Can Kidney Disease Be Reversible?

It can be in some cases-- chronic kidney failure is less commonly reversible than acute renal failure. Usually kidney disease is a progressive disease and the damage once done to the kidneys is permanent. Hence, an early diagnosis of the condition is important. Fortunately, if diagnosed in the early stages, treatment of CKD can be done very effectively.

Acute kidney failure is a condition characterized by sudden inability of the kidneys to filter waste products out of the blood, leading to accumulation of these waste products in the body to dangerous levels. This disrupts the chemical balance of your blood.

Acute kidney failure develops suddenly either over a few hour or a few days. It is most common in patients who are hospitalized for some other illness, especially those who are critically ill and require intensive care.

Is it eversible? Yes, acute kidney failure may be reversed. Patients who are otherwise healthy may recover with normal kidney function.

However, if there is complete failure of one or both of the kidneys then damage caused is irreversible, the condition is referred to as end-stage renal disease (ESRD). During ESRD, the kidneys are unable to filter waster from the bloodstream. The various symptoms of ESRD include weakness, fatigue, vomiting, nausea and itching.

What about chronic kidney disease? Is kidney disease reversible in this case? There are 5 stages of chronic kidney disease. Both stage 1 and stage 2 kidney disease are reversible. In stage 3 and 4, there are only 50% chances of your kidney function being reversed. During stage 3 kidney disease moderate damage to the kidneys occur. Stage 3 is one vital stage for patients to improve their health. By following a systemic treatment plan, patients can either reverse their stage 3 kidney disease or at least stay in the same stage for greater than 20 years. The stage 5 kidney disease is the end-stage renal disease and cannot be reversed.

The main aim of treatment of CKD is to prevent its progression to end-stage renal disease. The best way to achieve this is to make a correct diagnosis and control the cause underlying the disease.

Slowing the Progression of Kidney Disease

Once you have developed CKD, it may become worse gradually over the months or years. This can happen even if treatment has been provided for the underlying cause. Your physician would provide you advice on how to slow down or prevent the progression of your CKD. Some of these include:

Control of blood pressure: To keep your blood pressure under control is one of the most important ways to delay the progression of your CKD, whatever may be the underlying cause. The majority of the patients with CKD will need medicines for controlling their blood pressure. The usual blood pressure to aim for is below 130/80 mm Hg and even lower in some cases.

Review of your medicine: Your kidneys may get affected by certain medicines making CKD worse. For instance, patients having CKD should not take anti inflammatory medication unless advised by a physician. The dose of certain medicines may need to get adjusted if your CKD worsens.

What is the Prognosis?

Is kidney disease reversible? We already know it can be. Mild to moderate CKD are common with the majority of the cases happening in the elderly. It gradually worsens over months or years. However, how frequently it will progress varies from one individual to another and also depends on how severe any underlying condition present is. Only a very small number of patients will reach end-stage renal failure requiring dialysis or transplant.

Patients suffering from CKD are more prone to have cardiovascular diseases such as stroke, heart disease, and peripheral arterial disease. Therefore, it is important to take precautions:

• Keeping your blood pressure and blood sugar (if you have diabetes) in control.

• Taking medicines (referred to as statins) to reduce your cholesterol levels.

• Tackling lifestyle factors where relevant, for instance, quitting smoking if you smoke, eating a well-balanced and healthy diet with low sodium intake, keeping your weight in check, doing regular physical activity and reducing your alcohol intake.

Patients who have high protein levels in urine may be recommended to take medicine even if they have normal blood pressure. A type of medicine referred to as ACE inhibitor (for instance, enalapril, captopril, lisinopril) has been found to be beneficial in patients suffering from CKD. It decreases the risk of CVD and prevents further worsening of kidney function.

Patients suffering from stage 3 CKD or worse should be given influenza vaccine every year and also immunized against pneumococcus.

Treatment for End-Stage Kidney Failure

During complete kidney failure, the kidney function is completely lost and dialysis or kidney transplantation is needed to maintain life of the patient. Dialysis is of two major types:

• Hemodialysis: In hemodialysis, the blood is passed through an external filter and then the clean blood is infused back to the body. It is done at a dialysis center and the usual frequency is 3 times a week.

• Peritoneal dialysis: In peritoneal dialysis the lining of the patient’s abdominal cavity (the space present in the body, which holds organs such as intestines, liver and stomach) is utilized to filter the blood. Peritoneal dialysis has to be done daily; however, it can be performed at your home even while you are asleep.

During a kidney transplant, a healthy kidney from a donor is transplanted into the patient’s body and the diseased kidney is removed. The transplanted healthy kidney takes over the work of the failed kidneys and dialysis is no longer required.