How to treat kidney failure
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Summary
10 papers analyzed
These studies suggest that treating kidney failure involves a combination of education, conservative and supportive care, new medical strategies, nutritional and drug therapy, physical therapy, and dialysis options.
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Treatment Options for Kidney Failure
Diabetic Kidney Disease and Kidney Replacement Therapy
Diabetic kidney disease (DKD) is a leading cause of kidney failure (KF). Management of patients with severely reduced glomerular filtration rate (GFR) often involves multidisciplinary teams led by nephrologists. These teams aim to halt chronic kidney disease (CKD) progression and prevent cardiovascular complications. Treatment decisions for patients with diabetes and KF include whether to pursue kidney replacement therapy (KRT) or opt for conservative care. If KRT is chosen, options include dialysis (home or in-center) and transplantation (from living or deceased donors).
Conservative Management of Acute Renal Failure
Acute renal failure (ARF) treatment is primarily conservative and supportive. This includes stabilizing the patient, monitoring fluid and electrolyte balance, preventing infections, and adjusting medication dosages based on renal function. Specific therapies may involve steroids, immunosuppressive agents, and anticoagulants. Dialysis remains the only FDA-approved treatment for ARF, although it can sometimes prolong renal failure .
New Perspectives in Acute Renal Failure Management
Despite advances in medical care, ARF remains a significant issue with high mortality rates. New strategies, such as the use of biocompatible membranes and continuous renal replacement therapy (CRRT), show promise. Calcium channel blockers and vasoactive agents like dopamine may also aid in managing ARF. However, more controlled clinical studies are needed to confirm their efficacy.
Conservative Care for Chronic Kidney Disease
For older patients with advanced CKD, conservative care focuses on symptom alleviation rather than dialysis. This approach can maintain quality of life and mental well-being until near the end of life. However, conservative care is often under-discussed, and more comprehensive information is needed to support patient decision-making.
Management of Heart Failure in CKD Patients
Heart failure (HF) is common in CKD patients and requires integrated care from both HF and renal specialists. Effective treatments include β-blockers, RAAS inhibitors, ARNIs, and MRAs, although their use is often limited by concerns about hyperkalemia and worsening renal function. Sodium-glucose co-transporter 2 inhibitors and IV iron therapy are emerging as beneficial treatments for HF in CKD patients.
Therapeutic Management in Polycystic Kidney Disease
In polycystic kidney disease (PKD), therapeutic management aims to provide nutritional support, reduce uremic symptoms, and manage electrolyte and acid-base disturbances. Drug therapy targets the physiological consequences of CKD, aiming to slow disease progression and improve patient outcomes.
Physical Therapy in Chronic Renal Failure
Physical therapy is crucial for patients with chronic renal failure, especially those undergoing dialysis or post-kidney transplant. It helps manage complications such as congestive heart failure and peripheral neuropathies, improving overall patient rehabilitation.
Renal Replacement Therapy in Heart and Kidney Failure
For patients with both heart and kidney failure, renal replacement therapy (RRT) is essential when conservative management fails. Ultrafiltration (UF) and peritoneal dialysis (PD) are effective in managing fluid overload and improving heart function. PD, in particular, offers advantages such as better preservation of residual kidney function and the convenience of home treatment.
Conclusion
The treatment of kidney failure involves a range of strategies tailored to the underlying cause and patient condition. From conservative management and supportive care to advanced therapies like dialysis and transplantation, a multidisciplinary approach is essential for optimizing patient outcomes.
Sources and full results
Most relevant research papers on this topic
2
[Treatment of acute renal failure].
2
386 Citations
1998
8
Conservative therapy in chronic renal failure
8
0 Citations
2015