Chronic kidney disease (CKD) generally cannot be cured, but not everyone with CKD progresses to kidney failure. Treatment is essential for improving symptoms, protecting kidney function, and reducing the risk of complications. When CKD is managed properly, many people with the condition can live fulfilling lives.
Treatment generally consists of treating or controlling the underlying cause—such as diabetes or high blood pressure—as well as managing symptoms and any complications that may arise. It generally falls into three categories: lifestyle adjustments, nutritional changes, and medications. Each category is vital to the management of CKD. Here’s what you should know about them:
Lifestyle Interventions: When you are first diagnosed with CKD and throughout your treatment, your provider may encourage you to make lifestyle changes. Aiming for regular physical activity, managing stress, maintaining a healthy weight, following a kidney-friendly diet, and not smoking can make a big difference in managing CKD and feeling better. You can learn about your condition, get support for managing it, and find out more about lifestyle interventions by taking part in a program that teaches CKD self-management techniques. Studies suggest being involved in CKD self-management may result in fewer trips to your provider’s office or to the hospital, compared to usual care.
Nutritional Interventions: Also called medical nutrition therapy, these changes generally consist of following a heart-healthy low-salt diet, avoiding foods high in cholesterol such as fatty meats and fried foods, choosing foods that can help lower cholesterol such as high-fiber foods including whole grains, fruits and vegetables, and avoiding too much protein consumption. As CKD progresses, additional dietary changes may be necessary, such as limiting potassium and foods high in phosphorus. Seeing a registered dietitian with knowledge about kidney-friendly (or renal) diets can help you find an eating plan that is right for you.
Medication management: A wide range of medications are used to treat kidney disease and its complications. Certain types of high blood pressure medications called angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) treat high blood pressure while decreasing albuminuria (protein in the urine) at the same time. These medications can also slow the progression of CKD and reduce the risk of heart disease. Many people with CKD also take medication to manage abnormal cholesterol levels. For people with diabetes, medications to manage blood sugar can also help decrease albuminuria. Diuretics (also called water pills) can decrease fluid retention and reduce swelling in the body. Other medications are used to improve the production of red blood cells and treat anemia (low levels of healthy red blood cells) if it develops. Medication to decrease the amount of phosphate in the blood along with calcium and vitamin D supplements can also help protect your bones.
Medication generally works best when you take it exactly how your healthcare provider tells you to. If you have questions about your treatment and whether it is working, attending regular medical appointments can help get your questions answered. At these appointments, your provider can monitor your symptoms and check regular follow-up lab tests to see if you may need a change in management plan.
Dialysis and Kidney Transplant: Sometimes, even with treatment CKD can progress to kidney failure, which is also called end-stage renal disease (ESRD). When this happens, dialysis or kidney transplant becomes necessary. Two methods can be used for dialysis:
- Hemodialysis: Uses a machine that does the job of the kidneys by filtering waste and excess fluids from the body through an access point in the arm. This procedure usually requires about four one-hour treatment sessions per week at a dialysis center.
- Peritoneal dialysis: Uses a tube placed in the abdomen to fill it with a solution that removes waste and excess fluids, which exit the body via the same tube. This treatment can be done at home.
Kidney transplant involves placing a healthy kidney from either a living or deceased donor into your body. Kidney transplant recipients need to take medication to reduce the risk of their immune system rejecting the donated kidney (immunosuppressants). People wait about 3 to 5 years, on average, for a kidney transplant.
Conservative management for kidney failure is also an option. It consists of treating symptoms, advance care planning in the event you become unable to make decisions for yourself, and palliative care to treat pain and ease stress.
