21 Mar Kidney Disease: Failure, Treatment and Outlook

Kidneys are responsible for regulating pH, salt, potassium, and more. Various diseases, lifestyle habits, and genetic factors can affect kidney function.

Last week we explored the basics of kidney disease: what it is, its different types and symptoms, and more.

Today we’re taking a closer look at how kidney disease, once diagnosed, is treated.

How is kidney disease treated?

Treatment for kidney disease usually focuses on controlling the underlying cause of the disease. This means your doctor will help you better manage your blood pressure, blood sugar, and cholesterol levels. They may use one or more of the following methods to treat kidney disease.

Drugs and medication

Your doctor will either prescribe…

• Angiotensin-converting enzyme (ACE) inhibitors, such as
• lisinopril
• ramipril
• Angiotensin receptor blockers (ARBs), such as
• Irbesartan
• Olmesartan

These are blood pressure medications that can slow the progression of kidney disease. Your doctor may prescribe these medications to preserve kidney function, even if you don’t have high blood pressure.

You may also be treated with cholesterol drugs (such as simvastatin). These medications can reduce blood cholesterol levels and help maintain kidney health. Depending on your symptoms, your doctor may also prescribe drugs to relieve swelling and treat anemia (decrease in the number of red blood cells).

Dietary and lifestyle changes

Making changes to your diet is just as important as taking medication. Adopting a lifestyle with health-promoting benefits can help prevent many of the underlying causes of kidney disease. Your doctor may recommend that you:

• manage diabetes through insulin injections
• limit foods high in cholesterol
• reduce salt intake
• eat a heart-healthy diet that includes fresh fruits, veggies, whole grains, and low fat dairy products
• limit alcohol consumption
• quit smoking if you smoke
• stay as physically active as possible
• maintain a moderate weight

If you need help developing and maintaining a diet, reach out to a PHMP Health Coach by emailing coaches@thephmp.com or calling 1-855-498-4643. For a starter, you can also check out our three-part series The Mega Superduper Ultimate List of Low-Calorie Snacks.

Dialysis and kidney disease

Dialysis is an artificial method of filtering the blood. It’s used when the kidneys have failed or are close to failing. Many people with late-stage kidney disease must go on dialysis permanently or until a donor kidney is found.

There are two types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis

• In hemodialysis, the blood is pumped through a special machine that filters out waste products and fluid
• Hemodialysis is done at your home or in a hospital or dialysis center
• Most people have three sessions per week, with each session lasting 3 to 5 hours
• However, hemodialysis can also be done in shorter, more frequent sessions

Several weeks before starting hemodialysis, most people will have surgery to create an arteriovenous (AV) fistula. An AV fistula is created by connecting an artery and a vein just below the skin, typically in the forearm. The larger blood vessel allows an increased amount of blood to flow continuously through the body during hemodialysis treatment.

This means more blood can be filtered and purified. An arteriovenous graft (a looped, plastic tube) may be implanted and used for the same purpose if an artery and vein cannot be joined together.

The most common side effects of hemodialysis are

• low blood pressure
• muscle cramping
• itching

Peritoneal dialysis

• In peritoneal dialysis, the peritoneum (membrane that lines the abdominal wall) stands in for the kidneys
• A tube is implanted and used to fill the abdomen with a fluid called dialysate
• Waste products in the blood flow from the peritoneum into the dialysate
• The dialysate is then drained from the abdomen

There are two forms of peritoneal dialysis: continuous ambulatory peritoneal dialysis, where the abdomen is filled and drained several times during the day, and continuous cycler-assisted peritoneal dialysis, which uses a machine to cycle the fluid in and out of the abdomen at night while the person sleeps.

The most common side effects of peritoneal dialysis are infections in the abdominal cavity or in the area where the tube was implanted.

Other side effects may include weight gain and hernias. A hernia is when the intestine pushes through a weak spot or tear in the lower abdominal wall.

What is the long-term outlook for someone with kidney disease?

Kidney disease normally does not go away once it’s diagnosed. The best way to maintain kidney health is to adopt a lifestyle with health-promoting benefits and follow your doctor’s advice. Kidney disease can get worse over time. It may even lead to kidney failure.

Kidney failure can be life threatening if left untreated.

Kidney failure occurs when your kidneys are barely working or not working at all. Dialysis is an artificial process to manage the function of the kidneys. Dialysis involves the use of a machine to filter waste from your blood. In some cases, your doctor may recommend a kidney transplant.

How can kidney disease be prevented?

Some non-modifiable risk factors for kidney disease — such as age or family history — cannot be controlled. Also, you cannot control ethnicity, which research shows can be an indicator that you’re at higher risk of developing kidney disease.

However, there are measures you can take to help prevent kidney disease:

• drink plenty of water
• manage your blood sugar if you have diabetes
• manage your blood pressure
• reduce salt intake
• quit smoking if you smoke

Be careful with over-the-counter drugs

You should always follow the dosage instructions for over-the-counter medications. Taking too much aspirin (Bayer) or ibuprofen (Advil, Motrin) can cause kidney damage. Call your doctor if the normal doses of these medications are not managing your pain effectively.

Get tested

Ask your doctor about getting a blood test for kidney problems.

• Kidney problems generally don’t cause symptoms until they’re more advanced
• A basic metabolic panel (BMP) is a standard blood test that can be done as part of a routine medical exam

BMPs check your blood for creatinine or urea. These are chemicals that leak into the blood when the kidneys are not working properly. A BMP can detect kidney problems early, which is when they’re easier to treat.

You should be tested annually if you have:

• diabetes
• heart disease
• high blood pressure
• Limit certain foods

Different chemicals in your food can contribute to certain types of kidney stones. These include:

• excessive sodium
• animal protein, such as
• beef
• chicken
• citric acid, found in citrus fruits such as
• oranges
• lemons
• grapefruits
• oxalate, a chemical found in
• beets
• spinach
• sweet potatoes
• chocolate

Ask about calcium

Talk with your doctor before taking a calcium supplement. Some calcium supplements have been linked to an increased risk of kidney stones.

This article was brought to you by the Proactive Health Management Plan in partnership with Healthline.