Managing Kidney Disease: Can Kidney Disease Be Reversed?

The primary role of the kidneys is to cleanse the blood of toxins and change waste into urine. However, when the kidneys are not functioning normally, excess fluids and harmful toxins will build up in your body, causing kidney failure. 

According to the National Kidney Foundation, approximately 80 million Americans¹ are at risk of kidney disease, affecting more women (14%) than men (12%). As the health of your kidneys deteriorates, you are more prone to other complications like anemia, weak bones, nerve damage, and high blood pressure.

Understanding kidney disease

Healthy kidneys filter nearly half a cup of blood every minute, eliminating waste, toxins, extra fluids, and water to make urine. After urine is made, it flows through two tubes of muscles called the ureters. The bladder stores the urine until you feel the urge to urinate.

The kidneys' function is impaired when there is kidney disease, which may eventually result in kidney failure. Kidney disease is where the kidneys are damaged and unable to filter out toxins and waste from the blood. Kidney failure is the end result of the damage and may result from different causes, including:

1. Acute kidney failure/ Acute renal failure

This is a sudden occurrence of kidney failure that develops rapidly over a few hours or days. It's most common among people who are critically ill or hospitalized. The symptoms may be subtle or may not appear until the kidney function is grossly abnormal. 

2. Chronic kidney disease (CKD)

A CKD diagnosis means that your kidneys have been damaged over months or years and cannot filter blood. Medication can help alleviate the symptoms, but a transplant or dialysis (filtering blood with the help of a machine) may be necessary for later stages of the disease. There are many causes of CKD, and they usually fall into three main categories:

3. Acute prerenal kidney failure and chronic prerenal kidney failure

Without enough flow of blood, your kidneys cannot filter out toxins and waste from your blood. In addition, a lack of enough blood for your kidneys for an extended period can cause the kidneys to shrink, resulting in them losing their ability to function. 

For these conditions, insufficient blood flow to the kidneys results in acute prerenal kidney failure. However, once the cause of the decreased blood flow is determined and treated, the kidneys can begin to function normally. 

4. Acute intrinsic kidney failure and chronic intrinsic kidney failure

This kidney failure condition results from direct trauma to the kidney cells themselves. Causes can include kidney toxicity from environmentally-induced toxins, allergic reactions to certain medications, autoimmune diseases such as lupus, or even diabetes. Certain chronic viruses, such as hepatitis or HIV, can also result in this. 

5. Chronic post-renal kidney failure

This type of kidney failure is caused by the blockage of urine flow (ureteral obstruction), which results in back pressure to the kidneys, causing damage to the nephrons. Ureteral obstruction is the blockage of the ureters — the tubes that carry urine from the kidney to the bladder. If not treated, the accumulated pressure can result in sepsis,² loss of kidney function, or death.

Symptoms of kidney disease

According to The National Kidney Foundation, approximately 37 million American adults³ have kidney failure but are unaware. The early stages of kidney disease have few to no symptoms. But once kidney failure progresses, some noticeable symptoms include:

• Frequent urge to urinate at night

• Foamy or bloody urine

• Swollen ankles, legs, and feet

• Muscle cramps 

• Dry and itchy skin

• Trouble sleeping or concentrating

• Tiredness and poor stamina

• Persistent puffiness around the eyes

• Poor appetite

What are the early signs of kidney failure?

Although early kidney failure exhibits unnoticeable symptoms, if you experience the following signs, see a doctor for further examinations:

• Swollen limbs due to fluid retention

• Reduced amount of urine

• Shortness of breath

Urine color for kidney disease

The color of your urine tells a lot about your overall wellness. Urine color changes may indicate potential issues with your internal organs. Below is a list of the different urine colors and their meaning:

• Pale yellow or clear - You are well hydrated and overall healthy.

• Amber or dark yellow - You are dehydrated. Or you should reduce your tea, coffee, and dark soda intake.

• Orange - There might be bile in your bloodstream, or you could be dehydrated. Alternatively, you may have taken a certain medication or vitamin that can cause this.

• Pink or red - Foods like beetroot or strawberries may alter your urine color, but blood might be a sign of kidney failure.

• Foamy  - Urine with bubbles shows the presence of proteins, a sign of kidney disease.

• Brown or “Coke” colored - This can signify aggressive intrinsic kidney disease.

