Kidney disease and medicines during illness
Kidney disease and vomiting, diarrhoea or fever can create dehydration risks; agree a written sick-day medicines plan with your clinical team.
How this guide was prepared
Purpose: urgent guidance · Level: detailed
Checked by: Does Your Duck Quack. Sources are linked below; seek professional advice for individual circumstances.
The short answer
What to do first
Kidney disease and vomiting, diarrhoea or fever can create dehydration risks; agree a written sick-day medicines plan with your clinical team.
Start here: Vomiting, diarrhoea, fever or being unable to drink can lead to dehydration and a sudden worsening in kidney function. Some medicines also need individual review during acute illness. This does not mean everyone with kidney disease should stop the same medicines.
Do not wait: Passing much less urine, severe vomiting or diarrhoea, confusion or unusual drowsiness needs urgent clinical advice. Contact your GP or kidney team; use NHS 111 in England or Wales, NHS 24 on 111 in Scotland, or the local urgent-care route in Northern Ireland. Call 999 if the person is severely unwell, collapses or is difficult to wake.
Scope of this guide
This guide helps you understand the options and questions to ask. It is not personal medical, legal or financial advice. Check the official sources for your nation and seek qualified help for high-stakes decisions.
Call 999 for a life-threatening emergency. For an urgent problem that is not clearly life-threatening, use the official NHS urgent-care route for the UK nation you are in. Have the address, symptoms, onset time, medicines and allergies ready.
Who this guide is for
People with chronic kidney disease who need a safe, personalised plan for medicines and fluids when illness makes eating or drinking difficult.
Chronic kidney disease means the kidneys are not working as well as they should over time. Many people feel well, but kidney function can become more vulnerable during illness, particularly if fluid is lost or medicines cannot be kept down. A general online list cannot tell you which medicines to change. Ask your GP, pharmacist or kidney team for instructions written for your own treatment and fluid needs.
What to do now
1. Know why illness matters for kidney health
Vomiting, diarrhoea, fever or being unable to drink can lead to dehydration and a sudden worsening in kidney function. Some medicines also need individual review during acute illness. This does not mean everyone with kidney disease should stop the same medicines.
2. Ask for your own written sick-day guidance
At a planned review, ask which symptoms should trigger a call, which medicines need special instructions and whom to contact during evenings or weekends. Ask the clinician to write the instructions for your exact medicines, including what to do when you recover and whether blood tests or a review are needed.
3. Follow your fluid plan rather than guessing
If you have not been told to restrict fluids, ask your clinician what to drink during illness and how to recognise dehydration. If you have heart or kidney-related fluid restriction, follow that individual plan and contact the team if vomiting, diarrhoea or fever makes it hard to manage.
4. Get advice early if symptoms affect medicines or urine
Contact your GP, kidney team or pharmacist if you cannot keep medicines down, are passing much less urine, feel increasingly weak or are unsure whether a dose was absorbed. Use NHS 111 or your nation’s urgent-care route if you need help and the practice is closed.
5. Review the plan after an illness
Once you are recovering, follow the written instructions for restarting or resuming any medicine and arrange a review if your team advised one. Do not restart or alter treatment from memory if the plan is unclear; call the prescriber or pharmacist.
Warning signs and checks
- Personal medicine plan written
- Restart instructions clear
- Day-and-night contact available
- Fluid advice is individual
- Non-prescription medicines checked
- Worsening symptoms escalated
- Kidney team, GP and pharmacy contact details are current.
- A personalised written sick-day plan covers each relevant medicine.
- Fluid restriction or usual fluid advice is clearly recorded.
- Urgent symptoms and out-of-hours routes are understood.
- No medicine is stopped, restarted or changed without agreed instructions.
- The plan is reviewed after illness or a treatment change.
Common questions
What are sick-day rules for kidney disease?
Sick-day guidance is a plan for what to do with your own medicines and fluids when an illness causes vomiting, diarrhoea, fever or poor intake. It is not a universal list of medicines to stop. Ask your GP, pharmacist or kidney team to write instructions for your prescriptions, including how and when to resume them and whom to call.
Should I stop my medicines if I have vomiting or diarrhoea?
Do not stop or restart medicines based on a general article or another person’s plan. Some medicines may need individual instructions during dehydration, while stopping others may also cause harm. Follow your written plan and contact your GP, pharmacist or kidney team if you do not have one or cannot keep medicines down.
Should I drink more water when I am ill with kidney disease?
That depends on your kidney function, heart health and whether you have a fluid restriction. If you have a written fluid plan, follow it and contact your team when illness makes it difficult. If you have not been restricted, ask the clinician who knows your condition what is appropriate.
When should I get urgent help during an illness?
Contact your GP or kidney team promptly if you are passing much less urine, cannot keep fluids or medicines down, or feel increasingly weak. Use NHS 111 or your nation’s urgent service if you need help outside normal hours. Call 999 for severe drowsiness, collapse, severe breathing difficulty or another life-threatening change.
Differences across the UK
Kidney and urgent-care services vary across the four NHS systems. Ask the kidney team in your nation for a personal plan. England and Wales use NHS 111; Scotland uses NHS 24 on 111; Northern Ireland has local GP out-of-hours and HSC urgent-care arrangements. Call 999 for life-threatening symptoms.
Passing much less urine, severe vomiting or diarrhoea, confusion or unusual drowsiness needs urgent clinical advice. Contact your GP or kidney team; use NHS 111 in England or Wales, NHS 24 on 111 in Scotland, or the local urgent-care route in Northern Ireland. Call 999 if the person is severely unwell, collapses or is difficult to wake.
Primary sources
The publisher checked this guide against the 10 official sources below. This is an editorial source check, not approval by a clinician, lawyer or benefits adviser.
- NHS: Chronic kidney disease
- NICE: Acute kidney injury
- NHS: Acute kidney injury
- NHS Think Kidneys: Information for the public
- NHS inform: Prescriptions and emergency supply in Scotland
- NHS: When to use NHS 111
- NHS 24 Scotland: When to phone 111
- NHS 111 Wales
- nidirect: GP out-of-hours service
- GOV.UK: Emergency numbers
Related guides
- Questions to ask at a medication review
- Pharmacist, GP, 111 or 999: choosing the right health help
- Dehydration in older people: signs, drinks and fluid limits
Editorial note: By Does Your Duck Quack.