How to Slow Down CKD: A Doctor’s Guide to Avoiding Dialysis

How to Slow Down CKD: A Doctor’s Guide to Avoiding Dialysis

First thing to do – know more about CKD. We hope this article will help you.

Chronic Kidney Disease (CKD) is very common. It affects approximately 10% of the population, yet (fortunately) only 1 in 100 people with the condition will progress to kidney failure (Stage 5) – and require dialysis or a kidney transplant.

Whilst CKD is rarely ‘curable,’ it is highly treatable. By using a coordinated approach between you, your GP, and your specialist, you can significantly delay or even halt kidney decline.

Here are 10 ways you and your doctor can slow CKD.

1. Use the ‘Triple Shield’ Prescription

The cornerstone of modern kidney protection is a combination of medications designed to prevent scarring (fibrosis) and reduce the workload on your kidney filters.

• SGLT2 Inhibitors: Drugs like Dapagliflozin have been shown to reduce the risk of kidney decline by 40%.

• ACE Inhibitors/ARBs (e.g. Ramipril or Losartan): These protect the kidneys by lowering internal pressure.

• MRAs (e.g. Finerenone): These help prevent the inflammation and scarring that lead to failure.

2. Monitor Your Urine ACR Annually

While many focus on blood tests (eGFR), the Urine ACR (Albumin-to-Creatinine Ratio) is the earliest warning sign of kidney stress. It measures protein ‘leakage.’

Reducing protein in the urine is directly linked to better long-term kidney survival. If your CKD is progressing, your doctor may suggest testing this more frequently than once a year.

3. Achieve the 130/80 Blood Pressure Target

Intensive blood pressure control is the foundation of renal care. High pressure physically batters the delicate filters in your kidneys.

Research, such as the SPRINT trial, confirms that maintaining a lower systolic blood pressure significantly reduces the risk of cardiovascular complications and death in kidney patients.

For a deeper dive into how blood pressure affects your kidneys, see our guide: How to Lower Blood Pressure

4. Avoid NSAIDs

Common over-the-counter painkillers known as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can cause permanent damage to those with CKD.

• Avoid: Ibuprofen, naproxen, diclofenac, and high-dose aspirin.

• The Risk: These drugs cause ‘haemodynamic’ injury, reducing the blood supply to the kidney’s filtering units.

5. Implement Salt Restriction

Excess salt does more than just raise blood pressure; it actively ‘blunts’ the protective effects of your medications, such as ACE inhibitors.

Aim for less than 5g of salt per day to ensure your medication can do its job effectively.

6. Intensive Glucose Management

If you have diabetes, managing your blood sugar is vital to prevent further “scarring” of the kidney filters.

A high HbA1c level indicates that glucose is damaging the small blood vessels in the kidneys.

Newer GLP-1 receptor agonists have shown significant promise in protecting the kidneys alongside traditional glucose monitoring.

7. Follow the ‘Sick Day Rules’

Acute Kidney Injury (AKI) often happens during a temporary illness (like a stomach bug or flu). You should know when to temporarily stop the ‘DAMN’ drugs to protect your function:

• Diuretics (water tablets)

• ACE inhibitors

• Metformin

• NSAIDs

8. Seek Targeted Therapy for Specific Causes

Not all CKD is the same. Depending on the cause of your kidney damage, you may need specific medical intervention to treat the underlying cause of CKD.

To understand the different categories of kidney disease, read: What are the causes of CKD?

9. Maintain Communication and Transparency

Communication gaps between hospital specialists and your GP can lead to progression.

• Up-Titration: Ensure your GP promptly implements dose increases suggested by your Nephrologist.

• Digital Portals: Use tools like Patients Know Best (PKB) to track your own eGFR trends.

• Pharmacy: Always ask your pharmacist to screen over-the-counter meds for ‘kidney safety.’

10. Understanding Your Stage and Goal

The primary goal is to freeze your kidney function at its current stage for as long as possible.

Expert Advice

Always bring a list of your current supplements to your doctor. Many ‘natural’ herbal remedies or high-protein shakes can unintentionally strain your kidneys.

Your team is there to help you navigate these choices to keep your kidneys functioning for a lifetime.

For more information on what your numbers mean, see: What is a GFR (Glomerular Filtration Rate)?

If you are concerned about advanced stages, read: Life Expectancy in Stage 5 CKD (Kidney Failure)