Why isn’t there a cure for CKD?

Treatment

Why isn’t there a cure for CKD? Can anything be done?

(Yes, yes and yes)

Whilst it’s true that medical science has made significant strides in treating many diseases, a cure for CKD remains elusive. The primary reason is that CKD often results from lasting damage to the kidneys that cannot be reversed.

Why? We do not know. Perhaps it is partly because the kidneys are complex organs each with a million tiny filtering units called a glomerulus. Once these are damaged, they have little ability to regenerate or repair themselves like some other cells in the body (e.g. liver cells). Other complex organs like the brain, nerves and eye (and specifically the retina) also have little powers of recovery.

Nonetheless, a lot can be done. Here are 7 effective and currently available treatments for CKD.

7 treatments for CKD

While CKD itself may not be curable, it can be managed effectively 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.

1. Lifestyle changes. This includes keeping your weight down (if overweight), regular exercise, quitting smoking, and limiting alcohol intake. These changes can help manage CKD and may slow its progression.

2. Medication. Many medications help CKD in most people:

  • ACE/ARBs (blood pressure tablets). Apart from patients with renovascular disease, these tablets benefit most patients with CKD and slow its progression
  • SGLT2is (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
  • 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).

3. Normal/low blood pressure.

“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”

4. Other specific treatments

5. Dialysis. This treatment, required for the advanced CKD (CKD5 or kidney failure), is a treatment to replicate the kidney’s filtration function. There are two types: peritoneal and haemodialysis. Both provide about 5% of normal kidney filtration function.

6. Kidney transplant. This is a surgical procedure where a healthy kidney from a donor is transplanted into a person with CKD. It’s often the most effective treatment for kidney failure (also called ESRF, end-stage renal failure).

7. 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. Do not run out.

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.

The future of CKD treatment

While a cure for CKD may not currently exist, research is ongoing, and new treatments are being developed, especially for some types of chronic glomerulonephritis (e.g. IgA nephropathy).  These advancements, coupled with early detection and management, offer hope for improving the quality of life for individuals with CKD.

In conclusion, while CKD is a serious condition, it’s important to remember that with the right management and treatment, people with CKD can lead fulfilling lives. If you or a loved one has been diagnosed with CKD, it’s crucial to work closely with your GP and kidney specialist (nephrologist) if you need one, to develop a personalised treatment plan.

Summary

We have answered the question ‘why isn’t there a cure for CKD, and can anything be done?’. Yes, yes and yes. We hope it has been helpful.

Last Reviewed on 29 January 2024

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