Kidney failure is most often discovered when it is not yet very advanced, during routine blood tests and when the patient has no particular symptoms. It is then time to institute all the treatments known to slow down its progression. First, avoid using any nephrotoxic agent such as non-steroidal anti-inflammatory drugs (NSAIDs). Second, diabetes and hypertension will be treated vigorously. As soon as the renal impairment is more than slight, patients will benefit from a referral for careful monitoring by a nephrologist.

If despite everything there is progress towards the need for dialysis, treatment is difficult but beneficial. Kidney transplantation is often successful.

 D^r Dominic Larose, MD, Montreal Heart Institute