“Kidney disease” is considered one of the complex diseases and is often misunderstood. Many people may receive information from word of mouth or from sources that are not medically accurate, leading to misconceptions about kidney function, treatment, and daily living with kidney disease. If not properly understood, it may result in neglecting health care or inappropriate self-care.

This article compiles 5 common misconceptions about kidney disease along with facts you should know, to help you understand this disease correctly and take proper care of your kidney health.

Myth 1: Reduced kidney function means only one kidney is deteriorating
Fact: The kidney test that doctors commonly use is measuring creatinine levels to calculate the eGFR (estimated Glomerular Filtration Rate), which assesses the combined function of both kidneys. It does not indicate the function of just one kidney. If separate measurement is needed, such as before kidney donation or if there is a disease affecting only one kidney like a mass or hydronephrosis, doctors will use a Renal scan for specific evaluation.

Myth 2: All kidney disease patients must undergo dialysis
Fact: Chronic kidney disease is divided into 5 stages. Only in stage 5 (eGFR < 15) is dialysis considered. However, this does not mean everyone must start dialysis immediately. The decision depends on symptoms such as inadequate waste elimination, uremia, or failure to improve with other treatments. Patients can consult their doctors to assess risk or use the Kidney Failure Risk Calculator (www.kidneyfailurerisk.com) by entering information such as age, gender, ethnicity, eGFR, and Microalbumin/Creatinine Ratio to help predict risk.

Myth 3: Once on dialysis, dietary control is unnecessary
Fact: Hemodialysis is performed only 2–3 times per week, about 4 hours each session, which is not enough to remove all waste. Patients still need to control their diet, such as

- Reduce sodium (salty foods)
- Avoid high potassium foods
- Limit fluid intake if urine output is low
Additionally, patients should consume high-quality protein such as lean meat because dialysis can cause protein and muscle mass loss. Patients should regularly consult their doctors or dietitians for personalized advice.

Myth 4: Back pain = Kidney disease
Fact: Back pain is not always caused by kidney disease. Causes may include muscles and bones, gastrointestinal diseases, pancreas, or even certain blood vessels. Kidney-related back pain is usually accompanied by abnormal urination or pain radiating to the groin. Therefore, examination by a nephrologist can provide an accurate diagnosis.

Myth 5: Taking multiple medications causes kidney deterioration
Fact: Some medications require caution, such as NSAIDs and certain antibiotics. However, regular medications like antihypertensives, lipid-lowering drugs, or blood sugar-lowering drugs, if used correctly and with regular kidney function monitoring, do not cause kidney deterioration. They also help control chronic diseases that are causes of future kidney disease.

Kidney disease is a complex condition that requires close diagnosis and care by doctors. Misconceptions may lead patients to make wrong decisions or improper self-care. Understanding the facts is therefore important, whether it is about kidney function, dialysis, diet control, back pain, or medication use. If you have any concerns about kidney health, you should consult a kidney specialist directly to receive accurate and appropriate information tailored to your health condition.

Dr. Methinee Sutthiwaikij

Nephrologist

Phyathai 2 Hospital