Photo: Anna Shvets

Can a damage kidney heal?

There's no cure for chronic kidney disease (CKD), but treatment can help relieve the symptoms and stop it getting worse. Your treatment will depend on the stage of your CKD. The main treatments are: lifestyle changes – to help you stay as healthy as possible.

nhs.uk - Chronic kidney disease - Treatment - NHS

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Your treatment will depend on the stage of your CKD.

There's no cure for chronic kidney disease (CKD), but treatment can help relieve the symptoms and stop it getting worse. Find out more about living with CKD and what you can do to stay healthy.

The following lifestyle measures are usually recommended for people with kidney disease:

Medicine

There's no medicine specifically for CKD, but medicine can help control many of the problems that cause the condition and the complications that can happen as a result of it. You may need to take medicine to treat or prevent the different problems caused by CKD.

High blood pressure

Good control of blood pressure is vital to protect the kidneys.

People with kidney disease should usually aim to get their blood pressure down to below 140/90mmHg, but you should aim to get it down to below 130/80mmHg if you also have diabetes. There are many types of blood pressure medicines, but medicines called angiotensin converting enzyme (ACE) inhibitors are often used. Examples include ramipril, enalapril and lisinopril.

Side effects of ACE inhibitors can include:

a persistent dry cough

dizziness

tiredness or weakness

headaches

If the side effects of ACE inhibitors are particularly troublesome, you can be given a medicine called an angiotensin-II receptor blocker (ARB) instead.

Find out more about how high blood pressure is treated.

Diabetes or high ACR

If you also have type 2 diabetes or a high albumin to creatinine ratio (ACR) you may be offered a medicine called dapagliflozin, as well as medicines for high blood pressure. Dapagliflozin helps to lower your blood sugar and can reduce damage to your kidneys.

High cholesterol

People with CKD have a higher risk of cardiovascular disease, including heart attack and stroke. This is because some of the causes of kidney disease are the same as those for cardiovascular disease, including high blood pressure and high cholesterol. You may be prescribed medicines called statins to reduce your risk of developing cardiovascular disease. Examples include atorvastatin and simvastatin.

Side effects of statins can include:

headaches

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feeling sick

constipation or diarrhoea

muscle and joint pain

Find out more about how high cholesterol is treated.

High potassium levels

People with CKD can develop high potassium levels in their blood, called hyperkalaemia, because their kidneys do not work properly. Hyperkalaemia can cause muscle weakness, stiffness and tiredness. If it becomes severe, it can cause an irregular heartbeat (arrhythmia) which can lead to a heart attack. If you have CKD, it's important to avoid taking potassium supplements and some medicines used to treat high blood pressure and heart failure because they can make your potassium levels too high. Talk to a GP about the medicines you take if you're worried. A medicine called sodium zirconium cyclosilicate can be used to treat hyperkalaemia in adults, but only if it's used:

in emergency care for acute life-threatening hyperkalaemia alongside standard care

in people with hyperkalaemia that does not get better, CKD stage 3b to 5, or heart failure People with hyperkalaemia that does not get better (called persistent CKD) who also have CKD stage 3b to 5, or heart failure, should only take sodium zirconium cyclosilicate if they:

have a serum potassium level of at least 6.0 mmol/litre and

are not also taking a certain amount of renin-angiotensin-aldosterone system (RAAS) inhibitor because of hyperkalaemia and

are not on dialysis

You should stop taking sodium zirconium cyclosilicate if RAAS inhibitors are no longer suitable for you.

Water retention

You may get swelling in your ankles, feet and hands if you have kidney disease. This is because your kidneys are not as effective at removing fluid from your blood, causing it to build up in body tissues (oedema). You may be advised to reduce your daily salt and fluid intake, including fluids in food such as soups and yoghurts, to help reduce the swelling. In some cases you may also be given diuretics (tablets to help you pee more), such as furosemide. Side effects of diuretics can include dehydration and reduced levels of sodium and potassium in the blood.

Anaemia

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Many people with advanced-stage CKD develop anaemia, which is a lack of red blood cells.

Symptoms of anaemia include:

tiredness

lack of energy

shortness of breath

a pounding, fluttering or irregular heartbeat (palpitations)

If you have anaemia, you may be given injections of a medicine called erythropoietin. This is a hormone that helps your body produce more red blood cells. If you have an iron deficiency as well, iron supplements may also be recommended.

Find out more about how iron deficiency anaemia is treated.

Want to know more?

National Institute for Health and Care Excellence (NICE): treating anaemia in people with chronic kidney disease

Bone problems

If your kidneys are severely damaged, you can get a build-up of phosphate in your body because your kidneys cannot get rid of it. Along with calcium, phosphate is important for maintaining healthy bones. But if your phosphate level rises too much, it can upset the balance of calcium in your body and lead to thinning of the bones. You may be advised to limit the amount food you eat which are high in phosphate, such as red meat, dairy products, eggs and fish. If this does not lower your phosphate level enough, you may be given medicines called phosphate binders. Commonly used medicines include calcium acetate and calcium carbonate. Some people with CKD also have low levels of vitamin D, which is necessary for healthy bones. If you're low in vitamin D, you may be given a supplement called colecalciferol or ergocalciferol to boost your vitamin D level.

Glomerulonephritis

Kidney disease can be caused by inflammation of the filters inside the kidneys, known as glomerulonephritis. In some cases this happens as a result of the immune system mistakenly attacking the kidneys. If a kidney biopsy finds this is the cause of your kidney problems, you may be prescribed medicine to reduce the activity of your immune system, such as a steroid or a medicine called cyclophosphamide.

Want to know more?

nhs.uk - Chronic kidney disease - Treatment - NHS

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