Kidney Disease – Part III

This week we will continue our discussion about kidney disease.  We will talk today about how to prevent chronic kidney disease (CKD).  We will also talk about treatment options and how you can help to manage CKD to prevent progression to kidney failure.

What can you do to keep your kidneys healthy?

We talked last week about some of the causes of CKD.  Just a reminder, you are more likely to develop CKD if you have one or more of the following conditions:

• Diabetes
• High blood pressure 
• A family history of kidney disease 
• Heart disease

If those conditions can increase your risk of CKD, preventing the development of these conditions can help prevent CKD.  If you already have these conditions, managing them well and keeping blood sugar and blood pressure readings within the normal range will help prevent CKD. 

Here are some things that you can do to help prevent or manage health conditions that cause kidney damage.

• Include physical activity as part of your daily routine - Try to be physically active for at least 30 minutes most days.
• Aim for a healthy weight - Talk with your doctor or dietician about a healthy weight-loss plan if you are overweight.
• Be sure to get enough sleep on a regular basis - Sleep deprivation causes an imbalance in many hormones and has many other negative health effects.  You should be getting 7-8 hours of sleep each night.
• Stop smoking - Smoking damages your blood vessels, increases your risk of kidney cancer, along with a myriad of other cancers and other health problems.  
• Pay attention to over-the-counter (OTC) medications - OTC pain-relieving medications can lead to kidney damage or worsen CKD.  Don't go over the dosing recommendations on the bottle without talking to your doctor.  If you already have CKD, don't take these medications.
• Manage diabetes, high blood pressure, and heart disease - The best way to keep these conditions from causing kidney damage is to keep your blood sugar and blood pressure under good control, take all of your medications as your doctor prescribes them, and maintain regular follow up visits with your doctor.
• Be an active participant in your health care -Take an active part in managing your chronic health conditions by asking your doctor about the things we have talked about.  
• Make healthy food choices - A healthy diet is important to help prevent CKD and the chronic health conditions that increase the risk of CKD.  If you already have CKD, talk with a dietician about a healthy meal plan to limit the amount of salt, potassium, and protein in your diet.

How is CKD treated?

If you already have CKD, there is no cure for it, but there are treatments that can slow or sometimes stop the progression.  There are also treatments to control the symptoms of CKD.  Here are some of the treatments your doctor might suggest:

• Treating the underlying cause - such as diabetes, high blood pressure, etc.
• Certain high blood pressure medications - Medications called ACE inhibitors can preserve kidney function, even if you do not have high blood pressure.
• Diuretics - can help to maintain the balance of fluids in your body.
• Medications to treat anemia - Can aid in the production of red blood cells.
• Medications to protect your bones - Calcium and vitamin D supplements may be recommended to prevent your bones from getting weaker.  
• Medications to bind phosphate -Phosphate binders lower phosphate levels in your blood (which can be too high in CKD).  This protects your blood vessels from damage.
• A lower protein diet - This can reduce the amount of work your kidneys must do.
• Regular monitoring - Your doctor will also want to test your kidney function at regular intervals to see if it is staying stable or progressing.

What if your CKD progresses to end-stage kidney (renal) disease (ESRD)?

If your kidneys cannot keep up with waste removal and fluid balance, this means you have developed ESRD or kidney failure.  At that point, you will need to have one of these two treatments:

• Dialysis - filters your blood and removes waste products and extra fluid.  There are two types.
  • Hemodialysis - A machine filters your blood to remove the extra waste and fluids. 
  • Peritoneal dialysis - Dialysis solution goes into the abdomen and absorbs waste and excess fluids then is drained from the body carrying the waste with it.
• Kidney Transplant - A healthy kidney from a donor is surgically placed into your body.  

Next week, we will have a guest Health Tip from one of our dieticians to discuss dietary considerations related to chronic kidney disease.  

If you want to read more about CKD, try these links below.  

Chronic kidney disease - Symptoms and causes - Mayo Clinic

Keeping Kidneys Safe: Smart Choices about Medicines | NIDDK (nih.gov)

Mineral & Bone Disorder in Chronic Kidney Disease | NIDDK (nih.gov)

If you have any questions about kidney disease, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor