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Routine Medicine Treatment

Routine treatments are clinically commonly applied approaches in treating kidney diseases. This includes a variety of drugs and approaches, which remit symptoms and complications, and delay or control further progression of kidney damage. Treatment measures mainly go as follows.

Control high blood sugar. Diabetes is currently the leading cause of end-stage kidney disease (ESRD). The persistent high blood sugar can impair filtering units of the kidneys and reduce kidney functions. Management of blood glucose is a lifelong affair to prevent onset of kidney disease. Dietary therapy, exercise and medicines are essential, and regular microalbuminuria is suggested to test out Diabetic Kidney Disease as early as possible.

Control high blood pressure. Most patients with kidney diseases have high blood pressure at some time during their disease. Medicines that lower blood pressure within targeted range help slow damage to their kidneys. In those with primary hypertension, long-term or poor controlling can also cause hypertensive nephropathy. In either case, anti-hypertensive medicines and a low sodium diet are essential to manage their blood pressure.

Commonly applied anti-hypertensive medicines mainly include the follows:

ACEI inhibitors

Beta-blockers

Calcium channel blockers

Diuretics

Vasodilators

Diuretic medicines for edema/swelling caused by fluid retention. The treatment is helpful for reducing hypertensive caused by excess blood fluid and decreasing burdens on their kidneys.

Erythropoietin and iron replacement therapy can stimulate production of red blood cells and may decrease the need for blood transfusions. The therapy may also be started before dialysis is started, when anemia is severe and causing symptoms.

Vitamin D and phosphorus binders are applied to keep balances between calcium and phosphorus and make bones strong and healthy.

Gastrointestinal tract absorbents can absorb creatinine and uric acids from gastrointestinal tract, thus reducing wastes from bloodstream. Diarrhea can sometimes be the side effect.

Immunosuppressive medicines for kidney diseases:

Some types of kidney diseases occur through activation of the immune system causing inflammation. Lupus Nephritis, vasculitis, and Goodpasture's disease are all diseases in which kidney damage is caused by inflammation. Immunosuppressive medicines and medicines that reduce inflammation are used to treat these diseases. 

Immunosuppressive drugs are essential in kidney transplants to suppress the immune system and prevent rejections. Some other kidney diseases are slower but also respond to this type of treatment, for example some causes of nephrotic syndrome. Commonly applied immunosuppressive medicines mainly include:

Steroids

Steroids, full description as corticosteroids, are the most commonly used immunosuppressive medicines which include prednisolone, methyl prednisolone, etc. Heavy dose or long-term use of those medicines can cause some well known side effects, including weight gain, thinning of bones, increased risks of infections, raised blood pressure, etc.

Cyclophosphamide

Cyclophosphmide is a powerful drug drug that attacks white blood cells. It has proven to be especially effective in several types of vasculitis that were often fatal in the past, and in SLE and in other conditions. However the drug has some serious side-effects, just to name a few: serious infections and bleeding, increased risks of leukemia and bladder cancer in later life, infertility in men and women, etc.

Azathioprine

This drug has similar side-effects to cyclophosphamide but is less powerful and generally safer. Azathioprine can be used at the outset in milder vasculitis or after a long course of cyclophosphamide in severe vasculitis. It is also applied to prevent rejection in kidney transplants or in some types of glomerulonephritis. People on long course of azathioprine are at increased risk of developing skin tumors.

Cyclosporin (ciclosporin) and tacrolimus

Cyclosporin and tacrolimus are powerful medicines to dampen the immune response. They are commonly used in kidney transplant and some kidney diseases such as Nephrotic Syndrome. Side effects may occur in both of the two. Cyclosporin may cause tremor and excessive hair growth especially on face. Tacrolimus can also cause tremor, but it also can cause headaches, feeling of sleekness, pins and needles in legs, etc. Both of the two may cause kidney damage themselves.

Renal replacement therapies:

 Receive multidisciplinary, comprehensive clinical management by kidney disease professionals for at least 6 months prior to requiring RRT. 

In end-stage kidney disease the kidneys function so poorly that they can no longer keep people alive. At this point, there are two treatment options in western medicine treatment, that is, dialysis and kidney transplant.

Dialysis

Dialysis is the term for several different methods of artificially filtering the blood. People who require dialysis are kept alive but give up some degree of their freedom because of their dialysis schedule, fragile health, or both. 

Kidney transplant

Kidney transplantation means replacement of the failed kidneys with a working kidney from another person, called a donor. Kidney transplantation is not a complete cure, although many people who receive a kidney transplant are able to live much as they did before their kidneys failed. People who receive a transplant must take immunosuppressive medicines and be monitored by a physician who specializes in kidney disease for the rest of their lives.

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