Conservative Treatment in CKD Predialysis Phase

Conservative treatment in the CKD predialysis phase

A comprehensive conservative treatment of chronic kidney disease (CKD) without dialysis uses dietary interventions and medications within the earlier stages of the disease.



The conservative treatment aims to:

  • Slow the disease‘s progression and thereby postpone the onset of renal replacement therapy (e.g. dialysis, transplantation).
  • Avoid or attenuate the development of secondary diseases (e.g. bone disease, cardiovascular disease)

It includes a broad spectrum of measures, e.g.:

  • Treatment/control of underlying diseases (e.g. diabetes mellitus, hypertension)1
  • Control of hypertension, which often develops as the disease progresses1
  • Prophylaxis and treatment of bone disease (diet, medication1,6)
  • Dietary protein restriction1,5 - read more about nutrition in predialysis
  • Correction of salt and water imbalances (diet, medication) - read more about fluid intake1,2
  • Treatment of renal anaemia (medication with erythropoietin and iron)7
  • Correction of high levels of lipids in the blood (medication)8
  • Avoiding medications that could damage the kidneys9
  • Smoking cessation9
  • Weight control (diet, life style changes)2
  • Prevention and treatment of urinary tract infections (medication)10
CKD nutrition

A kidney diet can help to slow the disease’s progression and attenuate symptoms of CKD.5

Sources

  1. Jameson, Fauci et al.: Harrison´s Principles of Internal Medicine, 20th Edition, McGraw Hill 2018
  2. National Kidney Foundation https://www.kidney.org/atoz/content/nutrikidfail_stage1-4 (Accesses 13.02.2019)
  3. National Kidney Foundation https://www.kidney.org/atoz/content/ironDialysis (Accessed 13.02.2019)
  4. National Kidney Foundation https://www.kidney.org/atoz/content/vitamineral (Accessed 13.02.2019)
  5. https://www.kidney.org/atoz/content/ckd-diet-how-much-protein-right-amount
  6. National Kidney Foundation www.kidney.org/atoz/content/MineralBoneDisorder (Accessed 13.02.2019)
  7. National Kidney Foundation https://www.kidney.org/atoz/content/what_anemia_ckd (Accessed 13.02.2019)
  8. National Kidney Foundation https://www.kidney.org/atoz/content/bloodlipids (Accessed 13.02.2019)
  9. National Kidney Foundation https://www.kidney.org/atoz/atozTopic_Drugs (Accessed 13.02.2019)
  10. National Kidney Foundation https://www.kidney.org/atoz/content/uti (Accessed 13.02.2019)