How kidney disease is treated depends on the stage of the disease:

  • To start with, it involves treating any underlying cause such as diabetes, high blood pressure, or kidney stones.
  • If kidney disease progresses, dietary modifications will be needed.
  • When it progresses to end-stage renal disease, dialysis or a transplant will be considered.

Other complications of kidney disease such as high blood pressure, anemia, and electrolyte disturbances also require treatment.

The first priority in the treatment of kidney disease is to determine the underlying cause, in case it is reversible, and to start the appropriate treatment, which can vary according to the underlying cause of kidney disease.

If you have kidney disease, your doctor may prescribe you an angiotensin converting enzyme (ACE) inhibitor (e.g., ramipril, perindopril) or an angiotensin receptor blocker (ARB) such as valsartan or losartan. Both of these types of medications have shown to slow the progression of kidney disease and are ideal choices for most people with kidney disease and high blood pressure or diabetes. It is important to control your blood pressure if you have kidney disease, since high blood pressure can worsen kidney disease and kidney disease can worsen high blood pressure.

In certain cases of glomerulonephritis, an inflammation of the filtering system of the kidneys, medications such as corticosteroids (e.g., prednisone) can slow the progression or even reverse the disease. In other types of kidney disease, such as congenital renal diseases (e.g., polycystic kidney disease), there is no specific treatment.

If you have kidney disease, you should be referred to a kidney specialist (nephrologist). Sometimes, judicious treatment such as dietary modification can delay the need to begin replacement therapy such as dialysis or transplant. As well, the dosages of many medications will need to be adjusted as kidney function worsens.

Despite the use of existing treatments, many people with kidney disease progress to end stage renal disease (ESRD), where the kidneys are functioning at less than 15% of normal. At this point, if you decide to continue with treatment, you will need dialysis (peritoneal dialysis or hemodialysis) or kidney transplantation. Your doctor will discuss the risks and benefits of these procedures and whether they are right for you.

Kidney transplantation is generally felt to be the best treatment in that it permits a return of nearly normal kidney function and a fairly normal lifestyle. However, people with kidney transplants do need to continue on medications to prevent rejection for the rest of their lives.

Written and reviewed by the MediResource Clinical Team