Can chronic kidney disease be managed without dialysis?


To stem the rising tide of end-stage renal disease, strategies must include early screening for proteinuria, optimal control or diabetes and hypertension and appropriate lifestyle modifications.

Answers with consultant nephrologist Dr Chow Yok Wai.

What does ‘chronic’ mean?

Chronic kidney disease (CKD) means your kidneys are damaged and can’t filter blood the way they should. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time.

This damage can cause wastes to build up in your body causing a multitude of health complications.

What are the symptoms?

Most people with early stages of CKD don't have any symptoms which is why many people do not know they have it. However, there are some signs CKD patients may notice themselves, or that doctors may notice when testing for kidney damage or other health conditions.

Symptoms can include: tiredness, dry or itchy skin, feeling the need to urinate more often, blood in urine, foamy urine, swollen feet and ankles, poor appetite, muscle cramps and persistent puffiness around the eyes.

How does diabetes affect the kidney?

Over time, high blood sugar from diabetes can damage blood vessels in the kidneys as well as nephrons so they don’t work as well as they should. Many people with diabetes also develop high blood pressure, which can damage kidneys too.

A sign to look out for is foam in your urine.

The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals. In addition, healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your kidney health.

According to Dr Chow Yok Wai, 'healthy lifestyle habits can help you reach your blood glucose and blood pressure goals and keep your kidneys healthy.'According to Dr Chow Yok Wai, 'healthy lifestyle habits can help you reach your blood glucose and blood pressure goals and keep your kidneys healthy.'

How do you manage diabetic kidney disease?

The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose target of below 7% for your Hba1c levels, and blood pressure goals. In addition, healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your kidney health.

Avoid drugs that are harmful to the kidneys like large amounts of pain-killers and visit your doctor annually to monitor how well you are managing your comorbid illnesses like diabetes and hypertension and to screen for kidney disease and other complications.

How can diet therapy help to delay dialysis?

When a patient reaches end-stage renal disease (ESRD), renal replacement therapy is the only option.

Thus, your lifestyle is an important aspect of managing kidney disease. Numerous studies show that a low protein diet combined with ketoacid therapy can delay the onset of dialysis and the need for a kidney transplant without causing malnourishment in patients.

Other ways include: early screening for proteinuria, optimal control or diabetes and hypertension appropriate lifestyle modification; smoking cessation, weight loss, adequate physical activity, low salt and low protein diet (with ketoacid therapy) and using pharmacological agents to delay the progression of CKD.

More information on how to protect your kidneys at https://www.chronic-kidney-disease.com/.

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