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Medical treatments for kidney failure
Without being able to cure chronic kidney disease, treatment can slow or even stop its progression. In acute renal failure, the process is often reversible. Priority is given to the disease that causes renal failure, such as diabetes or hypertension. Kidney failure itself is treated in parallel. |
Diet
The first measure offered to patients is often the diet modification. The doctor may recommend a reduced protein intake to slow the build-up of waste products in the blood and limit nausea and vomiting. The risk of having dialysis is reduced and mortality is reduced7.
Contributions in sodium (contained in salt) as well as in lipids (gras) must be limited. This should be adjusted to the severity of the kidney failure and the advice of a nutritionist will prove very useful in these circumstances.
Medical treatments for kidney failure: understand everything in 2 min
The doctor may also prescribe a reduced fluid intake : water, ice cubes, coffee, tea, soft drinks, juices, soups, milk, cream, ice cream and sorbets. For example, he could limit this consumption to 1,5 liters per day.
To control thirst, patients are advised to rinse their mouth regularly with water, without swallowing it. Sucking on candy or chewing gum can also help moisten the inside of the mouth with saliva. An oral spray like Biotène® can help.
pharmaceuticals
When the diet is no longer sufficient to control imbalances in water and electrolytes (calcium, phosphorus, potassium, etc.), the introduction of drugs in addition to good eating habits will help to achieve this goal: vitamin D, sevelamer (Rénagel ) to control the phosphorus, sodium polystyrene sulfonate (Kayexalate) to control the Potassium, and calcium and cinacalcet calcimimetics (Sensipar) to regulate the calcium.
Treatment will be offered as needed for maintain red blood cells blood at a certain level: darbopoietin (Aranesp) and erythropoietin (Eprex).
Un strict control of hypertension Blood pressure decreases the progression of kidney damage and medication will almost certainly be needed in order to achieve desired pressure values. The target is less than 140/90, or even 130/80 in the case of diabetes or proteinuria.
In addition, if necessary, we will try to urinate “excess water” present in the body with diuretics : furosemide (Lasix), hydrochlorothiazide (Hydrodiuril).
In diabetics, glucose should be maintained at an acceptable level, by the use of oral medications or insulin if the diet is no longer sufficient. See the fact sheet on diabetes.
Dialysis
Dialysis uses a membrane that acts as a filter and is used to remove toxins and excess fluid from the blood. There are two types of dialysis: peritoneal dialysis and hemodialysis. The choice of one method over the other is based on the patient’s age, his ability to manage his treatment (peritoneal dialysis requires a minimum of dexterity and autonomy), the presence of other diseases and the patient’s preference. patient.
In the peritoneal dialysis, we use the peritoneum to act as a filter. The peritoneum is the double membrane that lines the wall of the abdomen (tummy) and the abdominal organs (intestine, stomach, etc.) These two membranes are separated by a tiny space in which a catheter (a flexible tube, of very small dimension) permanently. Through this tube, the peritoneum is filled with a solution called dialysate, left for a few hours in this cavity. The blood which circulates in the vessels raking the peritoneum is then filtered: the toxins and the excess water pass to the side of the dialysate. Once the operation is complete, the dialysate is removed to replace it with another, virgin.
Peritoneal dialysis is usually done at home, by the patient or a family member. The continuous ambulatory peritoneal dialysis is usually repeated every 6 hours. The automated peritoneal dialysis is done once a day, during the night, thanks to a programmed device.
L’hemodialysis should be performed in a hospital or a specialized clinic. A machine called a “dialyzer” is used to filter the blood.
The blood is first pumped into the dialyzer. Inside the machine, it remains on one side of a membrane that serves as a filter. Waste and excess fluid pass through the membrane and pass to the other side, where the dialysate is. The filtered blood is returned to the body. Usually, the procedure takes 4 hours. It should be repeated about 3 times a week.
Kidney transplant
For some patients, a kidney transplant is needed. Applications are evaluated according to very strict criteria to avoid any form of discrimination. A detailed evaluation by a nephrologist specializing in kidney transplantation is necessary in order to establish whether this treatment option is appropriate for a given patient.
Le kidney can come from a living donor, often a relative, or from a donor who has just died. With a successful transplant, the recipient is able to lead an active, healthy life.