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Chronic kidney disease

  • Alternative Names

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure


    Treatment

    Controlling blood pressure is the key to delaying further kidney damage.

    • Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often.
    • The goal is to keep blood pressure at or below 130/80 mmHg

    Other tips for protecting the kdineys and preventing heart disease and stroke:

    • Do not smoke.
    • Eat meals that are low in fat and cholesterol
    • Get regular exercise (talk to your doctor or nurse before starting).
    • Take drugs to lower your cholesterol, if necessary.
    • Keep your blood sugar under control.

    Always talk to your kidney doctor before taking any over-the-counter medicine, vitamin, or herbal supplement. Make sure all of the doctors you visit know you have chronic kidney disease.

    Other treatments may include:

    • Special medicines called phosphate binders, to help prevent phosphorous levels from becoming too high
    • Treatment for anemia, such as extra iron in the diet, iron pills, special shots of a medicine called erythropoietin, and blood transfusions
    • Extra calcium and vitamin D (always talk to your doctor before taking)

    You may need to make changes in your diet. See: Diet for chronic kidney disease for more details.

    • You may need to limit fluids.
    • Your health care provider may recommend a low-protein diet.
    • You may have to restrict salt, potassium, phosphorous, and other electrolytes.
    • It is important to get enough calories when you are losing weight.

    Different treatments are available for problems with sleep or restless leg syndrome.

    Everyone with chronic kidney disease should be up-to-date on important vaccinations, including:

    • Pneumococcal polysaccharide vaccine (PPV)
    • Influenza vaccine
    • H1N1 (swine flu) vaccine
    • Hepatitis B vaccine
    • Hepatitis A vaccine

    When loss of kidney function becomes more severe, you will need to prepare for dialysis or a kidney transplant.

    • When you start dialysis depends on different factors, including your lab test results, severity of symptoms, and readiness.
    • You should begin to prepare for dialysis before it is absolutely necessary. The preparation includes learning about dialysis and the types of dialysis therapies, and placement of a dialysis access.
    • Even those who are candidates for a kidney transplant will need dialysis while waiting for a kidney to become available.

    Support Groups

    See: Kidney disease - support group


    Expectations (prognosis)

    Many people are not diagnosed with chronic kidney disease until they have lost much of their kidney function.

    There is no cure for chronic kidney disease. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic kidney disease.


    Complications
    • Anemia
    • Bleeding from the stomach or intestines
    • Bone, joint, and muscle pain
    • Changes in blood sugar
    • Damage to nerves of the legs and arms (peripheral neuropathy)
    • Dementia
    • Fluid buildup around the lungs (pleural effusion)
    • Heart and blood vessel complications
      • Congestive heart failure
      • Coronary artery disease
      • High blood pressure
      • Pericarditis
      • Stroke
    • High phosphorous levels
    • High potassium levels
    • Hyperparathyroidism
    • Increased risk of infections
    • Liver damage or failure
    • Malnutrition
    • Miscarriages and infertility
    • Seizures
    • Weakening of the bones and increased risk of fractures