How can the progression of CKD be slowed down?

How can the progression of CKD be slowed down?

In most people, CKD is not be curable, but it can be managed effectively. The aim of treatment is to slow its progression and control symptoms. The treatment approach depends on the stage of the disease and the underlying cause.

Even though CKD is common (1 in 10 of the population), progression to kidney failure (Stage 5CKD) is rare and only occurs in 1 in 100 of patients with CKD, i.e. 1 in 1000 of the population.

So. How can the progression of CKD be slowed down?

Quite alot actually.

1. Don’t smoke
2. Avoid anti-inflammatory drugs (including some that can be bought without a prescription, such as aspirin and ibuprofen) unless they are approved by a doctor who knows about your kidney problem. They can sometimes worsen kidney function in people with damaged kidneys
3. Eat a healthy diet – and follow the recommended special diet if you have one
4. Lose weight if you are overweight
5. Take regular exercise
6. Take your blood pressure regularly – and take tablets that have been prescribed for it
   

   “The one thing that all patients with CKD should strive for is normal (or better low) blood pressure = of<130/80 at all times, and <120/70 if you have diabetes. This will slow the progression of all causes of CKD”

7. Take medication – these medications help CKD in most people:
   – ACE/ARBs (names ends in ‘-pril’ or ‘-sartan’; blood pressure tablets). Apart from patients with renovascular disease, these tablets benefit most patients with CKD and slow its progression
   – SGLT2is (names end in ‘-gliflozin’; originally for diabetes). These also lower blood pressure and slow the progression of CKD. They benefit patients with or without diabetes. Most patients with CKD should be considered for SGLT2is and ACE/ARBs, usually in combination
8. Other drugs. These include other drugs to lower blood pressure. You may also need to have blood glucose levels controlled (if you have diabetes), tablets to lower cholesterol levels, anaemia treated (e.g. with EPO), and have your bones protected (with calcium and vitamin D tablets).
9. Kidney specialist (nephrologist). If you have Stage 3B CKD or worse you should see or be discussed with a nephrologist. If referred, it is important you are reliable, keep your appointments and take you tablets carefully. Ask questions. Do not run out of tablets. And do not allow yourself to be discharged unless your CKD is stable and there is little/no likelihood of progression to dialysis or a kidney transplant.
10. Rule out treatable causes of CKD – in a few causes of CKD, it is curable. These include obstructive nephropathy and some types of glomerulonephritis. Make sure your kidney doctor has thought of these. To diagnose either, start with a kidney ultrasound. Glomerulonephritis also requires a kidney biopsy to make the diagnosis.

Does CKD get better?

Yes, it can do. In fact, in this large Canadian study, advancing age, CKD regression (getting better) or death (i.e. die with it, not from it) were more likely than CKD progression or kidney failure: Liu, 2021.

Summary

We have described how can the progression of CKD be slowed down? It does not always get worse. But if it does, there is a lot you can to do to help yourself.

Top Tip

Have a kidney ultrasound.

Other resources

How quickly does CKD progress?
7 treatments for CKD
What is the outlook for CKD?

Last Reviewed on 9 April 2024