What Is the Best Kidney Disease Treatment?

Chronic kidney disease is divided into five stages. The stages vary depending on how much damage your kidneys have suffered and how well they function. For example, stage one can be mild enough that it doesn't affect your kidney's functioning at all. It can, however, get worse if left untreated.

Here are the five stages of kidney disease:

• Stage 1: Normal kidney function; mild damage
• Stage 2: Moderate kidney function; mild damage
• Stage 3:
  • Stage 3a: Reduced kidney function; mild-to-moderate damage
  • Stage 3b: Significant reduction in kidney function; moderate-to-severe damage
• Stage 4: Poor kidney function; severe damage
• Stage 5: Kidney failure

Depending on the stage of chronic kidney disease (CKD), five primary treatments include the following:

1. Lifestyle changes
   • The recommended lifestyle measures and preventive strategies for people with kidney disease include the following:
     • Eat a healthy, nutritious, and well-balanced diet.
     • Quit smoking.
     • Limit or quit alcohol consumption.
     • Restrict salt intake to less than 6 grams a day (about 1 teaspoon).
     • Exercise regularly (aim at least 150 minutes a week).
     • Lose weight if you are obese or overweight.
     • Avoid over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen, except when advised by a medical professional.
   • A renal diet is low in sodium, protein, potassium, purines, and phosphate.
2. Medications
   • Medications can help control associated problems such as high blood pressure and high cholesterol and prevent complications.
     • Hypertension (high blood pressure):
     • People with CKD should aim to get their blood pressure below 140/90 mmHg.
     • Blood pressure medicines that are often used include the following:
       • Angiotensin-converting enzyme inhibitors
         • Captopril 
         • Enalapril 
         • Fosinopril
         • Lisinopril 
         • Ramipril 
       • Angiotensin receptor blockers lower blood pressure by widening blood vessels
         • Azilsartan 
         • Eprosartan
         • Irbesartan 
         • Losartan 
         • Olmesartan 
         • Valsartan 
       • Beta-blockers lower blood pressure by blocking the hormone adrenaline
   • Diabetes:
     • Diabetes is the most common cause of CKD and is treated by different medicines that lower blood sugar and insulin shots.
   • High cholesterol:
     • People with CKD have a high risk of cardiovascular disease, including heart attack and stroke.
     • The most commonly prescribed medicines are statins, which help reduce the risk of cardiovascular disease (atorvastatin and simvastatin).
   • Water retention:
     • During CKD, the kidneys become ineffective at excreting fluid from the blood, causing edema (an accumulation in the body tissues).
     • In most cases, diuretics (water pills) are prescribed (furosemide).
     • In addition, you may be advised to reduce daily salt and fluid intake, including foods such as soups and yogurts to help reduce the swelling.
   • Anemia:
     • Many people with advanced-stage CKD develop anemia https://www.nhs.uk/conditions/iron-deficiency-anaemia/, a lack of red blood cells.
     • The treatment of anemia includes injections of a medicine called erythropoietin, a hormone that helps the body produce more red blood cells.
     • In cases of iron deficiency, iron supplements may also be recommended.
   • Bone problems:
     • Severely damaged kidneys cannot effectively excrete phosphates, leading to their accumulation in the body.
     • Phosphate is crucial for maintaining healthy bones, but if the phosphate level increases too much, it can upset the balance of calcium in the body and lead to thinning of the bones.
     • In such cases, medicines known as phosphate binders are prescribed (calcium acetate and calcium carbonate).
     • Some people with CKD are low in vitamin D. To treat this, a supplement of cholecalciferol or ergocalciferol is given to boost vitamin D levels.
     • Moreover, people are advised to limit the amount of food high in phosphates, such as red meat, dairy products, eggs, and fish.
   • Glomerulonephritis:
     • CKD can be caused by inflammation of the filters inside the kidneys, known as glomerulonephritis.
     • This condition can be caused by the immune system mistakenly attacking the kidneys.
     • The most commonly prescribed medicine to reduce the activity of the immune system includes a steroid (cyclophosphamide).
3. Dialysis
   • Over time, for some people with CKD, the kidneys will eventually stop working.
   • This stage of CKD requires dialysis, a method of removing waste products and excess fluid from the blood.
   • The two main types of dialysis include the following:
     • Hemodialysis: Involves diverting blood into an external machine, where it is filtered before being returned to the body and performed about three times a week.
     • Peritoneal dialysis: Involves pumping dialysis fluid into space inside the abdomen to draw out waste products from the blood and is performed several times a day or overnight.
4. Kidney transplantation
   • For people with severely reduced kidney function, a kidney transplant is an alternative to dialysis.
   • It is the most effective treatment of advanced kidney disease, but it involves major surgery and taking medicines (immunosuppressants) for the rest of your life.
   • Approximately 90% of transplants function at least for 5 years.
5. Palliative or conservative care
   • In rare instances, if the person with kidney failure is not a suitable candidate for dialysis or transplant, the only option left is supportive treatment.
   • This treatment aims to treat and control the symptoms of kidney failure, provides a better quality of life, and includes medical, psychological, and practical care for both the person with kidney failure and their family.