, and whether it interacts with medicines you already take (AHRQ).

Examples

  • A hospital stay. Carlos is admitted with pneumonia. His ACE inhibitor and diuretic are paused. At discharge he compares the hospital's list with his own and sees both are still "on hold". He asks when to restart them, and the doctor writes the dates on his discharge letter.
  • A new specialist. A foot doctor wants to prescribe an anti-inflammatory gel and tablets for Hannah's heel pain. Hannah shows her list and her eGFR. The doctor drops the tablets, which are an NSAID (Medicines to avoid).
  • Starting dialysis. Jim asks his kidney team to go through every medicine when he starts hemodialysis. Two are stopped, one is changed, and his diabetes team writes a new dialysis-day insulin plan (Insulin on dialysis).

A card for your wallet

My medicines (updated __)

Kidney disease stage _ eGFR _ (date ____) Type 1 diabetes: insulin by pen / pump

Full list: in my wallet / phone / with ____

Allergies: ________

Pharmacy: ____ Phone: ____

I keep glucagon at: ____

Please check every new medicine against my kidney function.

Ask your care team

  1. What is each of my medicines for, and how will I know it is working?
  2. Is every medicine I take still right for my current kidney function?
  3. Which of my medicines should I pause when I am ill, and when do I restart each one?
  4. Are there medicines I can stop?
  5. Which side effects should make me call you?

Get help now if…

  • You or someone else took too much of a medicine, or the wrong one: call Poison Help at 1-800-222-1222 (US, free, 24 hours) (America's Poison Centers). If the person has collapsed, has a seizure, has trouble breathing or cannot be woken, call 911.
  • You took too much insulin, or insulin without food: check glucose often and treat any low at once (Treating a low). Call your diabetes team or Poison Help now for advice: with kidney disease, insulin can keep working for longer than usual (ADA–KDIGO 2022; America's Poison Centers). Call 911 for a low the person cannot treat themselves.
  • You missed doses of anti-rejection medicine after a transplant: call your transplant center today. See Get help now.

Sources

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