How to manage chronic kidney disease

Written by: Dr Peter Hill
Published: | Updated: 22/01/2019
Edited by: Jay Staniland

Kidney disease is where the kidney has stopped functioning normally. In normal function, the kidneys get rid of waste products that we no longer need. They produce urine to help us control our fluid balance, they also control blood pressure and produce certain hormones —things like erythropoietin that stops us becoming anaemic, and keep our bones healthy using vitamin D. So with kidney disease, those things start to go wrong and in particular, we start to retain waste products.


What are the early signs of kidney disease?


The early signs of kidney disease can be really difficult to find. Many people who develop kidney failure develop high blood pressure and swelling as the early signs. They may also find that their urine becomes a little frothy, a little bit like the head of a beer. In some people, they become quite tired early on. But it’s really quite variable and very non-specific. Kidney disease is one of those things that is often difficult to put a finger on until quite late.


How is kidney disease treated?


The treatment of kidney disease is mainly about trying to prevent the progression of kidney failure, so the main thing about kidney treatment is to keep the blood pressure completely normal. By treating blood pressure really aggressively, we can prevent kidneys deteriorating to the point of total kidney failure.

If we can find out why there is kidney damage in the first place, then we can put specific treatments in to prevent decline. Let’s say you have diabetes causing kidney damage, then making sure the diabetes is perfectly controlled will be really helpful.

However, if there is an underlying cause for the kidney damage, such as an allergic response within the kidneys, then your kidney specialist will offer you specific treatment to prevent that disease deteriorating. That may require things like steroids or other drugs that can turn off immune response within the kidney.


What is the prognosis for kidney disease?


The prognosis for kidney disease can be quite variable. Kidney disease is often related to the underlying problem within the kidneys such as high blood pressure or diabetes. Controlling blood pressure, and keeping blood sugar levels as normal as possible, will often mean that the kidney damage that these diseases cause can be minimised, and prognosis can be quite good.

For other causes of kidney damage such as cysts in the kidneys, maintaining the blood pressure level is really important for a good prognosis. There are other specific treatments that can slow cyst growth to give patients with polycystic kidney disease a good outlook.

Where there’s an immune problem, good control of the underlying condition can keep the kidneys functioning for many years.

If there is a decline in kidney function, many patients may be faced with a decision whether to have a kidney transplant, or to consider going on to dialysis. Dialysis can come in the form of a home treatment like peritoneal dialysis or in a hospital base where haemodialysis is offered.

If you have kidney disease and would like advice on managing the condition better, or if you are experiencing the symptoms of kidney disease and would like a diagnosis, you can make an appointment with a kidney specialist here.

By Dr Peter Hill

Dr Peter Hill is one of London's leading consultant nephrologists. From his clinics in London, he specialises in acute and chronic kidney disease, hypertension  and dialysis. He has a specialist interest in genetic kidney diseases, such as polycystic kidney disease and how the kidney is affected in cancer. He is also expert in placing dialysis lines and performing renal biopsies.

Alongside his private clinics, Dr Peter Hill is also consultant nephrologist at Hammersmith Hospital, Imperial College Healthcare, as well as at the Royal Marsden Hospital. Dr Hill also dedicates time to research, and has published peer-reviewed articles in medical journals and has written chapters in medical text books. 

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