You’ve diligently taken your meds. You’ve also ditched the meals you love and stuck to the meals the dietician recommended. Yet at your follow-up visit, the doctor reports worsening kidney function. This is the reality for many people living with CKD.
Here are 5 possible reasons kidney function gets worse despite treatment.
Causes of worsening kidney function
There are several reasons your kidney function may drop.
An underlying disorder.
The first question is whether there is something else lurking under the surface attacking your kidneys.
When doctors start CKD treatments for patients, they look for things that may damage the kidneys. This is a crucial step since resolving any issue that causes kidney dysfunction gives the kidneys a chance to recover.
Unfortunately, a clinical condition can go unrecognized and cause ongoing damage. For example, autoimmune diseases can do this.
The problem is this. If you still have a condition knocking down the kidneys, your medical and nutritional therapy may not be enough.
Even though it is the last thing you want to hear, you may have an unrecognized medical conditions. To check for other underlying conditions, your doctor will likely ask you more questions and examine you to get some insight. You may also be asked to do some more lab work.
A recent medical condition
It is also possible that the cause of the worsening kidney function is a new medical condition.
I have had many patients experience a dip in kidney function after a bout of diarrhea. Other doctors have made similar observations. In one study, one in ten adults hospitalized for diarrhea developed kidney dysfunction. In that study, the odds of experiencing this decline in kidney function were higher in people who already had CKD.
Another scenario is when a man with CKD from diabetes develops prostate problems. It is possible to miss the prostate diagnosis for months because everyone is focused on the CKD and diabetes.
Whenever you go for a check-up, report any unusual symptoms. Don’t assume CKD caused it. This will help your doctor detect obscure causes of kidney dysfunction.
The good thing is that your numbers will likely bump back up after taking care of what caused the decline. So, when your kidney function dips, let your doctor know about any new symptoms or recent illnesses.
Medications
There are so many drugs linked with kidney dysfunction. For example, using medications like aminoglycoside antibiotics or non-steroidal anti-inflammatory drugs like diclofenac can worsen your renal function.
It is crucial that you don’t take medications without checking up with your doctor.
But even some drugs doctors use to treat CKD can cause a decline in kidney function. Examples are
- angiotensin-converting enzyme inhibitors,
- angiotensin receptor blockers and
- sodium-glucose cotransporter 2 inhibitors
These drugs have all been linked to worsening kidney function despite their benefits in patients who have diabetes and proteinuria. So when your doctor starts you on these drugs, they’ll watch closely. It is important to keep up with your check-ups when starting these drugs.
Another common cause is using herbal drugs. People sometimes think herbs are natural and safe. But the truth is that some herbs are unsafe for the kidneys. Even worse is that certain products sold as natural drugs have other active agents in them.
Always let your doctor know about any medications you’ve taken. I also ask my patients to have someone on the team review all their drugs, including herbs and supplements. As much as possible, it’s best to avoid taking meds because it has a fancy name or is promoted as an herbal supplement. Instead, take only the drugs you need to optimize your health.
Hidden nutrients.
It is entirely possible that you’ve not kept to dietary recommendations as you thought. Hear me out. I’ve had people come to me saying they’ve been on a low-salt diet when they were not. Someone once told me she was not cooking with any salt at all. Really? And you can eat it, I asked, feeling very impressed. She told me it was not that bad. Then, she went on to mention the seasoning she was using as an alternative to salt. The problem was that the seasoning had a lot of salt in it.
Excess salt can lead to fluid retention and worsening hypertension. And this extra body water and high blood pressure can affect kidney function.
Dietitians often warn about hidden salts and phosphates in packaged foods. Try to read food labels carefully. As much as possible, use fresh foods and spices. Also consider having a more detailed chat with your dietitian. This will help ensure you are not unknowingly sabotaging your nutritional therapy.
The nature of the disease.
CKD is a progressive clinical disorder. Unlike acute kidney injury (AKI), which is curable, CKD cannot be cured for now. However, with treatment, some people can keep their disease stable. This group of people may remain in the same stage for a long time. But for some others, the kidney damage gets worse, even when they keep strictly to their treatment.
If that is the case with you, just stick to your treatment plan. Sometimes, things may turn around
What can you do?
It’s easy to get overwhelmed by the disease and imposed lifestyle changes, especially when you do not see the gains you desire. But take it one day at a time. Focus on taking specific steps (like exercise and music) that can help you feel better. Try not to drown in the negative feeling. Many people have also found support groups and online forums helpful.
Here’s a quick summary
- Focus on taking action
- Keep up with your appointments and take your drugs
- Incorporate exercise without wearing yourself out
- Consult with a doctor if you’re ill
- Book a consultation with a dietitian to help you
- Learn to read food labels
- Find a support group
Remember to always work with your healthcare team. The information provided here is for educational purposes only.
