Treatment options for Kidney Failure

Kidney failure can be acute or chronic. Currently, there is no cure for chronic kidney failure. Treatment aims to control signs and symptoms of chronic kidney failure, reduce and if possible prevent complications and slow the progress of the disease. People with severely damaged kidney may need treatments for end-stage kidney disease.

Treatment of acute kidney failure includes:

• stopping the underlying cause (such as stopping the medication, which caused kidney failure) or correcting the cause of renal failure (such as shock, haemorrhage, burns, heart attack, etc.)
• medications to control associated complications such as high blood pressure, high levels of potassium and other blood chemicals until kidney function improves and
• in severe cases, dialysis may be needed till the kidney function improves.

Treatment of chronic kidney failure

i. Treatment of cause of kidney failure

Your doctor will try to treat the underlying cause of kidney failure as it may slow or control the worsening of kidney function. Treatment will depend on the underlying cause such as if kidney failure is caused because of high blood pressure, you will be given medicines to control blood pressure; if poor blood sugar control in diabetes is the cause, the doctor will prescribe medicines for the control of blood sugar levels. In many cases, however, the kidney damage may continue even after the underlying condition such as high blood pressure or diabetes has been controlled.

ii. Treatment of complications of kidney failure

Kidney failure affects all the organs and tissues in the body and can cause several complications. The doctor will prescribe medications to treat all the associated complications to make you more comfortable. Treatments may include:

• High blood pressure medications: High blood pressure is a common complication of chronic kidney failure. Medications will be given to lower your blood pressure if you suffer from high blood pressure. The commonly prescribed medications include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. Both these drugs help to preserve kidney function.
• Treatment to lower cholesterol levels: Levels of bad cholesterol is often increased in people with chronic kidney failure, which can increase the risk of heart disease. Statins are most commonly given to people with a lower than normal blood cholesterol.
• Treatment of anaemia: This includes supplements of the hormone erythropoietin with or without added iron. Erythropoietin supplements help to increase production of red blood cells, which may relieve fatigue and weakness associated with anaemia.
• Treatment of swelling: In the advanced stages of kidney failure, people may retain fluids, which can thereby cause swelling in the arms and legs and increase the blood pressure. Medications such as diuretics can increase urine output and help to maintain the balance of fluids in your body.
• Medications to protect bones: Calcium and vitamin D supplements are given in chronic kidney disease to prevent weak bones and lower the risk of fracture.
• Diet changes to minimise waste products in your blood: When protein in the food is processed, it creates waste products that your kidneys must filter from your blood. To reduce the work of your kidneys, you will be advised to eat less protein. A dietician can recommend a healthy diet, which is low in protein, but meets your nutritional requirements.

iii. Treatment for end-stage kidney disease

If the kidney function becomes so low that it cannot adequately clear waste and fluid from the body, it is known as end-stage kidney disease. People with end stage kidney disease need dialysis or a kidney transplant.

• Dialysis: In this, the waste products and extra fluid from your blood are removed artificially by a machine.
• Kidney transplant: This option is considered if you have no other life-threatening medical condition. In this, a healthy kidney from a donor is placed surgically into your body.