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How Can Chronic Kidney Disease Be Treated

Meet Your Blood Glucose Goal If You Have Diabetes

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To reach your blood glucose goal, check your blood glucose level regularly. Use the results to guide decisions about food, physical activity, and medicines. Ask your health care provider how often you should check your blood glucose level.

Your health care provider will also test your A1C. The A1C is a blood test that measures your average blood glucose level over the past 3 months. This test is different from the blood glucose checks you do regularly. The higher your A1C number, the higher your blood glucose levels have been during the past 3 months. Stay close to your daily blood glucose numbers to help you meet your A1C goal.

The A1C goal for many people with diabetes is below 7 percent. Ask your health care provider what your goal should be. Reaching your goal numbers will help you protect your kidneys. Learn more about how to manage diabetes.

How Is Chronic Kidney Disease Treated

There is no cure for chronic kidney disease , but steps may be taken in early CKD to preserve a higher level of kidney function for a longer period of time. If you have reduced kidney function:

  • Make and keep your regular healthcare provider / nephrologist visits.
  • Keep your blood sugar under control .
  • Avoid taking painkillers and other medications that may make your kidney disease worse.
  • Keep your blood pressure levels under control.
  • Consult a dietitian regarding useful changes in diet. Dietary changes may include limiting protein, eating foods that reduce blood cholesterol levels, and limiting sodium and potassium intake.
  • Exercise/be active on most days of the week.
  • Stay at a healthy weight.

Chronic Kidney Disease : Treatment And Medications

Chronic kidney disease, or CKD, is common among US adults. In fact, more than 1 in 7, or 15%, of US adults are estimated to have CKD, which is about 37 million people. In the United States, as many as 9 in 10 adults with CKD do not know they have it, while about 2 in 5 adults with severe CKD do not know they have it.

To gain a better understanding of what chronic kidney disease looks like, as well as prevention and treatment, read our latest blog below.

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Medicines Used During Dialysis

Both erythropoietin therapy and iron replacement therapy may also be used during dialysis to treat anemia, which often develops in advanced chronic kidney disease.

  • Erythropoietin stimulates the production of new red blood cells and may decrease the need for blood transfusions. This therapy may also be started before dialysis is needed, when anemia is severe and causing symptoms.
  • Iron therapy can help increase levels of iron in the body when EPO therapy alone is not effective.
  • Vitamin D helps keep bones strong and healthy.

Knowing About Your Chronic Kidney Disease

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If you are well aware of chronic kidney disease, you can take steps to stop chronic kidney disease progression or also to reverse it.

Chronic kidney disease is a kidney disease that mostly causes problems in the later years of time. But these days, due to poor habits and a sedentary lifestyle, these habits are not limited to any specific age group, and anyone can get this kidney disease.

If you are aware of the early signs and symptoms of chronic kidney disease, you can detect the disease on your own, which can help in seeking medical help immediately. The earlier you start the treatment, the better it is to fight kidney problems.

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What Is Chronic Kidney Disease

Having chronic kidney disease means that for some time your kidneys have not been working the way they should. Your kidneys have the important job of filtering your blood. They remove waste products and extra fluid and flush them from your body as urine. When your kidneys don’t work right, wastes build up in your blood and make you sick.

Chronic kidney disease may seem to have come on suddenly. But it has been happening bit by bit for many years as a result of damage to your kidneys.

Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons that are left cannot filter your blood well enough to keep you healthy.

One way to measure how well your kidneys are working is to figure out your glomerular filtration rate . The GFR is usually calculated using results from your blood creatinine test. Then the stage of kidney disease is figured out using the GFR. There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.

There are things you can do to slow or stop the damage to your kidneys. Taking medicines and making some lifestyle changes can help you manage your disease and feel better.

Chronic kidney disease is also called chronic renal failure or chronic renal insufficiency.

Recommendations For Stages 4 And 5 Ckd

As the disease progresses and your renal function drops below 70 percent of what it should be, your nephrologist will recommend a restriction of phosphorus and potassium, two electrolytes that can harm the body if they accumulate excessively.

Among the considerations:

  • Phosphorus is important to the body as it helps to convert the foods we eat into energy, aids in bone growth and muscle contraction, and regulates blood acidity. If you have too much, it can lead to a condition known as hyperphosphatemia which can damage the heart, bones, thyroid gland, and muscles. To avoid this, adults with stage 4 to 5 CKD would need to restrict their daily intake to 800 to 1,000 mg per day by cutting back on phosphorus-containing foods.
  • Potassium is used by the body to regulate the heart rate and balance of water in cells. Having too much can lead to hyperkalemia, a condition characterized by weakness, nerve pain, abnormal heart rate, and, in some cases, heart attack. To avoid this, you would need to eat on a low-potassium diet, consuming no more than 2,000 mg per day.

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Causes Of Kidney Failure

Some of the causes of kidney failure include:

  • diabetes even if it is well managed, diabetes can cause kidney damage
  • glomerulonephritis swelling or inflammation of the tiny filtering units in the kidney. Also known as nephritis
  • polycystic kidney disease an inherited condition that causes thousands of cysts to form in the kidneys
  • urinary reflux a bladder-valve problem that allows urine to flow back into the kidneys, causing scarring
  • medications some drugs such as lithium and cyclosporin can cause kidney failure. Continued misuse of compound analgesic preparations was once a common cause of permanent kidney damage. Non-steroidal anti-inflammatory drugs , taken in normal therapeutic doses, may occasionally cause acute kidney failure
  • medullary cystic kidney disease an inherited kidney disease that leads to the kidneys gradually losing their ability to work properly due to cysts in the centre of the kidneys.

Other Symptoms And Complications

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Other symptoms and complications that can occur as chronic kidney disease progresses include the following.

  • Chest pain and/or shortness of breath: Having chronic kidney disease increases the risk of developing heart disease, which may cause chest pain or shortness of breath. In addition, fluid overload from decreased urine output may cause fluid to build up in the lungs, causing shortness of breath.
  • Bone pain, skeletal deformities, and easy fractures: This is due to a mineral bone disorder that can develop with CKD, in which the normal mineral balance of the bones is disrupted.
  • Nausea, vomiting, and loss of appetite: A condition called uremia may cause these symptoms in the early stages. Uremia is caused by the inability of the kidneys to remove toxins from the body.
  • Loss of concentration, confusion, seizures, or coma: If severe uremia develops, this may result in these neurological symptoms.

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Can Kidney Disease Be Prevented

Seeing your healthcare provider on a regular basis throughout your life is a good start for preventing kidney disease. About one in every three people in the United States is at risk for kidney disease. Identify and manage any risk factors for developing kidney disease.

  • Control your high blood pressure. Normal blood pressure is 120/80.
  • Control your blood sugar if you have diabetes.
  • Eat a healthy diet. Follow a low-fat, low-salt diet.
  • Dont smoke.
  • Be active for 30 minutes at least five days a week.
  • Maintain a healthy weight.
  • Take nonprescription pain relievers only as directed. Taking more than directed can damage your kidneys.

Estimated Glomerular Filtration Rate

A normal eGFR is 90 ml/minute/1.73 m or more. If some of the glomeruli do not filter as much as normal then the kidney is said to have reduced or impaired kidney function.

The eGFR test involves a blood test which measures a chemical called creatinine. Creatinine is a breakdown product of muscle. Creatinine is normally cleared from the blood by the kidneys. If your kidneys are not working very well and the glomeruli are not filtering as much blood as normal, the level of creatinine in the blood goes up.

The eGFR is calculated from your age, sex and blood creatinine level. An adjustment to the calculation is needed for people with African-Caribbean origin. See the separate leaflets called Routine Kidney Function Blood Test and Estimated Glomerular Filtration Rate .

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British Columbia Specific Information

For your kidneys and overall health, it is important that you follow a healthy diet and maintain a healthy weight. Healthy eating can help you feel your best, reduce your symptoms and keep you as healthy as possible. Call 8-1-1 to speak to a registered dietitian, Monday to Friday 9:00 a.m. to 5:00 p.m., or Email a HealthLinkBC Dietitian with any healthy eating, food or nutrition questions you may have.

For information on healthy eating for people with early chronic kidney disease, you may also wish to review our Healthy Eating Guidelines For People with Early Chronic Kidney Disease Stages 1 and 2.

The BC Provincial Renal Agency plans and monitors the delivery of kidney care and dialysis services across the province. For more information visit BC Renal Agency.

The Kidney Foundation provides support and resources to kidney patients. You will find reliable information on living with reduced kidney function and kidney failure. For more information, visit www.kidney.ca.

Be Careful About The Over

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If you take OTC or prescription medicines for headaches, pain, fever, or colds, you may be taking nonsteroidal anti-inflammatory drugs . NSAIDs include commonly used pain relievers and cold medicines that can damage your kidneys and lead to acute kidney injury, especially in those with kidney disease, diabetes, and high blood pressure.

Ibuprofen and naproxen are NSAIDs. NSAIDs are sold under many different brand names, so ask your pharmacist or health care provider if the medicines you take are safe to use.

You also can look for NSAIDs on Drug Facts labels like the one below:

Watch a video explaining how NSAIDs can harm your kidneys.

If you have been taking NSAIDs regularly to control chronic pain, you may want to ask your health care provider about other ways to treat pain, such as meditation or other relaxation techniques. You can read more about pain management at the NIH National Center for Complementary and Integrative Health website.

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Approval Is First To Cover Many Causes Of Disease

For Immediate Release:

Today, the U.S. Food and Drug Administration approved Farxiga oral tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease who are at risk of disease progression.

Chronic kidney disease is an important public health issue, and there is a significant unmet need for therapies that slow disease progression and improve outcomes, said Aliza Thompson, M.D., M.S., deputy director of the Division of Cardiology and Nephrology in the FDAs Center for Drug Evaluation and Research. Todays approval of Farxiga for the treatment of chronic kidney disease is an important step forward in helping people living with kidney disease.

