Every year, World Kidney Day is observed on March 9 to raise awareness about the importance of kidney health and to spread information about the prevention and treatment of kidney diseases. Chronic kidney disease (CKD) is a serious health issue affecting millions of people worldwide.
Dr. Vishwanath S, HOD & Consultant – Nephrology, Transplant Physician, Manipal Hospital Old Airport Road, says, “Kidney disease is a condition that impairs the kidneys’ ability to properly function. When the kidneys start to fail, waste products and excess fluids can build up in the body, leading to serious health problems.”
In the initial stages of kidney disease, there are measures that can be taken to prevent further damage or halt progression. For example, maintaining good blood sugar control for those with diabetes, strict blood pressure control to keep readings under 130/80 mmHg, lifestyle modifications like quitting smoking, weight reduction for those who are obese, reducing salt intake, and avoiding over-the-counter medications that may be harmful to the kidneys.
While prevention of kidney disease is always the first priority, there are several treatments available for the management of CKD.
If you choose not to go through dialysis, there are other treatment options that can help you cope with symptoms. “You can decide to manage kidney failure through dialysis, get a kidney transplant, or do nothing at all. Conservative kidney failure treatment means your healthcare team continues to manage you without dialysis or a kidney transplant,” says Dr. A Santosh Kumar, Senior Nephrologist, Kamineni Hospitals, Hyderabad.
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The treatment of the primary disease is essential for the management of CKD. If diabetes, hypertension, or an autoimmune disease is the cause of CKD, it must be controlled to prevent further damage to the kidneys. In the later stages of CKD, when the kidneys’ ability to filter blood drops to less than 10%, patients require haemodialysis to maintain their health until a kidney transplant is available.
Patients with CKD can benefit from several treatments that help reduce the toxins in their blood, maintain hemoglobin levels, keep bones strong, and reduce phosphorus and parathyroid hormone levels. “Alpha-keto analogues and modified prebiotics can be used to reduce toxins in the blood through the intestinal tract. Sodium bicarbonate tablets can be taken to neutralize the acid produced in the body,” adds Dr Kumar.
Maintaining haemoglobin levels is essential for patients with CKD, and iron injections and erythropoietin can be used to help increase haemoglobin levels. “Patients can also take vitamin D supplements and calcium to keep their bones strong, reduce phosphorous levels, and lower parathyroid hormone levels. Phosphate binders and activated vitamin D3 can be used to further reduce phosphorus and parathyroid hormone levels,” believes Dr Kumar.
“For people with diabetes and proteinuria or most types of chronic kidney disease, special medications like ACE inhibitors or ARBs can be used to prevent further damage. Newer drugs like SGLT2 inhibitors and Finerenone have been shown to prevent the need for dialysis and kidney failure,” adds Dr. Vishwanath S. Stem cell therapy and bio-artificial kidney are still in the research stages and are not yet available for widespread use.
Usually, dialysis (haemodialysis or peritoneal dialysis) or kidney transplantation are the available options to replace kidney function when both kidneys have failed more than 90%. Kidney transplantation is often considered the best option as it can provide a better quality of life and longer survival compared to dialysis.
The decision to undergo any of these treatments depends on the individual’s specific kidney condition, the severity of the disease, and the patient’s overall health. A kidney transplant may be recommended for people with end-stage renal disease, while medications or dietary changes may be sufficient for people with early-stage kidney disease.
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