Treatment of Chronic Kidney Failure

There is no cure for chronic kidney failure. However, there are measures you can take to slow its progression.
Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then removed from your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes, and wastes to build up in your body.
You might have few signs or symptoms in the early stages of chronic kidney disease. You might not realize that you have kidney disease until the condition is advanced.
Treatment for chronic kidney disease focuses on slowing the progression of kidney damage, usually by controlling the cause. But, even controlling the cause might not keep kidney damage from progressing. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Symptoms

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Loss of kidney function can cause a buildup of fluid body waste or electrolyte problems. Depending on how severe it is, loss of kidney function can cause:

• Nausea, Vomiting, loss of appetite, Fatigue, weakness, Sleep problems, Urinating more or less, Decreased mental sharpness, Muscle cramps, Swelling of feet and ankles, Dry and itchy skin, High blood pressure (hypertension) that’s difficult to control, Shortness of breath, if fluid builds up in the lungs, Chest pain if fluid builds up around the lining of the heart

Signs and symptoms of kidney disease are often nonspecific. This means other illnesses can also cause them. Because your kidneys can compensate for lost function, you might not develop signs and symptoms until irreversible damage occurs.

Risk factors

Factors that can increase your risk of chronic kidney disease include:

• Diabetes
• High blood pressure
• Heart (cardiovascular) disease
• Smoking
• Obesity
• Being Black, Native American, or Asian American
• Family history of kidney disease
• Abnormal kidney structure
• Older age
• Frequent use of medications that can damage the kidneys

Complications

Chronic kidney disease can affect almost every part of your body. Potential complications include:

• Fluid retention could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema)
• A sudden rise in potassium levels in your blood (hyperkalemia), could impair your heart’s function and can be life-threatening
• Anemia
• Heart disease
• Weak bones and an increased risk of bone fractures
• Decreased sex drive, erectile dysfunction, or reduced fertility
• Damage to your central nervous system, which can cause difficulty concentrating, personality changes, or seizures
• Decreased immune response, which makes you more vulnerable to infection
• Pericarditis is an inflammation of the saclike membrane that envelops your heart (pericardium)
• Pregnancy complications that carry risks for the mother and the developing fetus
• Irreversible damage to your kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

Prevention

To reduce your risk of developing kidney disease:

• Follow instructions on over-the-counter medications. Follow the instructions on the package when using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others), and acetaminophen (Tylenol, others). Taking too many pain relievers for a long time could lead to kidney damage.
• Maintain a healthy weight. If you’re at a healthy weight, maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss.
• Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting. Support groups, counseling, and medications can all help you to stop.
• Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.

Medication

Kidney failure is linked to high blood pressure, so your doctor may put you on blood pressure medication. You might also need medications called statins to lower your cholesterol level.
Often, people with chronic kidney failure experience anemia. Anemia occurs when your body doesn’t produce enough red blood cells. You may need a supplement to help increase your red blood cell production. Because your body needs iron to manufacture blood cells, your doctor might prescribe iron pills or shots. Sometimes, you may need a blood transfusion to improve your red blood cell health.
If your kidney problem is causing fluid retention, diuretics can help relieve your swelling. This medicine makes you urinate frequently.
Calcium and vitamin D supplements help to protect your bones. If you have chronic kidney disease, you will have lower-than-normal levels of Vitamin D, which is essential for calcium absorption. Taking Vitamin D will reduce your risk of bone fractures. Phosphate is elevated in kidney failure, which can also reduce your body’s calcium absorption. Your doctor may prescribe phosphate binders, a type of medicine to control your phosphate level.

1. Antihistamines can relieve the symptoms of itchy skin.

2. Antiemetics can help with nausea.

Diet

Dietary changes might also be necessary. People with chronic kidney failure usually need to reduce their protein intake. As your body processes protein, it creates waste products. Your kidneys are responsible for filtering this waste. A lower-protein diet makes their job easier.
You might also need to monitor your salt, potassium, and phosphate levels. Work with a dietitian to determine how much of these substances you should eat.
Get in the habit of reading labels. Even if you don’t add table salt, many prepared foods, such as canned soup or fast food, are already high in sodium.
Learn which foods are high in potassium and which are low. Your kidneys are responsible for filtering excess potassium out of your body. When they’re not functioning well, they won’t be able to filter potassium properly. In people with chronic kidney failure, high levels of potassium (hyperkalemia) can be life-threatening. It can lead to abnormal heart functioning or paralysis.
Your kidneys may not be able to process phosphate, either. Phosphate can also diminish your body’s ability to absorb calcium. High-phosphate foods include fish, dairy products, eggs, and meat. You may need to eat less of these.
You may also need to limit your fluids so your kidneys don’t have to work too hard.
People with chronic kidney failure often lose weight. Ensure you consume enough calories from foods your dietitian has approved and recommended.

Lifestyle

You should also avoid smoking and keep up to date on your vaccinations, including your flu shots. Discuss supplements and over-the-counter medications with your doctor before taking them. If you see other doctors for different conditions, always inform them of your kidney situation.

End-Stage Treatment

If attempts to control your condition through diet and medication fail, you might face end-stage kidney disease. This occurs when your kidneys operate at only 10 to 15 percent of their full capacity. At this stage, your kidneys can no longer eliminate waste as fast as you’re producing it.
There are two treatment options for end-stage kidney disease: dialysis and kidney transplant. Doctors try to postpone these options as long as possible because both carry serious risks.
Dialysis is a system for filtering waste products and excess fluids out of your blood. There are several ways to do this. The two main types of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, your blood is filtered outside your body in a machine. In peritoneal dialysis, you fill your abdominal cavity with a special solution via a catheter. The solution absorbs excess fluid and waste before draining your body. Because dialysis usually needs to be done several times a week, it’s a big lifestyle change. Dr. Hussain’s staff and nurses have a very robust teaching and training program in collaboration with professional companies to help educate and train patients needing any form of dialysis.
A kidney transplant is more convenient than dialysis if you can find an appropriate donor kidney. The donor needs to have the same blood type you. A kidney from a living sibling or other close relative is usually best. You could also get your kidney from a deceased donor. Dr. Hussain is also a fellowship-trained transplant nephrologist to care for his transplant patients.