Chronic kidney disease occurs when the kidneys are damaged and cannot filter blood normally. Due to this defective filtering, patients can have complications related to fluid, electrolytes , and waste build-up in the body. Chronic kidney disease sometimes can progress to kidney failure. Patients also are at high risk of cardiovascular disease, including heart disease and stroke.

Farxiga was not studied, nor is expected to be effective, in treating chronic kidney disease among patients with autosomal dominant or recessive polycystic kidney disease or among patients who require or have recently used immunosuppressive therapy to treat kidney disease.

The FDA granted the approval of Farxiga to AstraZeneca.

Treating Any Underlying Kidney Condition

There are various conditions that can cause CKD. For some of these there may be specific treatments for that particular condition – for example:

  • Good blood sugar control for people with diabetes.
  • Blood pressure control for people with high blood pressure.
  • Antibiotic medication for people with recurring kidney infections.
  • Surgery for people with a blockage to urine flow.

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Things You May Be Able To Control

You may be able to slow the progression of chronic kidney disease and prevent or delay kidney failure by controlling things that increase your risk of kidney damage, such as:

  • High blood pressure, which gradually damages the tiny blood vessels in the kidneys.
  • Diabetes. A persistently high blood sugar level can damage blood vessels in the kidneys. Over time, kidney damage can progress, and the kidneys may stop working altogether.
  • Eating protein and fats. Eating a diet low in protein and fat may reduce your risk for kidney disease.
  • Certain medicines. Avoid long-term use of medicines that can damage the kidneys, such as pain relievers called NSAIDs and certain antibiotics.

Testing Results And Follow

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The results of your examination will help your doctor make a diagnosis. It can also help them determine the cause of your kidney failure.

If youre diagnosed with chronic kidney failure, you will need regular blood tests. These will be used to measure various substances in your body, such as calcium, potassium, cholesterol, sodium, magnesium, and phosphorous. You will also need to undergo ongoing kidney function tests for creatinine and urea levels.

There is no cure for chronic kidney failure. However, there are measures you can take to slow its progression.

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Reata Pharmaceuticals Announces Outcome Of Fda Advisory Committee Meeting Of Bardoxolone For The Treatment Of Patients With Chronic Kidney Disease Caused By Alport Syndrome

PLANO, Texas, December 08, 2021—-Reata Pharmaceuticals, Inc. , today announced the outcome of the U.S. Food and Drug Administration Cardiovascular and Renal Drugs Advisory Committee meeting on bardoxolone methyl for the treatment of patients with chronic kidney disease caused by Alport syndrome.

The Committee voted no on the question of whether the provided evidence demonstrated that bardoxolone is effective in slowing the progression of CKD in patients with Alport syndrome and that its benefits outweigh its risks.

“We are disappointed with todays outcome of the Committees vote regarding bardoxolone, an investigational drug with a novel mechanism of action,” said Warren Huff, Reatas President and Chief Executive Officer. “We believe the scientific evidence supports bardoxolone approval in the U.S. for CKD in patients with Alport syndrome, which is one of the most rapidly progressive forms of CKD. We will continue to work with the FDA to answer any questions they may have.”

While the FDA is not required to follow the committee’s vote, the agency considers the committee’s recommendations when making its decision. Reata will continue to work closely with the agency to provide additional information and data until the upcoming Prescription Drug User-Fee Act date of February 25, 2022.

About Alport Syndrome

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Complications Of Chronic Kidney Disease

  • Uremic syndrome. You may be tired, have nausea and vomiting, not have an appetite, or not be able to sleep when substances build up in your blood. The substances can be poisonous if they reach high levels. This syndrome can affect many parts of your body, including the intestines, nerves, and heart.
  • Heart disease. Chronic kidney disease speeds up hardening of the arteries and increases the risk of stroke, heart attack, and heart failure. Heart disease is the most common cause of death in people with kidney failure.
  • Bone disease . Abnormal levels of substances, such as calcium, phosphate, and vitamin D, can lead to bone disease.
  • Fluid buildup . As kidney function gets worse, fluids and salt build up in the body. Fluid buildup can lead to heart failure and pulmonary edema.

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What Causes Kidney Disease

Kidney diseases happen when your kidneys are damaged and cant filter your blood. The damage can happen quickly when its caused by injury or toxins or, more commonly, over months or years.

High blood pressure and diabetes are the two most common causes of chronic kidney disease. Other causes and conditions that affect kidney function and can cause chronic kidney disease include:

  • Glomerulonephritis. This type of kidney disease involves damage to the glomeruli, which are the filtering units inside your kidneys.
  • Polycystic kidney disease. This is a genetic disorder that causes many fluid-filled cysts to grow in your kidneys, reducing the ability of your kidneys to function.
  • Hypertensive nephrosclerosis. Kidney damage caused by chronic, poorly controlled hypertension.
  • Membranous nephropathy. This is a disorder where your bodys immune system attacks the waste-filtering membranes in your kidney.
  • Obstructions of the urinary tract from kidney stones, an enlarged prostate or cancer.
  • Vesicourethral reflux. This is a condition in which urine flows backward refluxes back up the ureters to the kidneys
  • Nephrotic syndrome. This is a collection of symptoms that indicate kidney damage.

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