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CKD

 

Chronic Kidney Disease


 

Treating any underlying kidney condition

There are various conditions that can cause CKD. For some of these there may be specific treatments for that particular condition - for example:

Preventing or slowing down the progression of CKD

Once CKD has developed, in many cases it tends gradually to become worse over months or years. This can occur even if an underlying cause has been treated. You should have checks every now and then by your GP or practice nurse to monitor your kidney function - the estimated glomerular filtration rate (eGFR) test. They will also give you treatment and advice on how to prevent or slow down the progression of CKD. This usually includes:

Reducing the risk of developing CVD

People with CKD have an increased risk of developing cardiovascular diseases, such as heart disease, stroke, and peripheral arterial disease. People with CKD are actually twenty times more likely to die from cardiovascular-related problems than from kidney failure. This is why reducing any other cardiovascular risk factors is so important. See separate leaflet called Preventing Cardiovascular Diseases for details. Briefly, this typically includes:

If you have high levels of protein in your urine then you may be advised to take medication even if your blood pressure is normal. A type of medication called an angiotensin-converting enzyme (ACE) inhibitor (for example, captopril, enalapril, ramipril, lisinopril) has been shown to be beneficial for some people with CKD, as it reduces the risk of cardiovascular disease and can prevent further worsening of the function of your kidneys.

Relieving symptoms and problems caused by CKD

If CKD becomes severe you may need treatment to combat various problems caused by the poor kidney function. For example:

If end-stage kidney failure develops, you are likely to need kidney dialysis or a kidney transplant to survive.

People with stage 3 CKD or worse should be immunised against influenza each year, and have a one-off immunisation against pneumococcus. People with stage 4 CKD should be immunised against hepatitis B.

What is the outlook (prognosis)?

Stages 1-3 CKD (mild-to-moderate) are common, with most cases occurring in older people. It tends to become gradually worse over months or years. However, the rate of progression varies from case to case, and often depends on the severity of any underlying condition. For example, some kidney conditions may cause your kidney function to become worse relatively quickly. However, in most cases, CKD progresses only very slowly. Only a small number of people with CKD progress to end-stage kidney failure (stage 5 CKD) that requires kidney dialysis or kidney transplant.

For many people with CKD there is a much higher risk of developing serious CVD than of developing end-stage kidney failure.

In short, the following can make a big difference to your outlook: