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Understanding Kidney Disease -- Treatment

What Are the Treatments for Kidney Disease? continued...

Since damaged kidneys may no longer be able to produce erythropoietin, which regulates the manufacture of red blood cells in the bone marrow, your doctor may need to give erythropoietin (Procrit, Epogen) or darbepoetin alfa (Aranesp) drugs to curb anemia. Medication to help control phosphorus levels, as well as vitamin D supplements, are often needed.

Drugs are excreted through the kidneys, so you'll need to consult with your health care provider before taking any medications -- including over-the-counter drugs. You may be told to avoid NSAIDs, such as naproxen ( Aleve), ibuprofen (Motrin,Advil), and COX-II inhibitors, like celecoxib (Celebrex), which are possible contributors to kidney disease. Always discuss any alternative or herbal treatments with your doctor before trying them

Diet and Your Kidneys

With kidney damage, your kidneys lose their ability to rid the body of sodium, potassium, phosphorus, and other waste by-products. Depending on your stage of disease, your doctor may advise a special diet to decrease the workload on your kidneys, keep body fluids and minerals in balance, and fend off a buildup of wastes in the body. If a special diet is advised, a kidney diet specialist, called a renal dietitian, can help. These diets may include reducing your intake of protein, potassium, sodium, and phosphorus.

Your health care provider may also advise specific amounts of vitamins and minerals to take, such as calcium and the active form of vitamin D.

If You Have Diabetes or High Blood Pressure

Following a diet is just as critical for controlling diabetes and high blood pressure as it is for kidney health. With diabetes, it is important to make the right food choices so that your blood sugar levels stay under control throughout the day. With high blood pressure, a low-salt diet may be advised to control high blood pressure.

Dialysis

Once kidney disease has advanced to end stage, dialysis is needed to filter out waste products and remove excess fluid. Two types of dialysis are commonly used today:

  • Hemodialysis uses an artificial kidney machine with a mechanical filter to help cleanse your blood. Before the first treatment, a surgeon may create a fistula (or shunt), which connects an artery and vein, in your arm. Or you may require a dialysis catheter that goes into the jugular vein in your neck. Several times a week, for several hours at a time, another tube is connected to the shunt so that blood can be circulated through the kidney machine, cleaned, and pumped back into your body.
  • Peritoneal dialysis is a form of dialysis that makes use of the lining of the abdomen, or peritoneal membrane -- which has many of the kidneys' filtering characteristics -- to help clean the blood. In this treatment, a tube is surgically implanted into the abdominal cavity. Then, during each treatment, a dialysis fluid called dialyzate is sent (or "instilled") through the tube and into the abdomen. The dialysis fluid picks up waste products and is then drained out after several hours. Several cycles of treatment -- fluid instillation, time in the abdomen, and drainage -- are needed every 24 hours. Automated devices can now do this overnight, allowing people more freedom of movement and time during the day for usual activities.

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