Conservative treatment in the CKD predialysis phase

A comprehensive conservative treatment of chronic kidney disease (CKD) without dialysis uses dietary interventions and medications within the earlier stages of the disease. The conservative treatment aims to:

  • Slow the disease‘s progression and thereby postpone the onset of renal replacement therapy (e.g., dialysis, transplantation). 
  • Avoid or attenuate the development of secondary diseases (e.g., bone disease, cardiovascular disease)

It includes a broad spectrum of measures, e.g.:

  • Treatment/control of underlying diseases (e.g. diabetes mellitus, hypertension) 
  • Control of hypertension, which often develops as the disease progresses 
  • Prophylaxis and treatment of bone disease (diet, medication) 
  • Dietary protein restriction (supplemented with medication containing essential keto acids/amino acids, if required) - read more about nutrition in predialysis 
  • Correction of salt and water imbalances (diet, medication) - read more about fluid intake
  • Treatment of renal anaemia (medication with erythropoietin and iron) 
  • Correction of high levels of lipids in the blood (medication) 
  • Avoiding medications that could damage the kidneys 
  • Smoking cessation 
  • Weight control (diet, life style changes) 
  • Prevention and treatment of urinary tract infections (medication)

A kidney diet can help to slow the disease’s progression and attenuate symptoms of CKD.

Content last updated
  1. Fauci A, Braunwald E, Kasper DL et al.: Harrison´s Principles of Internal Medicine, 17th Edition, 2008