How to Slow Chronic Kidney Disease and Avoid Dialysis
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How to Slow Chronic Kidney Disease and Avoid Dialysis
🩺 How to Slow Chronic Kidney Disease and Avoid Dialysis
Introduction: Don’t Wait Until It’s Too Late
Chronic Kidney Disease (CKD) often goes unnoticed until the kidneys have lost up to 90% of their function. At that point, dialysis or a transplant becomes necessary. Many patients don’t know their kidneys are failing until symptoms like shortness of breath, swelling, or fatigue appear. The good news is that with early detection and the right lifestyle choices, the progression of CKD can be slowed—and even halted.
What Causes CKD?
The two most common causes are:
- High Blood Pressure (Hypertension)
- Damages kidney blood vessels over time
- Often silent, but very harmful
- Needs lifelong management with diet and medication
- Diabetes (Type 1 or 2)
- High blood sugar damages the kidneys’ filters
- Can cause protein leakage in urine before function drops
- Controlled blood sugar reduces the risk of kidney damage
Other contributing causes include:
- Chronic dehydration
- Overuse of NSAIDs (ibuprofen, naproxen)
- Frequent urinary tract infections
- Autoimmune conditions like lupus
- Polycystic kidney disease
- Urinary obstructions (e.g., enlarged prostate)
Understanding the Stages of CKD
CKD progresses in five stages, based on estimated glomerular filtration rate (eGFR):
- Stage 1: eGFR ≥ 90 – Normal function but with signs of damage
- Stage 2: eGFR 60–89 – Mild decline, often symptomless
- Stage 3a/b: eGFR 45–59 or 30–44 – Moderate loss, fatigue and swelling may appear
- Stage 4: eGFR 15–29 – Severe loss with anemia, weakness, and electrolyte issues
- Stage 5 (ESRD): eGFR < 15 – End-stage renal disease; dialysis or transplant needed
Dialysis usually starts at Stage 5, but it may begin earlier if life-threatening fluid overload, high potassium, or severe uremic symptoms (like confusion or pericarditis) develop.
Types of Dialysis
Hemodialysis (HD)
- Blood is filtered through a machine using a vascular access (fistula or graft)
- Typically done 3 times/week, 3–5 hours per session
- Common side effects: fatigue, low blood pressure, cramps
- Requires regular visits to a dialysis center
- Best for patients who prefer care from medical staff
Peritoneal Dialysis (PD)
- Uses a catheter in the abdomen and the peritoneal membrane to filter waste
- Can be done manually (CAPD) or with a machine overnight (APD)
- Allows more independence and travel flexibility
- Requires strict hygiene and manual skill
- Common complications: infections (peritonitis), hernias, and weight gain
Why Dialysis Patients End Up in the ER
Emergency room visits are common and often preventable. Common reasons include:
- Bleeding at the access site – Can lead to shock if not controlled
- Fluid overload – Leads to shortness of breath and pulmonary edema
- Heart failure – Triggered by volume overload and hypertension
- Infections – Peritonitis or sepsis from catheters or fistulas
- Low blood pressure – Can cause fainting and falls
- High potassium (hyperkalemia) – Can lead to sudden cardiac arrest
How to Reduce Your Risk of Dialysis
1. Keep Blood Pressure in a Safe Range
- Target: Below 140/90 mm Hg—but not too low
- Avoid falling below 90/60 mm Hg to prevent acute kidney injury
- If BP drops below 90 systolic, call your doctor or go to the ER
2. Control Blood Sugar—Especially After Meals
- Post-meal targets:
- Less than 155 mg/dL at 1 hour
- Less than 140 mg/dL at 2 hours
- Avoid sugary drinks and walk after meals
3. Stay Physically Active
- 150 minutes of moderate activity weekly
- Improves blood sugar and pressure control
- Examples: walking, gardening, biking, dancing
4. Lose Weight if Overweight
- Losing 5–10% of body weight improves metabolic control
- Focus on whole foods and avoid ultra-processed products
5. Get Tested Regularly
- Ask your doctor for:
- eGFR (blood test)
- Urine albumin-creatinine ratio
- Especially important if you have diabetes, high BP, or a family history of CKD
6. Work With a Dietitian
- Adjust intake of potassium, phosphorus, protein, and sodium as CKD progresses
- Your needs change over time—update the plan regularly
7. Take Medications as Prescribed
- ACE inhibitors and ARBs help kidneys
- Avoid NSAIDs unless approved
- Inform your doctor if you’re sick—especially if vomiting or having diarrhea
- Stop diuretics or ACEIs during dehydration, only under medical supervision
8. Avoid Dehydration During Illness
- Most common reason for sudden kidney decline
- CKD patients on blood pressure meds are vulnerable
- Use oral rehydration solution (ORS) during vomiting or diarrhea
- If unable to drink, seek emergency care immediately
WHO-Recommended ORS Recipe (Home Version)
Mix the following to make 1 liter of ORS:
- 1 liter clean water
- 6 level teaspoons of sugar
- ½ level teaspoon of salt
Use small sips every few minutes. Refrigerate and discard unused portions after 24 hours.
