Is It Possible to Reverse Kidney Disease? Here's What Nephrologists Recommend

Doing these things can limit or slow the damage to your blood-filtering organs.

If you have kidney disease, you may wonder if you can reverse it. After all, you can do that with other chronic health conditions, such as high blood pressure, elevated cholesterol, and type 2 diabetes. But when it comes to chronic kidney disease (CKD), it's not as simple.

"CKD tends to be a progressive chronic condition," says Dugan Maddux, MD, PhD, vice president of kidney disease initiatives at Fresenius Medical Care in Waltham, Massachusetts.

You may be able to "stabilize or even reverse some of the injury to your kidneys very early on in the course of the disease, when you're just experiencing kidney inflammation," but as Dr. Maddux tells Health, many people don't have symptoms at that point—"and they don't know to make the necessary changes."

That being said, there are things you can do, even if you don't have a diagnosis of kidney disease, to help keep your kidneys heathy, says Dr. Maddux. These include:

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Getting regular checkups

About a third of all Americans are at risk for developing kidney disease, according to the National Kidney Foundation (NKF), often because of risk factors such as being overweight or having high blood pressure, type 2 diabetes, or a family history of kidney disease.

If you have any of these, it's important to see your doctor regularly so you can get screened for kidney disease, notes Dr. Maddux. Per the NKF, there are two main tests:

  • A urine test called ACR. This test looks for albumin, a type of protein. If your test comes back positive, it's a sign that your kidneys are not filtering your blood well enough. Your doctor will repeat the test three times over a three-month period to confirm that you do indeed have early CKD.
  • A blood test to estimate your GFR. This test looks for creatinine, a waste product that can build up in your blood when your kidneys are damaged, Your doctor puts your result into a math formula to calculate your glomerular filtration rate (GFR). A normal GFR is above 90. If yours is between 60 and 90, you may have very early stage kidney disease, says NKF.

Knowing your numbers

Diabetes and high blood pressure are the two most common causes of chronic kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

When you have too much glucose in your blood, it damages blood vessels everywhere—including your kidneys, says Dr. Maddux. As a result, your kidney's filters become damaged.

The good news? "Diabetes is one of the most modifiable risk factors," says David Goldfarb, MD, clinical chief of nephrology at NYU Langone Health. A small study in the Lancet found that people with type 2 diabetes who underwent an intensive weight-management program were not only able to reverse their diabetes, but about a third of them were still in remission two years later. The goal is to get your A1C levels (a marker of type 2 diabetes) to under 6.5% for more than three months.

The same is true for high blood pressure, which also damages blood vessels in the kidneys so they don't work as well, explains Dr. Maddux. If yours is high (and anything over 120/80 is now considered elevated) try to get it under control with lifestyle changes: make sure you are at a healthy weight, exercise, follow a heart healthy, low-sodium diet like the Mediterranean diet, and don't smoke.

If those steps don't work, you'll need to try medications. Two types of blood pressure-lowering meds—angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)—work well to both lower blood pressure and slow the progression of kidney disease. It's not unusual for people with both conditions to require at least two drugs to control their blood pressure.

Watching your meds

If you are at risk for kidney disease or have early-stage chronic kidney disease, it's important to avoid taking large amounts of over-the-counter painkillers such as acetaminophen, nonsteroidal anti-inflammatories, or aspirin, says Dr. Maddux. All of these drugs can damage kidney tissue and reduce blood flow, according to the NKF. This is especially true if you're elderly.

If you do need to take them to treat aches and pains, the NKF recommends that you follow the dosing directions on the label, and take the lowest dose possible for the shortest period of time.

You also should make sure you stay hydrated—that means drinking about eight glasses of fluid a day, and avoid alcohol while taking them. If you've already been diagnosed with kidney disease, always check with your doctor before you take an OTC pain medicine, NKF advises. This is also true if you have high blood pressure or heart disease.

Quitting smoking

Yes, you know lighting up raises risk of both heart and lung disease, but it affects your kidneys too.

"Studies have shown that quitting smoking may slow the decline of kidney disease," says Dr. Maddux. A 2018 study published in the Clinical Journal of the American Society of Nephrology found that both former and current tobacco smokers, for example, were significantly more likely to see progression of their chronic kidney disease.

"Smoking raises risk of developing heart disease, which in turn leads to decreased blood flow to the kidneys," explains Dr. Maddux. "It also narrows blood vessels, including those in the kidney, and thickens and hardens renal arteries." Another small study published in 2017 in the American Journal of Nephrology found that people who quit smoking were half as likely to experience GFR decline than those who continued the habit over a five-year period.

Eating a healthy diet

In general, a heart healthy Mediterranean-style diet is best, says Erin Rossi, RD, a nutritionist who specializes in kidney disease at the Cleveland Clinic. A 2014 study in the Clinical Journal of the American Society of Nephrology found that this sort of eating pattern reduces risk to develop chronic kidney disease by about 50%.

All patients with CKD—even at the early stages—need to watch their salt intake, since even slight damage to your kidneys can affect how it filters sodium, adds Rossi.

Follow the recommendation of groups like the American Heart Association and NKF and consume under 2,300 milligrams a day. You may also want to slightly moderate your daily protein intake—in general, the rule of thumb is 0.8 grams per kilogram of body weight, or roughly 55 grams of protein a day for a 150-pound person, says NKF. In the later stages of kidney disease, you may need to restrict potassium and phosphorous as well.

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