How to Treat Kidney Disease
Effective management of kidney disease involves a combination of medical treatments and lifestyle changes aimed at slowing disease progression, managing symptoms and preventing complications. In this article, we look at medications used to treat immunoglobulin A nephropathy (IgAN)—a common form of kidney disease—and explore essential lifestyle modifications that support kidney health.
Medications for Immunoglobulin A Nephropathy
Treatment typically focuses on controlling symptoms, reducing proteinuria (excess protein in the urine) and preserving kidney function. The following medications are commonly employed in managing IgAN.
Tarpeyo
Tarpeyo (budesonide) is a relatively new medication approved for primary IgAN. It's an orally administered, delayed-release corticosteroid capsule designed to decrease inflammation and slow the decline of kidney function in adults with primary IgAN who are at risk of their disease worsening.
Diuretics
Diuretics, commonly known as water pills, help the kidneys remove excess sodium and water from the body. This reduction in fluid volume helps lower blood pressure and decreases the workload on the kidneys. Diuretics are particularly beneficial in managing edema (swelling) associated with kidney disease.
Angiotensin-Converting Enzyme (ACE) Inhibitors
ACE inhibitors, such as lisinopril and enalapril, are cornerstone therapies in treating IgAN. They work by inhibiting the enzyme responsible for the production of angiotensin II, a potent vasoconstrictor. This leads to vasodilation, reduced blood pressure and decreased proteinuria.
Steroids
Corticosteroids, like prednisone, are often prescribed for patients with IgAN who experience significant proteinuria or declining kidney function. Steroids reduce inflammation and suppress the immune system, thereby decreasing the deposition of IgA antibodies in the kidneys.
Statins
Statins, such as atorvastatin and rosuvastatin, are primarily used to lower cholesterol levels. In kidney disease patients, managing cholesterol is crucial, as high cholesterol can exacerbate cardiovascular risks, which are elevated in primary IgAN. By reducing LDL cholesterol and stabilizing atherosclerotic plaques, statins help prevent cardiovascular events.
Lifestyle Changes to Support Kidney Health
In addition to medications, lifestyle modifications play a vital role in managing kidney disease. Adopting healthy habits can slow disease progression, enhance overall well-being and reduce the risk of complications. Here are some lifestyle changes that can help manage kidney health.
Diet
A kidney-friendly diet is crucial for managing chronic kidney disease. Key dietary strategies include reducing sodium intake, managing protein consumption and balancing fluids.
Exercise
Regular physical activity has multiple benefits for kidney disease patients including lowering blood pressure, enhancing heart health and maintaining a healthy weight. Patients should aim for at least 150 minutes of moderate-intensity exercise per week, such as walking, swimming or cycling, unless otherwise advised by their healthcare provider.
Smoking Cessation
Smoking adversely affects kidney health by reducing blood flow to the kidneys and increasing the risk of cardiovascular disease. Quitting smoking can significantly improve kidney outcomes and overall health.
Managing Blood Sugar Levels
For kidney disease patients with diabetes, tight blood sugar control is essential as consistently high blood sugar levels damage blood vessels in the kidneys. Effective glucose management delays the onset and progression of diabetic kidney disease. In addition, regular monitoring of blood sugar and adherence to diabetes medications and management plans are critical components of kidney disease treatment.
Avoiding Painkillers
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can harm kidney function by reducing blood flow to the kidneys, with prolonged use leading to acute kidney injury. Alternative pain management strategies should be used and healthcare providers should be consulted before taking any over-the-counter pain medications.
Managing Weight
Obesity is a risk factor for kidney disease and its complications. A lower body weight decreases the workload on kidneys and helps manage blood pressure. Weight loss can also improve insulin sensitivity and lipid profiles, reducing the risk of diabetes and hypertension.
Managing Blood Pressure
Hypertension is both a cause and a complication of kidney disease. Keeping track of blood pressure, using antihypertensive medications and making lifestyle adjustments helps in maintaining blood pressure within target range. This is crucial for preserving kidney function and preventing cardiovascular events.
Final Notes
Managing kidney disease, particularly primary immunoglobulin A nephropathy, requires a multifaceted approach that combines targeted medications with comprehensive lifestyle modifications. Patients should work closely with their healthcare providers to develop a personalized treatment plan that addresses both medical and lifestyle aspects, ultimately aiming to enhance quality of life and preserve kidney function.