9. Quit Smoking
- Raises BP
- Damages kidney blood vessels
- Reduces effectiveness of kidney-protective medications
10. Include a Nephrologist on Your Care Team
- They fine-tune medications and monitor CKD progression closely
- Help prevent complications from diabetes, high BP, and medications
11. Inform All Your Doctors and Pharmacists
- This ensures safer prescriptions
- Wear a medical ID if you’re on dialysis or Stage 4–5 CKD
Final Thoughts: Act Early
Most kidney failure is preventable. Don’t wait for symptoms to start. Control your blood sugar, manage blood pressure, stay hydrated, and avoid harmful medications. The earlier you act, the more kidney function you save—and the longer and better you live.
Don’t wait for dialysis. Don’t Get Sick.
🩺 Paano Pabagalin ang Chronic Kidney Disease at Iwasan ang Dialysis
Panimula: Huwag Maghintay Hanggang Huli Na
Ang Chronic Kidney Disease (CKD) ay kadalasang hindi nararamdaman hanggang sa bumaba ng halos 90% ang kakayahan ng mga bato. Sa puntong iyon, kailangan na ng dialysis o kidney transplant. Maraming pasyente ang hindi alam na unti-unti nang nasisira ang kanilang bato—hanggang sa dumating ang mga sintomas tulad ng hirap sa paghinga, pamamaga, o matinding pagkapagod.
Ang maganda, kung maagang matukoy at maagapan sa pamamagitan ng tamang pamumuhay, puwedeng pabagalin o pigilan ang paglala ng sakit.
Sanhi ng CKD
Pinakamadalas na sanhi:
- Altapresyon (High Blood Pressure)
- Sumisira sa maliliit na daluyan ng dugo sa kidney
- Tahimik pero mapanganib
- Kailangan ng panghabambuhay na gamot at kontrol sa pagkain
- Diabetes (Type 1 o Type 2)
- Ang labis na asukal sa dugo ay sumisira sa mga filter ng bato
- Nagdudulot ng protina sa ihi kahit hindi pa bumababa ang kidney function
- Kung makokontrol ang asukal, bababa ang panganib sa kidney
Iba pang posibleng dahilan:
- Palagiang kakulangan sa tubig (dehydration)
- Madalas na paggamit ng NSAIDs gaya ng ibuprofen o naproxen
- Paulit-ulit na impeksyon sa ihi
- Autoimmune diseases (hal. lupus)
- Polycystic kidney disease
- Pagbara sa daanan ng ihi (hal. pinalaking prostate)
Mga Yugto ng CKD
Ang CKD ay may limang yugto base sa eGFR (estimated Glomerular Filtration Rate):
- Stage 1 (eGFR ≥ 90): Normal pero may senyales ng damage
- Stage 2 (eGFR 60–89): Banayad ang pagbagsak, kadalasang walang sintomas
- Stage 3a/b (eGFR 45–59 o 30–44): Katamtamang pagbagsak, may pagkapagod at pamamaga
- Stage 4 (eGFR 15–29): Malubha na, may anemya at abala sa electrolytes
- Stage 5 (eGFR < 15): Kidney failure, kailangan ng dialysis o transplant
Maaaring magsimula ang dialysis sa Stage 5, o mas maaga kung may sobrang tubig sa katawan, mataas na potassium, o sintomas ng uremia gaya ng pagkalito o pananakit ng dibdib.
