The newest treatment for chronic kidney disease

The kidneys might not get the same attention that the heart or brain does, but they are unquestionably a pair of hardworking organs. Every 30 minutes, your kidneys filter all the blood in your body, removing waste, toxins and excess fluid. And this helps keep your blood pressure in check.

What is CKD?

Chronic kidney disease is a condition in which your kidneys are damaged and gradually lose function over time. This damage is typically caused by other conditions. The No. 1 cause of CKD is diabetes. In fact, nearly 1 in 3 people who have diabetes also have CKD. That’s because high blood sugar can harm the blood vessels in your kidneys and make it harder for them to filter your blood.

Other major risk factors for CKD include high blood pressure, heart disease and a family history of kidney failure. CKD is also more common as you age. An estimated 38% of Indians over the age of 65 have CKD.

When kidney damage occurs, waste and fluid can begin to build up in the body. That can raise your blood pressure and also lead to protein in your urine, fluid retention and electrolyte disturbances.

It can be hard to recognize CKD at first, but signs of more advanced disease can include:

  • Swelling
  • Chest pain
  • Dry skin
  • Fatigue
  • Headaches
  • Increased or decreased urination
  • Muscle cramps
  • Shortness of breath
  • Vomiting
  • Weight loss
If left untreated, CKD can lead to kidney failure. That’s when the kidneys are functioning at less than 15% of normal levels. People with permanent, severe kidney damage will require dialysis or a kidney transplant.




What are the different stages of CKD?


CKD is often broken down into five stages based on how well your kidneys are working. Kidney function can be measured in a few different ways, but the most common is a blood test measuring the amount of waste in your bloodstream. If your provider mentions an estimated glomerular filtration rate, or eGFR, when discussing your CKD, know that it represents how well your kidneys are working (the higher your eGFR, the better your kidneys are doing).



HOW DID YOU GET CKD?

CKD is called a “silent disease,” with most people feeling no symptoms in the early stages. But there are several factors that are more common in people who develop CKD. Type 2 diabetes and high blood pressure are the two leading risk factors for CKD in the United States, but there are others—some within our control, some not. The adjacent chart shows common risk factors, including diabetes, high blood pressure, ethnicity, weight, family history, and age


How is CKD treated?

While the damage from CKD can’t be reversed, there are many steps you can take to stop it from getting worse. And many of them also protect your heart and overall health, too.

  • If you have diabetes, try to keep your blood sugar in your target range.
  • If you have high blood pressure, talk with your doctor about ways to lower it.
  • If you smoke, take action to quit.
  • Gradually incorporate more movement into your day.
  • Fill your plate with wholesome, heart-healthy foods: fruits and vegetables, beans, fish, low-fat dairy and lean cuts of meat.
  • Opt for fresh or homemade foods with less sodium.
  • Find ways to manage stress.
  • Talk to your doctor about medications that can help support your kidneys.
  • Reach out to your doctor for help, if you need it. 
Managing your blood sugar levels and blood pressure are 2 of the most important ways to protect your kidneys. But they’re not always easy to do. Talk to your doctor about how your care plan is working for you.

Which medications help with CKD?

Two types of medications widely used to treat CKD are angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). Both help lower blood pressure.

Recently, a third kind of medication has been added to the list of treatment options. They’re called sodium-glucose cotransporter 2 (SGLT-2) inhibitors. They were initially used to treat diabetes. But SGLT-2 inhibitors have shown potential in slowing down CKD when used with an ACE or ARB medication.

By 2014, the Food and Drug Administration had approved 3 types of SGLT-2 inhibitors to lower blood sugar levels in people with type 2 diabetes. In April, dapagliflozin (Diaflozin®) became the first to be approved to also treat CKD.

A 2020 study published in The New England Journal of Medicine found that Diaflozin lowered the risk of worsening kidney function, kidney failure or death from kidney failure or heart failure by 39%. It also reduced the risk of death from any cause by 31%.

How does Diaflozin work for CKD?

It’s an oral medication that’s taken once a day. It works by blocking the absorption of excess glucose (blood sugar) and sodium into the body.

You then excrete this extra glucose when you pee. That’s great news for people with type 2 diabetes because it can help lower their blood sugar levels. Diaflozin also lowers blood pressure (although researchers are still trying to understand how). This makes it easier for the heart to pump blood and for the kidneys to do their job.



Who can take Diaflozin?

Diaflozin is approved to treat 3 conditions: type 2 diabetes, heart failure and CKD.
When it comes to CKD, it works for people with or without diabetes. “Diaflozin is meant to slow the progression of chronic kidney disease and help prevent end-stage kidney disease,” says James J. O’Donnell, PhD. He’s an assistant professor at Rosalind Franklin University of Medicine and Science in North Chicago.
Diaflozin isn’t recommended for those with severe CKD who are on dialysis. Nor is it recommended for those with polycystic kidney disease or those who need or have recently undergone immunosuppressive therapy for kidney disease, says O’Donnell.
Being told you have CKD can be overwhelming. But having this knowledge puts you in the driver’s seat to take action. Thankfully there are more tools than ever at your disposal to halt CKD in its tracks.

What are the risk and side effects of Diaflozin for CKD?

Like all medications, Diaflozin has some risks and side effects you should be aware of before taking it. Most people tolerate this medication well. Common side effects include:

  • Yeast infections around the genitals (more common for people with external female genitals)
  • Urinary tract infections (UTIs)
  • Cold-like symptoms
  • Urinating more often than usual

Since more frequent urination is a common side effect of this medication, it is possible to become dehydrated while taking Diaflozin. This is more likely to happen if you also take diuretics (“water pills”). You should have regular blood tests while taking Diaflozin to watch for this complication. Let your provider know if your blood pressure has gone down since starting this medication, as that could be a possible sign of dehydration.

Very rarely, Diaflozin can cause a serious problem called ketoacidosis for people with diabetes. This life-threatening situation is caused by dangerously low insulin levels and leads to a build-up of acid in the body. Ketoacidosis is more common in people with type 1 diabetes, which is why you should not take Diaflozin if you have this form of diabetes. If you notice your sugar levels have dropped lower than your goal range since starting this medication, speak with your provider right away.
There are some people who should not take Diaflozin. People currently on dialysis should not take this medication, as it was not studied in those individuals, and they may have a higher risk for side effects. People who are pregnant should also not take Diaflozin, as there’s a concern that the medication could negatively affect the developing kidneys of a developing baby.

Packaging

 




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The newest treatment for chronic kidney disease The kidneys might not get the same attention that the heart or brain does, but they are unqu...