Chronic kidney disease, also known as CKD, is a long-term condition in which the kidneys do not work as they should. This condition most commonly affects the elderly as it can be linked to the ageing process. However, you can develop the condition at any age. For information about other conditions that commonly affect the elderly, you can see our guide to the 20 most common.
In this article, we are going to focus on the common treatments available for chronic kidney disease. If you would like to learn more about kidney disease as a whole, then take a look at our in-depth article.
Can Chronic Kidney Disease be Treated?
There is currently no cure for chronic kidney disease, but there are options available to prevent the condition worsening and to relieve the uncomfortable symptoms. When you are diagnosed with the condition your medical professional will discuss the treatment options available with you. It is important to remember that while there a variety of treatments that can be used, each case is different.
The treatment you receive will rely mainly on the stage of your CKD. In the early stages of kidney disease, many people do not realise they have the condition. This is due to the lack of symptoms. The condition is often only picked up through routine blood or urine tests.
Lifestyle Changes and Medication
When you have CKD, it is recommended that you make healthy lifestyle changes to ensure you remain as healthy as possible. This includes the usual steps to a healthier lifestyle including:
- Quitting smoking
- Eating a healthy diet
- Exercising regularly
- Moderating alcohol intake
- Losing excess weight
A more specific important lifestyle factor with CKD is to avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) which can be bought over the counter. An example of this would be ibuprofen. This is because these medications can cause harm to the kidneys if you have kidney disease. There are no medications which directly treat CKD. However, you may be given medications to treat related conditions and to help relieve symptoms you may experience with this condition.
Blood Pressure Control
Having high blood pressure can cause further issues if you have CKD. Therefore, it is crucial that you have good control over your blood pressure if you have this condition. According to the NHS, people with kidney disease should usually aim to get their blood pressure down to below 140/90mmHg, but if you have diabetes you should aim to get it down to below 130/80mmHg. You may be given medication to treat your blood pressure if it is above the recommended level.
High Cholesterol
If you have CKD, it is thought that you may be at a higher risk of developing cardiovascular disease, which includes heart attacks. This, alongside CKD, can be caused by having high cholesterol. Therefore, your cholesterol should be checked when you are diagnosed with CKD, and your doctor may prescribe you medication to control your cholesterol known as a Statin.
Water Retention
Your kidneys are responsible for removing excess fluid from your body. However, when you have CKD your kidneys are not as effective at this. Due to this, you may experience swelling in your ankles, feet, and hands, known as oedema (a fluid build-up).
You can help to prevent this by reducing the amount of salt in your diet. There are also other treatments for this symptom in the form of medication prescribed by your doctor. This is called a diuretic medication, an example of this is Furosemide.
This will help to make you pass urine more frequently to reduce the excess water built up in your body. This medication can have side-effects such as dehydration, but your doctor should go through these with you and ensure you are monitored.
Anaemia
Another problem that you may develop as a result of CKD could be anaemia, which is the lack of red blood cells. This often happens at a later stage of kidney disease. This may make you feel tired and short of breath. The treatments to relieve this condition can vary, most commonly you will be given some form of an oral iron supplement. In some cases, you may be given a hormone injection of something called erythropoietin. This is a hormone that helps your body produce more red blood cells.
Bone Problems
According to Kidney Research UK, chronic kidney disease can affect the mineral balance in your bones which can cause them to become weaker and thinner. There are a few ways this can be managed and treated:
- Food – You may need to limit the amount of high phosphate foods in your diet, such as red meat and dairy. This is because high levels of phosphate can upset the bone’s mineral balance.
- Medication – If diet changes alone are not enough, you may be given medicine to take from a group called phosphate binders.
- Increasing vitamin D level – This would be a prescribed supplement. Vitamin D is crucial for bone health as it affects the vitamin balance of the bones. If you are having bone problems, you are likely to be prescribed a vitamin D supplement.
Treatment for Advanced Stage Chronic Kidney Disease
In a proportion of people living with CKD, as the condition advances, more invasive treatments may be required. This is because the condition can eventually get to the point where the kidneys stop working. Most of the time this will be a progressive change; it rarely happens suddenly, which means you should have time to discuss your options with your doctor about what the right choice is for you for the next stage of treatment.
Dialysis
This is a procedure in which waste products and excess fluids are removed from the blood through medical intervention. Your medical professional will discuss this with you as there are two main types of dialysis, each with different pros and cons. This is not a treatment that will be used in early stages of kidney disease, but it is essential to discuss with your health professionals to have a plan in place for when the condition progresses. Once you are in the advanced stages of CKD, unless you have a kidney transplant, dialysis will usually be a lifelong treatment.
The two types of dialysis:
- Haemodialysis – Blood is diverted into an external machine which filters out waste products and excess fluids then returns the blood to the body. This is generally done around three times per week and can be done at the hospital or at home. Although this depends very much on your personal circumstances as all CKD cases are different.
- Peritoneal dialysis – The blood is not pumped out of the body through an external machine. Instead, dialysis fluid is pumped into the space inside your tummy. This draws out waste products from the blood, which passes through the vessels that line the inside of your tummy. This type of dialysis is typically done at home, but it is done more frequently. Usually several times throughout the day or overnight.
As each case is different, you should always discuss this with your doctor as they will be able to give you information more specific to your situation.
Kidney Transplant
This is an alternative to life-long dialysis treatment for patients with severely reduced kidney function. It is thought to be the most effective treatment in most cases, as a successful transplant will mean you have a kidney which functions properly. According to the NHS, Kidney transplants have an excellent success rate in recent times due to advances in medicine. This means around 90% of transplants are still functioning after five years and many will work for 10 years or more.
However, there are downsides to this treatment, as having an organ transplant is a significant operation and like all operations, there are risks involved. Therefore, the procedure would only be used for advanced stages of CKD. After the transplant, you will also be on lifelong medication as you need to stop your immune system attacking the new donor organ. These medications are all immunosuppressants, and they can come with side effects.
Kidney transplants are vital, lifesaving treatments; however, as with all treatments for this condition it is dependent on your situation and the stage of your CKD. Another point to note is that unfortunately, there is a long transplant list, with a massive shortage of donors. This means you could potentially wait months or even sometimes years for the right donor.
Supportive Treatment
Some people may decide that they do not want to have dialysis or a kidney transplant when they are in the advanced stages of kidney disease. Or, in some cases, this may not be an option available to them. If this is the case, then supportive treatment will be offered to the person, which aims to control the symptoms and keep the person cared for medically, psychologically and practically. Often, as part of supportive treatment, you and your family will be offered support to start the discussion about planning for the end of life.
You may decide to choose supportive treatment for many reasons including:
- The inconvenience of dialysis
- Your quality of life without treatment outweighs the benefits of dialysis or a transplant
- You are unable to have dialysis because of other serious illnesses, or
- That you are having dialysis, but another serious illness will shorten your life
Regardless of the level of your CKD, or the treatments you choose to have, the kidney unit medical professionals will ensure that you are cared for and you have the best quality of life possible. Chronic kidney disease may be a long-term illness without a cure, but there are many treatment options and things that can be done to ensure you have relief of the symptoms and you can continue to live as full of a life as possible.
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Editor’s Note: This article was updated on 10th May 2022 to reflect current information.
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