Mga Uri ng Dialysis
Hemodialysis (HD)
- Dugo ang sinasala sa makina gamit ang fistula o graft
- Tatlong beses kada linggo, 3–5 oras bawat session
- Side effects: pagod, mababang BP, pulikat
- Ginagawa sa dialysis center
- Para sa gustong alagaan ng staff
Peritoneal Dialysis (PD)
- Gamit ang catheter sa tiyan at lining ng abdomen
- Puwedeng manual (CAPD) o machine (APD) habang natutulog
- Mas malaya ang pasyente at puwedeng maglakbay
- Kailangan ng linis at kasanayan
- Panganib: impeksyon (peritonitis), luslos, pagdagdag ng timbang
Bakit Nauuwi sa ER ang Dialysis Patients
Maraming pasyente ang napupunta sa ER dahil sa komplikasyong puwedeng iwasan:
- Pagdurugo sa access site
- Sobrang tubig sa katawan (fluid overload)
- Heart failure
- Impeksyon (peritonitis o sepsis)
- Mababang blood pressure
- Mataas na potassium (hyperkalemia)
Paano Iwasan ang Paglala at Dialysis
1. Panatilihin ang Tamang Presyon ng Dugo
- Target: hindi lalampas sa 140/90 mm Hg
- Huwag ding sobrang baba (iwasan ang <90/60 mm Hg)
- Tumawag agad sa doktor kung masyadong mababa
2. Kontrolin ang Blood Sugar—Lalo na Pagkatapos Kumain
- Target post-meal:
- <155 mg/dL sa 1 oras
- <140 mg/dL sa 2 oras
- Umiwas sa matatamis, maglakad pagkatapos kumain
3. Mag-ehersisyo
- 150 minuto kada linggo
- Nagpapababa ng asukal at BP
- Halimbawa: paglalakad, pag-garden, sayaw, bisikleta
4. Magbawas ng Timbang kung Overweight
- Kahit 5–10% na bawas ay malaki ang epekto
- Iwasan ang processed food, kumain ng whole foods
5. Magpa-test Regularly
- eGFR at urine protein test (albumin-creatinine ratio)
- Para sa may diabetes, altapresyon, o edad 60 pataas
6. Kumonsulta sa Dietitian
- Ayusin ang pagkain base sa potassium, phosphorus, at protina
- Pa-regular ang check habang lumalala ang CKD
7. Uminom ng Tamang Gamot
- ACE inhibitors at ARBs ay nakakatulong sa bato
- Iwasan ang NSAIDs maliban kung pinayagan
- Kapag may pagsusuka o pagtatae, tanungin ang doktor kung ihihinto muna ang gamot
8. Iwasan ang Dehydration
- Pinakakaraniwang sanhi ng biglaang kidney failure
- Lalo na kung umiinom ng BP meds o diuretics
- Uminom ng ORS (oral rehydration solution) kung may pagsusuka o pagtatae
- Kung di makainom, pumunta agad sa ER
ORS na Aprobado ng WHO (Homemade)
Sangkap para sa 1 litro:
- 1 litrong malinis na tubig
- 6 na kutsarita ng asukal
- ½ kutsarita ng asin
Haluing mabuti hanggang matunaw.
9. Itigil ang Paninigarilyo
- Nakakasira ng blood vessels
- Nagpapataas ng BP
- Binabawasan ang bisa ng gamot sa bato
10. Magpa-konsulta sa Nephrologist
- Eksperto sa kalagayan ng kidney
- Tumutulong sa tamang gamot at monitoring
11. Sabihin sa Lahat ng Doktor at Parmasiyutiko na May CKD Ka
- Para maiwasan ang gamot na nakakasama sa kidney
- Magdala ng medical ID kung nasa Stage 4–5 ka o naka-dialysis
Pangwakas: Maagang Pag-aksyon ang Susi
Karamihan sa mga kaso ng kidney failure ay puwedeng iwasan. Huwag nang hintayin ang sintomas. Kontrolin ang asukal, BP, uminom ng sapat, at iwasan ang gamot o gawing makakasama sa bato.
Ang oras para mag-ingat ay ngayon.
Huwag maghintay ng dialysis.
Huwag Magkasakit! Don’t Get Sick!
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References:
- Centers for Disease Control and Prevention (CDC).
“Chronic Kidney Disease Initiative.”
Centers for Disease Control and Prevention, 2022. https://www.cdc.gov/kidney-disease/index.html - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
“Chronic Kidney Disease (CKD).”
U.S. Department of Health and Human Services,
https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd - Kidney Disease: Improving Global Outcomes (KDIGO).
“KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.”
Kidney International Supplements, vol. 3, no. 1, 2013, pp. 1–150.
https://kdigo.org/guidelines/ckd-evaluation-and-management/ - World Health Organization (WHO).
“Oral Rehydration Salts: Production of the New ORS.”
World Health Organization, 2006.
https://www.who.int/publications/i/item/WHO-FCH-CAH-06.1 - Palmer, Suetonia C., et al.
“Dietary Interventions for Adults with Chronic Kidney Disease.”
Cochrane Database of Systematic Reviews, no. 4, 2017, Art. No. CD011998.
https://doi.org/10.1002/14651858.CD011998.pub2 - Mayo Clinic Staff.
“Peritoneal Dialysis.”
Mayo Clinic, 2022.
https://www.mayoclinic.org/tests-procedures/peritoneal-dialysis/about/pac-20384725 - National Kidney Foundation.
“High Blood Pressure and Kidney Disease.”
National Kidney Foundation, https://www.kidney.org/sites/default/files/high_blood_pressure_and_ckd_stages_1-4.pdf
Image Credits:
- Hemodialysis By GYassineMrabetTalk✉This W3C-unspecified vector image was created with Inkscape. – Own work from Image: Hemodialysis schematic.gif., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=3411574
- Peritoneal Dialysis National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, USA
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