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:1,5

  • 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 restriction (supplemented with medication containing essential keto acids/amino acids, if required)1,5 - 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
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. D'Alessandro C et al. "Dietaly": practical issues for the nutritional management of CKD patients in Italy. BMC Nephrol 2016; 17 (1): 102
  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)
the kidneys teaser

The kidneys

The kidneys’ vital job is to uphold the body’s fluid balance and chemical environment through filtering the body’s blood. In addition, they produce several hormones. Read more on kidneys and their functions.

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CKD treatment option teaser

Treatment options

Treatment of chronic kidney disease (CKD) varies according to the severity. However, steps can be taken in all cases to: control hypertension, correct salt and water imbalance, treat urinary tract infections, and reduce risk of heart and blood vessel diseases. Most people with CKD will be able to slow down progression through regular check-ups and medication intake.

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Nutritional management teaser

Nutritional management

When you suffer from chronic kidney disease (CKD), nutritional management is an essential part of your treatment plan. Depending on the severity of your disease, your recommended diet may change over time. In predialysis, a low protein diet is a key pillar of a CKD therapy. Read more about what food intake should look like in CKD.

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