kidney treatment options overview

Overview

Kidney disease means your kidneys are damaged and cannot clean your blood as well as they should. The kidneys are two bean-shaped organs near your lower back that filter waste and extra fluid from your body. Treatment depends on how mild or severe the damage is. The goal is to keep your kidneys working as long as possible, manage related health problems, and choose the best approach for your stage of kidney disease.

Kidney disease is common, especially in people over 60 and those with diabetes or high blood pressure. Many people do not know they have it until routine tests show a problem.

Anyone can develop kidney disease, but it is more likely if you have diabetes, high blood pressure, a family history of kidney disease, or you are older. Some ethnic groups have higher rates of kidney disease.

Symptoms

Common symptoms

• No symptoms at first, or only very mild ones
• Feeling tired
• Swollen ankles, feet, or hands
• Shortness of breath
• Blood in the urine
• Itchy skin
• Needing to urinate more often, especially at night

Symptoms in children

• Poor appetite or slow growth
• Swollen face, belly, hands, or feet
• Frequent headaches or feeling very tired
• Unusual fussiness or low energy
• Frequent urination or bedwetting at an older age

Symptoms in older adults

• Confusion or difficulty concentrating
• Swelling in the legs and feet
• Feeling more tired than usual
• Loss of appetite or nausea
• Changes in how often they urinate

Causes

Main causes

• Diabetes (high blood sugar damages kidney blood vessels)
• High blood pressure (damages the filters in the kidneys)
• Glomerulonephritis (inflammation in the tiny filters of the kidney)
• Polycystic kidney disease (an inherited condition with fluid-filled sacs)
• Long-term blockage in the urinary tract, such as from an enlarged prostate or kidney stones
• Repeated kidney infections

Risk factors

• Older age
• Family history of kidney disease
• Smoking
• Obesity
• Heart disease
• Long-term use of some pain medicines

When to see a doctor

See a doctor urgently if:

• If you have the emergency symptoms listed above, call your local emergency number now.
• If you see blood in your urine or have severe pain in your back or side, get medical help the same day.

Book a routine appointment if:

• If you have diabetes, high blood pressure, or a family history of kidney disease, ask your doctor how often you need kidney function tests.
• If you notice new swelling, persistent tiredness, or changes in urination, make an appointment with your doctor.

Diagnosis

Doctors use blood and urine tests to check how well your kidneys are filtering and whether they are leaking protein. If kidney disease is found, your doctor may order an ultrasound or other imaging of your kidneys and sometimes a kidney biopsy to understand the cause.

Tests that may be done

• Blood test to check creatinine and estimate GFR (a measure of kidney function)
• Urine test to check for protein or blood
• Ultrasound or CT scan of the kidneys
• Kidney biopsy (a tiny sample of kidney tissue taken with a needle)

What to expect at your appointment

Your doctor will explain your test results and what stage of kidney disease you have. Stages range from mild to severe. Based on your stage and underlying cause, you and your doctor will build a care plan together. You may be referred to a kidney specialist.

Treatment

Treatment for kidney disease is not one-size-fits-all. The main goals are to treat the cause, slow the damage, control symptoms, and prevent complications. For early kidney disease, lifestyle changes and medications are the main approach. For advanced kidney failure, you may need dialysis or a kidney transplant.

Self-care at home

• Follow a kidney-friendly diet as advised by your doctor or dietitian (this often means limiting salt and eating fresh foods)
• Stay physically active with activities that work for you
• Do not smoke
• Drink fluids based on your doctor's advice — too little or too much can both be harmful
• Keep your blood pressure and blood sugar within your target range

Medical treatments

Depending on the cause and stage, your doctor may prescribe medications to lower blood pressure, control blood sugar, lower cholesterol, or protect your kidneys. Some medicines help the kidneys get rid of extra fluid. Your doctor will carefully adjust any medications because kidney problems change how your body processes them. Always take medicines exactly as prescribed and never change the dose on your own.

When is surgery considered?

If kidney disease reaches the final stage, a kidney transplant — surgery to place a healthy kidney from a donor — is the most complete treatment for kidney failure. Surgery may also be needed to fix a blockage in the urinary tract, such as from kidney stones or an enlarged prostate.

Living with this condition

Living with kidney disease means staying connected with your healthcare team, taking your medications as prescribed, and watching for new symptoms. You may need to check your blood pressure regularly and keep your appointments for blood and urine tests. Ask your doctor or nurse when you should call them.

Lifestyle tips

• Eat a balanced diet that matches your stage of kidney disease
• Manage stress through activities like walking, reading, or relaxation exercises
• Get enough rest and tell your doctor if you often feel exhausted
• Take all medicines and supplements only after checking with your doctor
• Stay involved with the people and activities you enjoy

Diet and exercise

A renal dietitian can help you choose the right amount of protein, salt, potassium, and phosphorus for your stage of disease. In general, cooking at home with fresh ingredients is helpful. Exercise is safe for most people — even walking 30 minutes a day can protect your heart and help control blood pressure. Ask your doctor what level of activity is right for you.

Mental health and emotional wellbeing

Having a long-term kidney condition can cause stress, worry, or low mood. These feelings are normal. Talk to your healthcare team, a counsellor, or someone you trust. If you feel overwhelmed, hopeless, or think about harming yourself, reach out to a mental health crisis service or call your local emergency number right away.

Prevention

Not all kidney disease can be prevented, but you can lower your risk by keeping diabetes and high blood pressure under control, maintaining a healthy weight, staying active, not smoking, and having regular check-ups. Be cautious with long-term use of over-the-counter pain medications and always follow the recommended dose or ask your pharmacist.

Vaccines

Staying current with recommended vaccines, such as flu and certain others, can help you avoid infections that might stress your kidneys. Ask your doctor or pharmacist which vaccines they recommend for you.

Screening programmes

If you have diabetes, high blood pressure, a family history of kidney disease, or are over 60, talk to your doctor about annual kidney function screening with blood and urine tests.

Complications

If left untreated

• Kidney damage can progress to kidney failure, which needs dialysis or a transplant
• Heart and blood vessel disease becomes more likely
• Anemia (low red blood cells) can develop
• Bone disease and mineral problems can occur
• Sudden kidney failure may happen in some cases

Long-term outlook

With regular medical care, most people with kidney disease can lead full, active lives. Treatment for advanced kidney disease has improved greatly. Dialysis can keep you alive and functioning, and a kidney transplant offers the chance for most people to return to a more normal life — though a transplant requires lifelong follow-up. Your healthcare team will help you choose the option that best fits your values and health situation.

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