The basics

How to delay the onset of dialysis

Perhaps the most frightening issue that confronts someone diagnosed with chronic kidney disease is that life will dramatically change. The thought of not being able to enjoy important activities, such as work, family life, social occasions and athletic endeavors is unsettling. Many people even ask if they are going to die. While it is scary to be diagnosed with a chronic disease, the good news is, there are steps you can take to prolong kidney function.

Following good health practices, staying on the job and continuing to enjoy social activities are ways a person can feel in control of their condition. In addition to doing everything physically and medically possible to prolong kidney function, having a job with health insurance provides security that income and health benefits will be available.

While there are many causes of chronic kidney disease, there are certain recommendations that, when followed, can help a person delay kidney failure, which leads to dialysis or kidney transplant.

The two main causes of chronic kidney disease in Americans are diabetes and high blood pressure. These diseases should be controlled—or prevented—to prolong kidney function.

Diabetes

Diabetics need to keep their blood glucose level in an acceptable range and take all physician-prescribed medications. In addition, the hemoglobin A1c should be kept under 6.5% and kidney function tests should be performed at least once a year. Studies have shown that certain high blood pressure medications (ACE inhibitors and ARB) can protect the kidneys of people with diabetes, even if they have normal blood pressure.

High blood pressure

Patients with hypertension should take their medicine as directed by their doctor. Besides controlling blood pressure, medications, such as ACE inhibitors and beta-blockers, can also reduce the risk of kidney failure. The National Heart, Lung, and Blood Institute recommends that blood pressure remain under control at 125/75 or lower for those with kidney problems who are not diabetic, or 130/85 or lower for those with diabetes.

Other causes

Other diseases that can damage kidneys include IgA nephropathy, glomerulonephritis, and lupus. With these diseases the immune system overacts and inflammation occurs in the kidneys. To slow the disease process, a doctor may prescribe steroids and other medications.

Chronic kidney disease may also be brought on by infections, blockages and medications that damage the kidneys. Infections can sometimes be cleared up with antibiotics. Blockages may be removed with surgery or other procedures. Certain medications, such as prescription and non-prescription painkillers, some antibiotics and contrast dye (used in medical testing) may have adverse effects on the kidneys. A patient needs to tell all their doctors that they have chronic kidney disease and provide a list of all the medications they are taking, including over-the-counter drugs, to prevent further kidney damage.

Steps to prolong kidney function

Regardless of how a person develops chronic kidney disease, there are actions an individual can take to prolong kidney function. Smoking causes faster progression of kidney disease, therefore, it is recommended that those with kidney disease stop smoking. Naturally, eating a healthy diet, losing excess weight and exercising are keys to better health that are completely in the patient's control. In fact, many type 2 diabetics can prevent diabetes by following those steps. People with high blood pressure are advised to limit sodium in their diet. Many doctors believe that avoiding too much protein and phosphorus in the diet may also slow the progression of kidney disease. Research continues on other foods and drugs to see their effect on delaying kidney failure, including: fish oil for IgA nephropathy; dietary intake of antioxidant or anti-inflammatory vitamins and foods; and prescribing the anti-fibrotic drug, pirfenidone, for the treatment of focal segmental glomerulosclerosis (FSGS).

Remember, your condition is unique. You'll want to work with your physician and health care team for personalized tips on how to prolong your kidney function. An open and frequent dialog will produce the best results. As well as discussing your medical condition, talk to your doctor about your feelings and ask for advice on how to talk with your family about chronic kidney disease. Your health care team wants to help keep you healthy both physically and emotionally.

How to delay the onset of dialysis—at a glance

• Eat right and lose excess weight
• Exercise regularly
• Don't smoke
• Avoid excess salt in your diet
• Control high blood pressure
• Control diabetes
• Stay on the job and keep your health insurance
• Visit DaVita.com to learn all you can about your condition
• Talk with your health care team

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a kidney doctor tool to locate a nephrologist in your area.