Your treatment will depend on how severe your kidney disease is.
The main treatments are:
lifestyle changes to ensure you remain as healthy as possible
medication to control associated problems such as high blood pressure, high cholesterol and any other underlying causes and contributing factors
dialysis – treatment to replicate some of the kidney's functions; this may be necessary in advanced chronic kidney disease
kidney transplant – this may also be necessary in advanced chronic kidney disease
You'll also be advised to have regular check-ups to monitor your condition.
This is the removal of waste products and excessive fluids from blood when the kidneys cannot do the job properly any more. Dialysis has some serious risks, including infection.
There are two main types of kidney dialysis. Each type also has subtypes. The two main types are:
Hemodialysis: Blood is pumped out of the patient's body and goes through a dialyzer (an artificial kidney). The patient undergoes hemodialysis about three times per week. Each session lasts for at least 3 hours.
Experts now recognize that more frequent sessions result in a better quality of life for the patient, but modern home-use dialysis machines are making this more regular use of hemodialysis possible.
Peritoneal dialysis: The blood is filtered in the patient's own abdomen; in the peritoneal cavity which contains a vast network of tiny blood vessels. A catheter is implanted into the abdomen, into which a dialysis solution is infused and drained out for as long as is necessary to remove waste and excess fluid.
A kidney transplant is a better option than dialysis for patients who have no other conditions apart from kidney failure. Even so, candidates for kidney transplant will have to undergo dialysis until they receive a new kidney.
The kidney donor and recipient should have the same blood type, cell-surface proteins and antibodies, in order to minimize the risk of rejection of the new kidney.
However, not everyone is a candidate for a kidney transplant. People need to undergo extensive testing to ensure their suitability for transplantation. Also, there is a shortage of organs for transplantation, requiring waiting times of months to years before getting a transplant.
A person who needs a kidney transplant undergoes several tests to identify characteristics of his or her immune system. Transplants from a living related donor generally have the best results.
If a living donor is not possible, the search will begin for a cadaver donor (dead person).
Transplant surgery is a major procedure and generally requires 4 to 7 days in the hospital. All transplant recipients require lifelong immunosuppressant medications to prevent their bodies from rejecting the new kidney. Immunosuppressant medications require careful monitoring of blood levels and increase the risk of infection as well as some types of cancer.
You'll be offered supportive treatment if you decide not to have dialysis or a transplant for kidney failure, or they're not suitable for you. This is also called palliative or conservative care.
The aim is to treat and control the symptoms of kidney failure. It includes medical, psychological and practical care for both the person with kidney failure and their family, including discussion about how you feel and planning for the end of life.
Many people choose supportive treatment because they:
are unlikely to benefit from or have a good quality of life with treatment
don't want to go through the inconvenience of treatment with dialysis
are advised against dialysis because they have other serious illnesses, and the negative aspects of treatment outweigh any likely benefits
have been on dialysis, but have decided to stop this treatment
are being treated with dialysis, but have another serious illness, such as severe heart disease or stroke, that will shorten their life
If you choose to have supportive treatment, your kidney unit will still look after you. Supportive care can still allow you to live for some time with a good quality of life.
Doctors and nurses will make sure you receive:
medicines to protect your remaining kidney function for as long as possible
medicines to treat other symptoms of kidney failure, such as feeling out of breath, anaemia, loss of appetite or itchy skin
help to plan your home and money affairs
The following lifestyle measures are usually recommended for people with kidney disease:
stop smoking if you smoke
eat a healthy, balanced diet
restrict your salt intake to less than 6g (0.2oz) a day
do regular exercise – aim to do at least 150 minutes a week
moderate your alcohol intake so it's within the recommended limits of no more than 14 alcohol units a week
lose weight if you're overweight or obese
avoid over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, except when advised to by a medical professional – these medicines can harm your kidneys if you have kidney disease
Kidney disease can put a significant strain on your body and make you more vulnerable to infections.
Preventing Kidney Failure
Kidney failure cannot be prevented in most situations. The patient may be able to protect their kidneys from damage, or slow the progression of the disease by controlling their underlying conditions such as diabetes mellitus and high blood pressure.
There are steps you can take to reduce your risk of kidney failure:
Follow directions when taking over-the-counter medications. Taking doses that are too high (even of common drugs such as aspirin) can create high toxin levels in a short amount of time. This can overload your kidneys.
Whenever possible, you should limit your exposure to chemicals, such as household cleaners, tobacco, pesticides, and other toxic products.
Many kidney or urinary tract conditions lead to kidney failure when they’re not managed properly. Follow your doctor’s advice, always take prescribed medicine as directed, and maintain a healthy lifestyle.
Healthy lifestyle choices to keep your kidneys functioning well include:
Eat lots of fruit and vegetables including legumes (peas or beans) and grain-based food such as bread, pasta, noodles and rice.
Eat lean meat such as chicken and fish each week.
Eat only small amounts of salty or fatty food.
Drink plenty of water instead of other drinks. Minimise consumption of sugary soft drinks.
Maintain a healthy weight.
Stay fit. Do at least 30 minutes of physical activity that increases your heart rate on five or more days of the week, including walking, lawn mowing, bike riding, swimming or gentle aerobics.
If you don’t smoke, don’t start. If you do, quit.
Limit your alcohol to no more than two small drinks per day if you are male, or one small drink per day if you are female.
Have your blood pressure checked regularly.
Do things that help you relax and reduce your stress levels.
The natural course of chronic kidney disease is to progress until dialysis or transplant is required.
Chronic kidney disease can range from a mild condition with no or few symptoms, to a very serious condition where the kidneys stop working.
Most people with chronic kidney disease will be able to control their condition with medication and regular check-ups. Chronic kidney disease only progresses to kidney failure in around 1 in 50 people with the condition.
The elderly and those who have diabetes have worse outcomes.
But if you have chronic kidney disease, even if it's mild, you're at an increased risk of developing other serious problems, such as cardiovascular disease. This is a group of conditions affecting the heart and blood vessels, which includes heart attacks and strokes.
Cardiovascular disease is one of the main causes of death in people with kidney disease, although healthy lifestyle changes and medication can help reduce your risk of developing it.