Choosing the treatment option that’s right for you

Good blood pressure control is important for people with Chronic Kidney Disease

Your options, CKD stages 1-3

Most people who come to a kidney (or nephrology) clinic have mild early kidney disease.  This is quite common in the general population and probably affects about 10% of people in the UK.  It was probably picked up by your family doctor or via an insurance medical.

There are a number of causes of this kind of kidney disease but diabetes and high blood pressure (hypertension) are two of the commonest causes.

What will happen at the kidney clinic?

When you come to the clinic, as well as asking you some questions, you will have some simple tests to try to find out the cause of your kidney problem such as blood tests and an ultrasound scan of your kidneys.  Most kidney clinics have lots of leaflets about specific causes of kidney disease so you could ask for one of these if you think it may be helpful.

Most kidney clinics also provide a number of other support services such as:

• social workers who can give financial and practical advice
• counsellors or psychologists who can offer support with the emotional aspects of kidney disease
• anaemia nurse specialists to help treat you if your haemoglobin (or blood count) becomes low, which is one of the commonest side effects of kidney disease.

What is the treatment for CKD stage 1-3?

The doctors and other staff in the clinic will focus on measures to protect your kidneys from further damage.  These include:

• Losing weight (if you are overweight) and taking regular exercise
• Advising you to eat a healthy, balanced diet
• Supporting you to give up smoking
• Reducing the amount of salt in your diet to help control your blood pressure; some people also need medications to lower their blood pressure
• If you are diabetic,  getting your diabetes really well controlled by taking the correct medications
• Giving you advice on avoiding medications that may further damage your kidneys.

You can help yourself and give your kidneys the best chance of remaining healthy by trying to follow all of this advice.

For a small percentage of patients who have more unusual causes of their kidney problem, there may be some additional more specific treatments to help keep your kidneys healthy, such as medications to suppress your immune system.

What will happen in the future?

Often your kidney disease will remain stable or progress at a very slow rate and you will be reviewed by the clinic or your family doctor at regular intervals.

If you have more than 20% of kidney function you may never need to have dialysis or a transplant even though you do not have perfect kidney function.  The most important thing will be to look after your blood pressure and diabetes and lead a healthy lifestyle.

For a smaller number of people, the kidneys will continue to deteriorate and the function will drop below 20% of perfect kidney function. It is at this point that you will need to consider further treatment options such as dialysis, transplantation or conservative management.