Chronic kidney disease treatment

Depending on the underlying cause of the condition, some forms of kidney disease can be treated. However, once the damage has been done to the kidneys, it is usually permanent.

The management of chronic kidney disease is generally aimed at controlling your signs and symptoms, treating and reducing the risk for complications, and slowing down the disease’s progression. Treatment for end-stage kidney disease becomes necessary when the kidneys have been severely damaged.

Both medications and healthy lifestyle habits may be used to manage the symptoms and underlying causes of CKD. Such treatments may include:

• High blood pressure medications: Kidney disease may lead to elevated blood pressure in some patients. Your provider may prescribe medications to lower blood pressure and preserve kidney function.

Because high blood pressure medications can initially decrease kidney function and alter the body’s electrolyte levels, you may need to undergo routine blood testing to monitor your condition. Your provider will likely also recommend a water pill (diuretic) and a low-salt diet to manage hypertension.

• Medications to lower cholesterol levels: Your provider may prescribe medications used to lower cholesterol called statins. People with chronic kidney disease often have high levels of bad cholesterol (LDL levels greater than 100 mg/dL). Having high LDL levels can increase the risk of heart disease.

• Medications to treat anemia: If you have anemia caused by kidney disease, your provider may recommend taking supplements of the hormone erythropoietin, sometimes with added iron. Erythropoietin supplements help produce higher numbers of red blood cells. This can help relieve the fatigue and weakness associated with anemia.

• Medications to relieve swelling: Chronic kidney disease can lead to fluid retention, which can cause swelling in the legs and high blood pressure. Diuretics, which increase the volume of water and salt passed through the body in urine, can help maintain the body’s fluid balance.

• Medications to protect your bones: Your provider may recommend taking calcium and vitamin D supplements to prevent weakened bones and lower the risk for fractures. They may also prescribe a medication known as a phosphate binder. Phosphate binders help lower the amount of phosphate in the blood and protect the blood vessels from damage caused by calcium deposits (called calcification).

• Diet with less protein: When the body processes the protein from foods, waste products are formed. The kidneys’ job is to filter these wastes from your blood. Your provider may recommend decreasing your protein intake in order to reduce the amount of work your kidneys must do to filter these wastes. They may also suggest that you meet with a dietitian, who can recommend ways to lower your protein intake while still eating a healthy diet.

Your provider may recommend follow-up testing at regular intervals to see whether your kidney disease remains stable or progresses during treatment.

Treatment for end-stage kidney disease

End-stage kidney disease occurs when the kidneys can't keep up with waste and fluid filtration on their own, causing you to develop complete or near-complete kidney failure. At this point in the disease, dialysis or kidney transplants become necessary.

• Dialysis: Dialysis artificially removes waste products and excess fluids from the blood when the kidneys are no longer able to do so.

Hemodialysis involves using a machine to filter wastes and excess fluids from your blood. Peritoneal dialysis involves using a thin tube (catheter) to fill the abdominal cavity with a cleaning solution called dialysate. This solution absorbs wastes and excess fluids. The dialysis solution eventually drains from the body, carrying the wastes with it.

• Kidney transplant: A kidney transplant involves surgically replacing your kidney with a healthy donor organ. Transplanted kidneys can come from deceased or living donors. After undergoing a transplant, you will need to take medications for the rest of your life to keep your body from rejecting the new organ. It is not necessary to undergo dialysis before receiving a kidney transplant.

Chronic kidney disease medication

Your provider may prescribe the following medications for chronic kidney disease:

Potential future treatments

Regenerative medicine, which is still being researched, holds the potential to fully heal damaged tissues and organs in the future.

Regenerative approaches to treating kidney disease include:

• Boosting the body's natural ability to heal itself
• Using healthy donor cells, tissues, or organs to replace damaged ones
• Delivering specific types of cells or cell products to diseased organs or tissues to restore function

Chronic kidney disease prevention

To better manage¹² kidney disease or reduce your risk of developing kidney disease:

• Manage your blood glucose: If you have diabetes, it’s important that you reach and maintain your blood sugar goal. Check your blood glucose level regularly and use the results to guide healthy decisions about diet, physical activity, and medication. Your provider is the best person to determine how frequently you should be checking your blood glucose level.
• Control your blood pressure: High blood pressure can damage your kidneys. You can protect your kidneys by keeping your blood pressure at or under the goal set by your provider. The blood pressure goal for most people with diabetes is generally 140/90, while the recommended blood pressure goal is typically 130/80 for people without diabetes.
• Maintain a healthy weight: If you're at a healthy weight, work to maintain it by being physically active most days of the week. If you need to lose weight, talk with your provider about strategies for healthy weight loss. This generally requires increasing daily physical activity and reducing your caloric intake.
• Don't smoke: Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you're a smoker, talk to your provider about strategies for quitting. Support groups, counseling, medications, and nicotine replacement products are all available to help you to quit.
• Manage your medical conditions with your provider's help: If you have diseases or conditions that increase your risk of kidney disease, work with your healthcare provider to control them.

Chronic kidney disease diet

As part of your treatment for chronic kidney disease, your provider may recommend starting a specific diet to help support and relieve strain on your kidneys. You may want to ask your provider for a referral to a dietitian. Dietitians can analyze your current diet and suggest adjustments that will be easier on your kidneys.

Depending on your situation, kidney function, and overall health, your dietitian may recommend that you:

• Avoid products with added salt: A high sodium intake can contribute to high blood pressure (hypertension). Eat a diet rich in fresh fruits and vegetables, and decrease the amount of sodium you eat by avoiding products with added salt, such as highly processed and preserved foods.
• Choose foods lower in potassium: Your dietitian may recommend that you avoid foods with high levels of potassium. These include bananas, oranges, potatoes, spinach, and tomatoes. Some low-potassium foods include apples, cabbage, carrots, green beans, grapes, and strawberries.

Be aware that many salt substitutes contain potassium, so you should avoid them if you have kidney failure.

• Limit the amount of protein you eat: Your dietitian will determine your appropriate daily protein requirement and make diet recommendations based on that amount. High-protein foods include lean meats, eggs, milk, cheese, and beans. Some low-protein foods include vegetables, fruits, breads, and cereals.