Chronic Kidney Disease Treatment | Newsroom - Mass General Brigham

The Centers for Disease Control and Prevention (CDC) estimates that more than 1 in 7 American adults (37 million people) has chronic kidney disease (CKD) in the United States. Most of these people are undiagnosed. Without treatment, CKD can cause serious health problems including end-stage renal disease (ESRD). But if treated early, some patients may be able to reverse or delay the progression of their condition. 

In recognition of National Kidney Month, Merranda Logan, M.D., MPH, FACP answers patients' most commonly searched questions about chronic kidney disease treatment. Dr. Logan is the Associate Chief Academic Officer at Mass General Brigham and a nephrologist at Massachusetts General Hospital. 

What is chronic kidney disease?

CKD is a slow decline in your kidney function. This decline generally happens over a time period that's greater than three months. Your kidneys are the organs that remove wastes, toxins, and excess fluid from the body. They then exit the body in the form of urine. The kidneys also help control blood pressure, make new red blood cells, maintain healthy bones, and regulate chemicals that are essential to life.

Each kidney has about a million tiny structures called nephrons that filter your blood. CKD usually damages the nephrons slowly over several years. This may leave the kidneys unable to remove wastes and toxins. If waste products build up in your body, it can be dangerous and even cause death.

Risk factors

Most people with CKD have few or no signs or symptoms. Symptoms tend to appear in the later stages of the disease. Many patients are diagnosed with CKD unexpectedly following a blood test. 

Diabetes and high blood pressure (also called hypertension) are the leading causes of CKD. Other risk factors include a family history of CKD, obesity and heart disease. If you have these conditions, talk to your health care provider about getting tested for CKD. Generally, the sooner you get a diagnosis and treatment, the better your outcome. 

Management of chronic kidney disease 

If you have CKD, you may be eligible for therapies that could reverse or delay the worsening of your condition. This means that you could live longer and with fewer health complications. Without treatment, CKD can advance to complete kidney failure or ESRD.

Treatment options 

There are several treatment options, depending on the underlying cause of your condition and the stage of your CKD. Some causes are treatable and some are not. Treatment options for CKD may include:

• Lifestyle changes such as getting to a healthy weight, eating well, exercising and quitting smoking 
• Medications to help manage blood pressure, cholesterol, iron, calcium, or Vitamin D levels 
• Dialysis. If your kidneys fail or stop working, you may need dialysis to stay alive. Dialysis is a form of kidney replacement therapy that removes waste products from the blood and regulates fluids.
• Kidney transplant. Some patients with kidney failure may be a candidate for kidney transplant. The kidney may be donated by a family member, an unrelated donor, or a cadaver donor.

Chronic kidney disease medications and supplements

Your doctor may recommend medications and supplements to manage your condition in combination with lifestyle changes. Medications and supplements used to treat CKD Include:

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. They help manage high blood pressure.
• Statins. These medications help lower cholesterol levels.
• Diuretics. They help keep body fluids in balance. Patients with CKD may retain fluids.
• Erythropoietin supplements. These supplements treat anemia by helping the body produce red blood cells. 
• Calcium and vitamin D supplements. These supplements can strengthen bones to reduce risk of fracture. 

Types of chronic kidney disease dialysis

Mass General Brigham offers dialysis for acute and chronic treatment. We use state-of-the-art dialysis equipment and stations. Doctors and patients work together to determine the best dialysis option. There are two kinds of dialysis: 

1. Hemodialysis
   An artificial kidney machines cleans or filters your blood. Health care providers perform this procedure in a dialysis center or in the patient's home. Patients need hemodialysis several times a week. 
2. Peritoneal dialysis
   Patients sometimes prefer this type of dialysis because it can be done at home or at work. The patient inserts a tube into their abdomen, which pumps a special fluid into the belly. The fluid absorbs wastes and extra fluid and then drains out of the body. Peritoneal dialysis can be done manually, four to five times per day, or it can be done while you're sleeping. 

Kidney transplant

Our kidney transplant programs at Brigham and Women's Hospital and Massachusetts General Hospital provide nationally recognized, personalized care for kidney failure. We lead innovative clinical trials and Mass General Brigham's pioneering research allows some patients to live drug-free after transplant. Our clinical teams offer advanced treatment options for highly sensitized patients, patients with incompatible living donors, and patients with complex medical or surgical issues.