These Kidney Disease Treatments Can Help Slow the Decline of Kidney Function, According to Nephrologists

The sooner the condition is managed, the better off you may be.

While there's no "cure" for kidney disease, that doesn't mean there's nothing you can do about it. Far from it. There are treatments for managing underlying conditions—conditions that may worsen the disease—and treatments for slowing down the condition's progression. That's why, if you are diagnosed with kidney disease, it is very important to see a kidney doctor, or nephrologist, to make sure you're getting the best possible treatment.

"Early referral lowers the chances that you'll develop some of the complications associated with chronic kidney disease," Cassandra Kovach, MD, a nephrologist at the Cleveland Clinic, tells Health.

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Kidney disease and its symptoms

Among other tasks, your kidneys are responsible for filtering waste and extra water from your blood, says the US National Library of Medicine (NLM). A diagnosis of kidney disease means these vital organs have sustained damage that prevents them from functioning as intended. "Chronic kidney disease" refers to damage that occurs slowly over time, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Diabetes and high blood pressure are common causes, which is why it's important for people with these medical conditions to get checked for kidney disease.

You might not know, at first, if your kidneys aren't performing as they should. However, early signs of kidney damage can be detected through blood and urine tests. Doctors also look for swelling in the legs, ankles, and feet, which is common as the disease progresses due to fluid and salt retention, per the NIDDK. Over time, other symptoms can surface, from lack of energy and frequent urination to dry, itchy skin, says the National Kidney Foundation.

How is kidney disease treated?

Since kidney disease is progressive, it's important to identify it as soon as possible. Treatment is aimed at managing underlying health issues to slow its progression and stave off complications, says NIDDK.

Here's a look at some of the treatments available.

Blood pressure medications

Anywhere from 85% to a whopping 95% of people with chronic kidney disease have high blood pressure, according to a 2012 review in US Pharmacist.

But it's important to maintain good blood pressure control, since if your kidney's blood vessels are damaged, they won't be able to work properly, notes Dr. Kovach. There are two types of medication that are widely used, she adds. These are known as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB). (Want a quick way to tell? The names of these medicines end in –pril or –sartan.) They not only lower your blood pressure—"they're also thought to slow the progression of CKD to a greater extent than some of the other hypertension medications," says Dr. Kovach.

Your doctor may also add a diuretic, or water pill, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). That will not only help lower blood pressure but reduce swelling associated with the disease, says the Mayo Clinic.

Diabetes medications

If you have type 2 diabetes, it's also very important that you get it under control. "If your diabetes is poorly controlled, it can damage the blood vessels in your kidneys, which will worsen CKD," explains Uday Nori, MD, a kidney specialist at the Ohio State University Wexner Medical Center in Columbus, Ohio. You should take all the medicines prescribed by your doctor. Sometimes, it takes more than one drug to bring your diabetes under control, says the NIDDK.

Cholesterol-lowering medications

People with chronic kidney disease often have high levels of bad cholesterol, which can increase the risk of heart disease, Dr. Nori tells Health. Medications like statins can lower your cholesterol.

Medications to treat anemia

Anemia is a common complication of chronic kidney disease. You're more likely to develop it if you are over the age of 60 or have type 2 diabetes. Your doctor can prescribe a drug known as an erythropoiesis-stimulating agent (ESA), which sends a signal to your bone marrow to make more red blood cells, according to the NIDDK.

Phosphate binders

When you have chronic kidney disease, your body retains phosphate, a mineral that helps keep your bones healthy but can be dangerous at high levels, says Erin Rossi, RD, a nutritionist who specializes in kidney disease at the Cleveland Clinic. This is usually treated with a medicine called a phosphate binder, which prevents phosphate (found in foods) from being absorbed by your digestive tract.

You'll also need to limit your phosphorus from food. It's often found in processed foods, so avoiding them can help lower your intake, adds Rossi. Check the list of ingredients on the nutrition facts label and look for "PHOS" to find phosphorus additives, advises the National Kidney Foundation (NKF).

Potassium binders

Some people with CKD develop a high blood-potassium level, which can interfere with normal cell function. A binder medication helps your body get rid of excess potassium in your BMs, per a review published by the NLM. Your doctor can also treat you with a diuretic that helps your body get rid of the extra potassium through your pee. You should also try to choose fruits low in potassium like apples, cherries, peaches, plums, pears, and grapes, says the NKF.

Dietary changes

Your diet plays an important part in the treatment of chronic kidney disease. The most important thing you can do is reduce your salt intake to lower your blood pressure, says Rossi. If you have kidney disease, it's very important that you follow the NKF recommendation and consume under 2,300 milligrams a day. People in the later stages of kidney disease may need to go even lower, adds Rossi.

You should also talk to your doctor about restricting protein. "Having too much protein can cause waste to build up in your blood, and your kidneys may not be able to remove all the extra waste," explains Rossi.

How is advanced kidney disease treated?

About 37 million Americans live with chronic kidney disease. Out of them, about 786,000—around 2%—live with advanced kidney disease, or end-stage renal disease (ESRD).

"It's still a very small number—for most people with kidney disease, the risk of heart attack or stroke is greater than the risk that they will eventually need dialysis or kidney transplant," says Richard Glassock, MD, Professor Emeritus at the David Geffen School of Medicine at UCLA and past president of both the American Society of Nephrology and the National Kidney Foundation.

Here's a look at both:

Dialysis

About 70% of people with ESRD are on dialysis, says the NIDDK. There are two main types: hemodialysis, when your blood goes through a filter outside your body, and peritoneal dialysis, per the NIDDK, where a solution flows from a bag through a catheter inserted into your belly to absorb waste and extra fluid from your body. One type of dialysis, known as automated peritoneal dialysis, even lets you do this while you sleep, explains the NIDDK.

The advantage of peritoneal dialysis is that it interferes less with day-to-day activities, since you can do it at home and even when sleeping, says Dr. Glassock. (Hemodialysis needs to be done three times a week for about four hours at a time at a hospital or kidney center, says the NKF.) But peritoneal dialysis isn't an option for people who are very obese, and it carries a higher rate of infection, according to the NKF.

Kidney transplant

Almost 30% of people with ESRD end up getting a kidney transplant. "There's no question that a transplant will offer a better quality of life, but it's usually considered as an option for younger patients, since older ones may have other health complications such as dementia or cancer that can make transplantation more difficult," explains Dr. Glassock. There's also a national kidney shortage, so you'll have to go on a waiting list and go on dialysis until a kidney becomes available, he notes—a process that may take years.

While a kidney can be transplanted from either an alive or dead person, kidneys from living donors work longer—up to 20 years, compared to about 15 years from a deceased donor, notes the American Kidney Fund. Sometimes, a family member or friend may even opt to donate a kidney, since you only need one to survive, it notes.

Even if you do get a kidney transplant, you'll still experience challenges post-surgery. You'll need to take medications for the rest of your life to prevent your body from rejecting your new kidney. This can lower your immune system, raising your risk of severe infections and even some cancers, says the American Kidney Fund. You'll also need to stay vigilant against COVID-19, as research shows that the vaccines only provide limited protection for organ transplant patients. The National Institutes of Health is now studying whether a third dose will offer more protection.

"This is really important, because many people who get kidney transplants also have other risk factors that raise their risk to develop severe COVID-19, like heart disease or type 2 diabetes," says Dr. Kovach.

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