Chronic kidney disease (CKD) is a chronic condition that can eventually progress into end-stage renal disease (ESRD) and kidney failure. Different genetic, clinical, and environmental factors may influence the rate of an individual’s CKD progression, and current treatment options only work to delay disease progression and support prolonged life expectancy.
However, comprehensive care models provide the framework and access to value-based care that patients need to enjoy the special moments in their life.
Key Points:
- Chronic kidney disease (CKD) is generally characterized as a progressive and incurable loss of kidney function.
- Many treatment options and steps can be implemented to help manage CKD symptoms, control complications, and potentially slow disease progression.
- Each patient’s CKD journey is different; thus, personalized and comprehensive kidney care is needed to help slow disease progression and improve their overall quality of life.
How Quickly Can Kidney Function Decline?
CKD disease progression does not occur at the same rate for every patient, as there are different factors such as age, lifestyle, sex, related medical conditions, and other environmental factors that increase the rate of kidney function decline.
Some potential indicators of sudden or fast CKD progression:
- Acute kidney injury (AKI)
- Hypertension
- Congestive heart failure
- Low serum albumin
- Proteinuria
- Long duration of diabetes
Blood and urine tests are used not only to diagnose kidney disease but also used to indicate which stage of the disease the patient is in. Regular kidney tests are a valuable tool for healthcare providers to monitor CKD disease progression.
Can You Stop CKD From Progressing?
There is no guarantee that CKD progression can be stopped, as each patient has different needs. If there is an injury to the kidneys in the setting of CKD, it is often irreversible. Once the nephrons that make up the kidney are scarred or die, they cannot grow back or heal themselves. Other factors that may contribute to CKD progression include chronic inflammation, parenchymal cell death, fibrosis, and decreased regenerative capacity of the kidney.
However, many steps may be adopted to potentially prevent further injury to your kidneys and slow chronic kidney disease progression.
Slowing Down Kidney Disease
CKD is typically characterized as an irreversible and progressive disease; there are steps that both patients and providers may implement to help slow disease progression. Comorbidities and complications of CKD must also be addressed to enable patients to have a better quality of life. Treatment strategies include nutritional interventions, lifestyle changes, medical management, and monitoring of complications.
Nutritional interventions
Different diets may be recommended during the various stages of kidney disease to help preserve kidney function, control blood pressure and manage diabetes. Your care team and dietician will provide you with a diet plan based on your individual needs.
In kidney disease stages 1 and 2, your kidney function may be reduced due to mild damage, and it is important to make dietary changes to help preserve the function of your kidneys and reduce the risk of developing complications such as hypertension (high blood pressure).
Kidney stages 3, 4, and 5, for patients not on dialysis, the damage to your kidneys prevents them from normally filtering waste and extra fluid out of the body. You may need to change how you eat and drink to help prevent further kidney damage and help slow disease progression. For example, you may need to reduce the amount of salt, protein, and fluid intake.
When you are in kidney failure and are on dialysis, changing the way you eat and drink is recommended to help control blood pressure and fluid retention. As dialysis is not a replacement for fully functioning kidneys, you may find that there is still some waste and fluid buildup in your body, particularly in between dialysis treatments.
After a kidney transplant, many food restrictions recommended during dialysis may no longer be needed. A dietician will recommend a kidney transplant-friendly diet plan to help keep your transplanted kidney healthy and body weight in a healthy range.
Lifestyle interventions
Health-promoting behavior, such as daily physical activity, limiting alcohol intake, and quitting smoking, are encouraged. Smoking cigarettes has been linked with abnormal urine albumin, which can progress CKD. Smoking also increases the risk of heart attacks and strokes in people with CKD. Patients who quit smoking with the help of nicotine replacement therapy need to be monitored for any side effects.
The provision of self-management education has been shown to improve chronic disease patients’ health status and behaviors.
Medical Management
Treatment strategies may include; improving blood pressure control, blood glucose control for patients with diabetes, and using ACE inhibitors or ARBs to reduce albuminuria and control blood pressure. Other medicines that may help protect the kidneys include:
- General blood pressure-lowering medicines
- Renin-Angiotensin-Aldosterone-System (RAAS) inhibitors
- Diuretics (water pills) to help manage blood pressure
Routine monitoring of blood pressure is also needed for CKD patients.
How to Slow Down Polycystic Kidney Disease
Polycystic kidney disease (PKD) is a genetic disease resulting in many cysts forming inside the kidneys. These cysts are growths filled with fluid that damage the kidneys and enlarge them.
There are two types of PKD: autosomal recessive polycystic kidney disease (ARPKD) and autosomal dominant polycystic kidney disease (ADPKD).
ARPKD is a much less common form of PKD and is typically diagnosed in babies, sometimes even before they are born (infantile PKD). ARPKD can affect the liver and other organs of the body. ADPKD is the most common type of PKD and is generally diagnosed during adulthood. Over time, ADPKD can start to affect other organs in the body.
PKD causes CKD, which reduces kidney function and may result in end-stage kidney disease or kidney failure. It is known that PKD may also be responsible for causing other complications, such as cysts in the liver, high blood pressure, and problems with blood vessels. PKD is known to cause about 2% of the cases of kidney failure in the US each year.
Many supportive treatment options can be employed to help slow the growth of kidney cysts, control symptoms and possibly prevent or slow down the loss of kidney function.
Polycystic kidney disease progression may be slowed by:
- Making lifestyle changes
- Acquire a healthy weight
- Quit smoking
- Reduce stress
- Get enough sleep (try to aim for 7 to 8 hours per night)
- Be active for 30 minutes most days
- Drink less alcohol
- Medications to manage complications, such as blood pressure medication
- Making dietary changes to help protect your kidneys
In 2018, the FDA approved a new drug called tolvaptan for treating ADPKD. This medication affects how the kidneys control the concentration of urine. In some adult cases, it has also been shown to reduce the growth of kidney cysts when taken over a period of time.
How Does Panoramic Health Help To Slow Kidney Disease Progression?
Panoramic Health is a physician-led, integrated value-based kidney care platform providing holistic care for all patients across the CKD spectrum. Our care model includes provider engagement and decision support tools, holistic care management, data platform and predictive analytics, and patient engagement and education.
As part of our holistic care management, patients can expect a comprehensive care model, including nutrition, SDOH services, pharmacy, and PCP coordination. These services and their frequency are customized to the patient’s stage and risk profile.
Our value-based care model drives improved patient outcomes and slows kidney disease progression by creating a pathway for our patients to access the appropriate care they need when they need it.
