Health Tips

Kidneys are the main filtration system of our body – they get rid of our body wastes and fluids, while retaining nutrients for our body’s optimal functioning. Now, just imagine this crucial factory deteriorates or worse still—shut down in operation—what would that mean for our body?

This medical condition is known as the chronic kidney disease (CKD). It is a condition in which the kidneys lose some of their ability to remove waste products and excess fluid from the bloodstream. As waste products and fluids build up in the body, other body systems are affected, which can be harmful to your health.

If you would like to learn more about CKD, check out our article here. If you have diabetes and chronic kidney disease, our article here can give you more clarity on a subset of CKD known as diabetic kidney disease.

Photo by Robina Weermeijer on Unsplash

CKD cannot be cured, but it can be treated

Is it the end of the world if you have CKD? The good news is, it’s not. Although CKD cannot be cured completely, and your kidneys typically won’t improve in terms of their functions, its deterioration can be slowed down using medical treatment and lifestyle changes.

Treat the root cause

If your CKD is implicated by high blood pressure, it’s important that you strictly adhere to your blood pressure medications. Maintaining good blood pressure control is the most important goal for trying to slow the progression of CKD. Taking a medication called an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) reduces blood pressure and levels of protein in the urine and is thought to slow the progression of CKD to a greater extent than some of the other medicines used to treat high blood pressure. 

Examples of ACE inhibitors are:

• Perindopril

• Enalapril

• Lisinopril

Examples of ARB are:

• Losartan

• Valsartan

Monitoring your blood pressure at home consistently is also important to ensure your blood pressure is well-controlled.The same goes to diabetes: if your kidney is harmed because of your diabetes, it’s crucial for you to stick to your diabetes treatment so that you don’t lose your kidney functions.

Anemia

People with CKD are at risk for anemia. This occurs because improperly functioning kidneys produce less amounts of a substance called erythropoietin. Erythropoietin is a substance that stimulates the body to produce red blood cells. With a lesser amount of erythropoietin, there would be a lesser amount of red blood cells to transport oxygen around, which leads to anemia. Anemia can lead to fatigue and other complications. 

As a result, patients with CKD are often prescribed with a medication called erythropoietin-stimulating agent (ESA) injection at home, as well as taking iron supplements. In severe cases of anemia, iron IV therapy may be required, which typically takes place in hospital.

High blood phosphate

Phosphate is a mineral that helps to keep the bones healthy, but not the more the merrier. In CKD patients, due to the declining functions of the kidney, the body begins to retain phosphate. As the disease progresses, high blood phosphate levels can develop, thus leading to bone and muscle problems and increasing your risk for heart attacks and strokes.

Photo by Shelley Pauls on Unsplash

This is why CKD patients are also prescribed with a phosphate binder. Phosphate binders are medicines that prevent phosphate (found in foods) from being absorbed in the digestive tract. There are many types of phosphate binders, and calcium carbonate is the most readily available option. In order for the phosphate binders to work, these medicines must be taken or chewed with meals and snacks. The typical dose of calcium carbonate for the purpose of binding phosphate is maximum 2g per day. Your doctor might also recommend you eat foods that have low amounts of phosphate.

Vitamin D supplements

Having chronic kidney disease can lead to having low levels of calcium in the blood. This can cause bone problems. To help prevent bone problems, doctors sometimes prescribe vitamin D to patients with CKD. There are various types of vitamin D supplements, though. What CKD patients should take is a special version of vitamin D supplement known as calcitriol, which goes by the chemical name of 1,25-dihydroxyvitamin D. People with normally functioning kidneys have the ability to convert vitamin D from their diets or skin into calcitriol, an activated form of vitamin D (which is what you ultimately want). However, patients with CKD lose such ability, hence they need to take the activated form of vitamin D itself. The dose for calcitriol is typically 0.25mcg once daily.

Mikael Häggström, Public domain, via Wikimedia Commons

High blood cholesterol and triglycerides

High cholesterol and triglyceride levels are common in people with kidney disease. High triglycerides have been associated with an increased risk of coronary artery disease, which can lead to heart attack. Treatments to reduce the risk of coronary artery disease are usually recommended, including dietary changes, medications for high triglyceride and cholesterol levels, stopping smoking, and tight blood sugar control in people with diabetes. We have an article on medications for lowering blood cholesterol here.

Take care of your kidneys!

All these medications are the integral part of making sure your kidneys don’t further deteriorate to the point of carrying out dialysis. Besides these medications, it’s also important that you work with a certified dietician to work out the best dietary plan for your kidney condition. Always remember to take your medications on time according to your pharmacist’s instructions, and attend your follow-up with doctors regularly.

If you have any questions related to kidney disease, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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Bonus reading: Medications to avoid or adjust if you have kidney disease

References

1. UpToDate - Patient education: Chronic kidney disease (Beyond the Basics)

2. UpToDate - Overview of chronic kidney disease-mineral and bone disorder (CKD-MBD)

3. UpToDate - Overview of vitamin D

4. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

5. CPG Management of Chronic Kidney Disease (Second Edition)

Cover image credit: Photo by Robina Weermeijer on Unsplash

Written by

Ms Joyce Toh