The newest treatment for chronic kidney disease
This silent condition can sneak up on you. We answer your most pressing questions, including how the newly approved Farxiga may help.
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.
But more than 37 million Americans have damage to their kidneys that prevents them from functioning as they should, a condition known as chronic kidney disease (CKD). This is according to the Centers for Disease Control and Prevention. And most people don’t even know they have it. In its early stages, CKD often doesn’t have any symptoms, says Muthiah Vaduganathan, MD. He is a cardiologist at the Center for Advanced Heart Failure at Brigham and Women’s Hospital in Boston.
That doesn’t mean you can’t take steps to protect your kidneys and your health. Here’s what you need to know about this silent disease.
(If your CKD plan includes medication, Optum Perks can take the stress out of paying for it. Get our discount card now to save up to 80%.)
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 Americans 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, Dr. Vaduganathan says.
It can be hard to recognize CKD at first, but signs of more advanced disease can include:
- Chest pain
- Dry skin
- Increased or decreased urination
- Muscle cramps
- Shortness of breath
- 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.
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. You can find a certified diabetes care and education specialist near you here.
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), Dr. Vaduganathan says. 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, Dr. Vaduganathan says.
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 (Farxiga®) became the first to be approved to also treat CKD. (Download a coupon for Farxiga®.)
A 2020 study published in The New England Journal of Medicine found that Farxiga 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 Farxiga 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. Farxiga 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 Farxiga?
Farxiga 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. “Farxiga 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.
Farxiga 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.
Is medication a part of your CKD management plan? Download the Optum Perks app now to see how much you could save.
Chronic kidney disease overview: National Institute of Diabetes and Digestive and Kidney Diseases
Dapagliflozin improves kidney function: New England Journal of Medicine (2020). “Dapagliflozin in patients with chronic kidney disease.”
Dapagliflozin prevents and reduces worsening of kidney disease: The Lancet (2019). “Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial.”