While kidney damage cannot be reversed, many aspects of the disease can be treated symptomatically. Starting with the early stages of the disease, the focus is on treating symptoms of hypertension and high urine protein. As the disease progresses, new symptoms such as anemia and high phosphorus levels are treated.
Determining which drugs and what doses are best can take months of adjustments. This is an ever-evolving picture, so doctors and patients must work together to optimize treatment.
Angiotensin converting enzyme inhibitors, otherwise known as ACE inhibitors, are the first line of defense against both hypertension and proteinuria, which almost invariably accompany chronic kidney disease. The great majority of people can take ACE inhibitors without side effects. According to NephrologyChannel.com, the most common side effect--a drug cough--affects 3 to 5 percent of patients who take it.
Angiotensin receptor blockers, or ARBs, are another hypertension medication often taken with ACE inhibitors or instead of ACE inhibitors. According to the National Institutes of Diabetes and Digestive and Kidney Diseases, ARBs are similar to ACE inhibitors in that they also lower urine protein and are easily tolerated by most patients.
Prednisone has many side effects, at least some of which are experienced by almost everyone who takes it. However, prednisone can be very effective in reducing serious urine protein.
Most of the common side effects of prednisone are minor. MayoClinic.com reports that some of the minor side effects are weight gain, fat redistribution, emotional issues and hyperactivity. More serious side effects include loss of bone density and stomach ulceration.
MayoClinic.com reports that because prednisone can cause serious side effects, the benefits of prescribing it must be weighed against the risk. Many doctors will not prescribe prednisone unless urine protein is very high.
Cellcept is the brand name for the immunosuppressant, mycophenolate mofetil. This is a relatively new drug used alone or with prednisone to lower levels of urine protein. Many patients who do not respond to prednisone, respond well with Cellcept. According to a 2008 issue of "Transplantation Proceedings," Cellcept has also been very helpful post-transplant. Cellcept is relatively easy for patients to take. A very few patients experience stomach upset, but this tends to go away over time.
Erythropoietin is used to treat anemia. According to the National Institutes of Diabetes and Digestive and Kidney Diseases, EPO is a hormone responsible for the maturation of red blood cells. Normally, this hormone is made by the kidneys. When kidneys become very scarred, they lose the ability to make this hormone so it must be replaced by synthetic EPO.
Kidney patients with advanced disease often have high levels of phosphorus. This can cause minor symptoms, such as itching, and serious symptoms, such as bone loss. Phosphorus binders can be taken to "lock up" excess serum. Often these binders are no more than a product such as TUMS. The calcium carbonate in the TUMS binds to the excess phosphorus.