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Treatments and drugs

By Mayo Clinic staff

Depending on the underlying cause, some types of chronic kidney failure can be treated. Often, though, chronic kidney failure has no cure. Treatment consists of measures to help control signs and symptoms of chronic kidney failure, reduce complications, and slow the progress of the disease. If your kidneys become severely damaged, you may need treatments for end-stage kidney disease.

Treating the cause of kidney failure
Your doctor will work to slow or control the disease or condition that's causing your kidney failure. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled.

Treating complications of kidney failure Kidney failure complications can be controlled to make you more comfortable. Treatments may include:

• High blood pressure medications. People with chronic kidney failure may experience worsening high blood pressure. Your doctor may recommend medications to lower your blood pressure — commonly angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers — and to preserve kidney function. High blood pressure medications can initially decrease kidney function and change electrolyte levels, so you may have frequent blood tests to monitor your condition. Your doctor will likely also recommend a low-salt diet.
• Medications to lower cholesterol levels. Your doctor may recommend medications, called statins, to lower your cholesterol. People with chronic kidney failure often experience high levels of bad cholesterol, which can increase the risk of heart disease.
• Medications to relieve anemia. In certain situations, your doctor may recommend supplements of the hormone erythropoietin (uh-rith-row-POY-uh-tin), sometimes with added iron. Erythropoietin supplements can induce production of more red blood cells, which may relieve fatigue and weakness associated with anemia.
• Medications to relieve swelling. People with chronic kidney failure may retain fluids. This can lead to swelling in the arms and legs, as well as high blood pressure. Medications called diuretics can help maintain the balance of fluids in your body.
• Medications to protect your bones. Your doctor may prescribe calcium and vitamin D supplements to prevent weak bones and lower your risk of fracture. You may also take medication to lower the amount of phosphate in your blood, which increases the amount of calcium available for your bones.
• A lower protein diet to minimize waste products in your blood. As your body processes protein from foods, it creates waste products that your kidneys must filter from your blood. To reduce the amount of work your kidneys must do, your doctor may recommend eating less protein. Your doctor may also ask you to meet with a dietitian who can suggest ways to lower your protein intake while still eating a healthy diet.

Treatment for end-stage kidney disease
If your kidneys can't keep up with waste and fluid clearance on their own and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, dialysis or a kidney transplant is needed.

• Dialysis. Dialysis artificially removes waste products and extra fluid from your blood when your kidneys aren't able to perform these functions. In hemodialysis, a machine filters waste and excess fluids from your blood. In peritoneal dialysis, you use a catheter to fill your abdominal cavity with a dialysis solution that absorbs waste and excess fluids — then this solution drains out of your body and is replaced with fresh solution.
• Kidney transplant. If you have no life-threatening medical conditions other than kidney failure, a kidney transplant may be an option for you. Kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased donors or from living donors.

If you're unwilling to have dialysis or a kidney transplant, a third option is to treat your kidney failure with conservative measures. However, your life expectancy generally would be only a few weeks in the case of complete kidney failure.

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• See Also

Hand Scheduled
Section Focus
• Kidney donation: Are there long-term risks?
• Kidney transplant
• Hemodialysis
• Peritoneal dialysis
• Kidney dialysis: When is it time to stop?

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