Want to see your GP?
Call us now on 024 76 39 33 88
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:
Good blood sugar (glucose) control for people with diabetes.
Blood pressure control for people with high blood pressure.
Antibiotic medication for people with recurring kidney infections.
Surgery for people with a blockage to urine flow.
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:
Blood pressure control. The most important treatment to prevent or delay the progression of CKD, whatever the underlying cause, is to keep your blood pressure well controlled. Most people with CKD will require medication to control their blood pressure. Your doctor will give you a target blood pressure level to aim for. This is usually below 130/80 mm Hg, and even lower in some circumstances.
Review of your medication. Certain medicines can affect the kidneys as a side-effect which can make CKD worse. For example, if you have CKD you should not take anti-inflammatory medicines unless advised to by a doctor. You may also need to adjust the dose of certain medicines that you may take if your CKD gets worse.
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:
Good control of blood pressure (and blood glucose level if you have diabetes).
Medication to lower your cholesterol level (called statins), which is often given to people with CKD.
Where relevant, to tackle lifestyle risk factors. This means to:
Stop smoking if you smoke and cut back if you drink a lot of alcohol.
Eat a healthy diet which includes a low salt intake.
Keep your weight and waist in check.
Take regular physical activity.
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:
Anaemia may develop which may need treatment with iron or erythropoietin - a hormone normally made by the kidneys.
Abnormal levels of calcium or phosphate in the blood may need treatment.
You may be advised about how much fluid to drink, and how much salt to take.
Other dietary advice may be given which can help to control factors such as the level of calcium and potassium in your body.
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:
Attention to blood pressure control.
Careful review of medications to make sure that the only ones used are those which put least strain on kidneys.
Tackling factors that reduce your risk of developing cardiovascular diseases
© Copyright 2019 by Purple Prince Media Ltd All Rights Reserved.