Common causes of kidney disease

According to the National Institute of Diabetes and Digestive and Kidney Disease⁴ (NIDDK), high blood pressure and diabetes are the leading causes of chronic kidney disease. Other conditions that may lead to kidney failure include:

• Kidney stones

• Heart attack

• Heart disease

• Severe infections like sepsis

• Blood clots in your urinary tract

• Liver failure

• Enlarged prostate

• Damaged nerves that control your bladder

• Autoimmune conditions such as lupus

• Bone marrow cancer

• Genetic conditions like Alport syndrome⁵

Other factors may also lead to kidney failure, including:

• Prolonged use of drugs and alcohol

• Heavy metal poisoning, like lead poisoning

• Chemotherapy drugs

• Certain antibiotics

• Dyes used in some imaging tests

• Smoking and obesity

How is kidney disease diagnosed?

Your doctor can use several diagnostic tests to identify signs or symptoms of kidney failure. Some of the most common tests are:

• Urinalysis

Your doctor will request a urine sample from you to test for anything unusual, like sugar or atypical protein. In addition, your doctor will conduct a urinary sediment examination, looking for high levels of bacteria, white or red blood cells, and many cellular casts — tube-shaped particles that may signify kidney disease.

• Blood sample 

The doctor can request a blood test to measure specific substances like creatinine and blood urea nitrogen. A high rise in levels may reveal the possibility of acute kidney failure.

• Urine volume measurements

Measuring urine output is one of the easiest tests for diagnosing kidney failure. For example, a low urinary output can suggest kidney failure due to urinary blockage.

• Kidney tissue sample

Through a kidney biopsy, your doctor will take a kidney tissue sample to examine for unusual deposits, infectious organisms, or scarring.

• Imaging

Tests like CT scans, MRIs, and ultrasounds can provide the doctor with a clear image of your kidneys’ health to identify blockages or other problems.

Treatment of kidney disease

Your treatment plan depends on the cause and the stage of your kidney failure. Treatment may include one or both of the following:

Dialysis

Also called renal replacement therapy, dialysis is a treatment plan that uses a machine to do the work of the kidney — to purify and filter the blood. Depending on the type of dialysis, you may be attached to a portable catheter bag or a large machine at a hospital or medical institution.

When the doctor recommends dialysis, you may need to follow a low-salt and low-potassium diet. Dialysis does not cure kidney failure, but it can extend your life.

Kidney transplant

A kidney transplant is not the first treatment option for everyone with kidney disease. If there is no compatible kidney donor, you will usually have to wait until one becomes available.

After a successful transplant, you must take immunosuppressant drugs to prevent your body from rejecting the new kidney. Talk with your doctor to see if you are a good candidate for a kidney transplant.

Can you reverse kidney damage?

Acute renal failure is reversible, but chronic kidney disease is marked by continuous, irreversible damage to the kidneys’ nephrons. For chronic kidney disease, further damage is preventable if you are at stage three or below. However, preventing further deterioration is difficult if the disease is at stage four or five.

With a kidney failure diagnosis, following the recommended treatment options may help extend your lifespan. According to the National Kidney Foundation,⁶ a person on dialysis can live up to ten years,⁶ provided they follow their treatment. Predicting exact life expectancy is impossible because each patient responds differently to a treatment.

How do you keep kidney diseases from getting worse?

You can take various steps to ensure your kidney disease doesn't worsen. You should:

• Maintain a healthy lifestyle, including regular exercise and lowering your alcohol intake

• Manage conditions like diabetes and high blood pressure according to your doctor's advice

• Follow your doctor's instructions on prescribed medication

• Make dietary changes like limiting your intake of sodium, potassium, and phosphorus

When to visit a doctor

After a kidney failure diagnosis, your doctor will put you through a suitable treatment plan: dialysis, medication, or a kidney transplant. If you have no prior kidney failure diagnosis but experience symptoms like foamy or bloody urine or water retention in your body, then see your doctor.

If you notice any of the following symptoms during your treatment, make an immediate appointment with your doctor:

• Fatigue or drowsiness

• Losing consciousness

• Water retention in your feet

• Prolonged bloody or foamy urine

• Shortness of breath

• Insomnia

• Confusion

• Tremors

The lowdown

Kidneys are essential organs in your body as they help filter out toxins, extra fluid, and acid to maintain an optimal balance of water, salts, and minerals. When your kidneys fail to remove your body's waste, your doctor will diagnose you with kidney failure.

You can prevent kidney failure by maintaining a healthy lifestyle, including exercise, well-balanced meals, and adequate water intake. If you have kidney disease, talk to your doctor about the treatment plan. Kidney disease can be fatal if ignored or unnoticed, especially since the condition does not have notable early signs and symptoms.