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Treatments and drugs
By Mayo Clinic staff
Chronic kidney failure has no cure, but treatment can help control signs and symptoms, 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 reverse the disease or condition that's causing your kidney failure. Treatment options vary depending on the cause of your kidney failure.
Stopping the underlying condition may slow kidney damage, but sometimes kidney failure worsens despite treatment. Damage to the kidneys can cause stress on the kidneys that continues 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:
- Treatment to control high blood pressure. 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, 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 to induce production of more red blood cells. This may help relieve the fatigue and weakness that's associated with anemia.
- Medications to relieve swelling. People with chronic kidney failure may retain fluids. This can lead to swelling in your 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. You may also take a phosphate-binding medication to lower the amount of phosphate in your blood. Lowering phosphate will increase the amount of calcium available for your bones so that they don't become weak and vulnerable to fracture.
- A low-protein diet to minimize waste products in your blood. As your body processes the proteins in the foods you eat, 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 a low-protein diet. Your doctor may ask you to meet with a dietitian who can help you assess how much protein you eat each day and suggest ways to lower your protein intake while still eating a healthy diet.
Treatment for end-stage kidney disease
If kidney damage continues to progress to the point where your kidneys are functioning at less than 15 percent of capacity, you have end-stage kidney disease. Your kidneys are no longer able to keep up with waste and fluid clearance on their own. Soon, dialysis or a kidney transplant becomes the only option to support life.
- Dialysis. Dialysis is an artificial means of removing waste products and extra fluid from your blood when your kidneys aren't able to perform these functions. There are two types of dialysis. In hemodialysis, blood is pumped out of your body to a machine that works like an artificial kidney, filtering waste out of your blood. The blood is then pumped back into your body. Another type of dialysis, called peritoneal dialysis, involves pumping a dialysis solution into your abdominal cavity. Peritoneal dialysis relies on your body's network of tiny blood vessels to carry waste products and excess fluids to your abdominal cavity where the dialysis solution absorbs them. The dialysis solution is then pumped out of your body, carrying the waste and excess fluids with it.
- 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 inside your body. Transplanted kidneys can come from deceased donors or from living donors.
- Mitch WE. Chronic kidney disease. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders; 2007. http://www.mdconsult.com/das/book/body/192064788-4/0/1492/0.html. Accessed March 30, 2010.
- Ferri FF. Renal failure, chronic. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby; 2009. http://www.mdconsult.com/das/book/body/192064788-4/0/2088/0.html. Accessed March 30, 2010.
- Wolfson AB. Renal failure. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniq=193452254. Accessed March 30, 2010.
- Kraut JA. Chronic renal failure. In: Bope ET, et al. Conn's Current Therapy 2010. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-1-4160-6642-2..C2009-0-38983-7--TOP&isbn=978-1-4160-6642-2&uniq=192064788. Accessed March 30, 2010.
- About chronic kidney disease: A guide for patients and their families. National Kidney Foundation. http://www.kidney.org/atoz/atozcopy.cfm?pdflink=11-50-0160_JAI_PatBro_AboutCKDv2lr.pdf. Accessed April 5, 2010.
- Coping effectively: A guide for patients and their families. National Kidney Foundation. http://www.kidney.org/atoz/atozcopy.cfm?pdflink=coping.pdf. Accessed April 5, 2010.
- Kidney failure: Choosing a treatment that's right for you. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/choosingtreatment/index.htm. Accessed March 30, 2010.
- Chronic kidney disease stage 5 nutrition therapy for people not on dialysis. ADA Nutrition Care Manual. http://nutritioncaremanual.org/vault/editor/Docs/ChronicKidneyDiseaseNutritionTherapyNo%20Dialysis_FINAL.pdf. Accessed April 6, 2010.
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