Treatment
Chronic Kidney Disease
Management of chronic kidney depends on
- how quickly it has developed
- the symptoms
- how reversible it is
- how treatable it is
- previous lifestyle and level of activity.
Chronic kidney (renal) failure is normally not reversible however factors may be addressed, in order to reduce the rate of decline in kidney function.
- Treat any reversible cause (relieve obstruction, stop drugs which damage the kidney such as non-steroidal anti inflammatories [NSAID’s]).
- Fluid restrictions, dependant on urine output.
- Monitor and treat hypertension (high blood pressure). Medications which may be used include ACE Inhibitors and Angiotensin 2 Receptor Blockers (ARB’s). The aim is for a target blood pressure of 140/90 for those with non- diabetic kidney disease, and 130/80 for diabetic kidney disease.
- Changes in diet, such as restriction of salt and phosphate, adequate intake of vitamins, iron and energy in the form of calories. Fat in the diet should be limited, to lower the level of triglyceride (fat) in the blood.
- Manage diabetes. Strict glycaemic (blood sugar) control delays the onset of damage and the progression of damage to the kidneys in patients with both Type1 and Type2 Diabetes.
- Smoking cessation: there is evidence that stopping smoking delays the progress in decline in kidney function.
- Lifelong Follow- up. Suggested follow-up frequency is:
- Yearly for Stages1 and 2 and 3A
- 6- monthly for Stages 3B and 4 (stable)
- 3- monthly for Stages 4 (progressive or newly- diagnosed), and Stage 5
(Joint Specialty Committee for Renal Disease of the Royal College of Physicians of London and the Renal Association)
Other factors in management:
- Anaemia can normally be treated with erythropoietin (a hormone). Erythropoietin is given via a subcutaneous injection [under the skin] 1 to 3 times weekly. Transfusions are less frequently used.
- Supplements of Vitamin D help prevent the bone condition renal osteodystrophy.
- Acidosis is treated with sodium bicarbonate and can be given during the dialysis process.
- Treat itching with antihistamines.
Renal Failure
For people in renal failure treatment will be either by dialysis or transplant.
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Amended April 2008
