How is Chronic Kidney Disease Treated ?

Chronic kidney disease is a disease that must be managed in close consultation with your health care provider. Self-treatment is not appropriate.
There are, however, several important dietary rules you can follow to help slow the progression of your kidney disease and decrease the likelihood of complications.
This is a complex process and must be individualized, generally with the help of your health care provider and a registered dietitian.     
The following are general dietary guidelines:
Protein restriction: Decreasing protein intake may slow the progression of chronic kidney disease. A dietitian can help you determine the appropriate amount of protein for you.  
Salt restriction: Limit to 4-6 grams a day to avoid fluid retention and help control high blood pressure.
Fluid intake: Excessive water intake does not help prevent kidney disease. In fact, you doctor may recommend restriction of water intake.
Potassium restriction: This is necessary in advanced kidney disease, because the kidneys are unable to remove potassium. High levels of potassium can cause abnormal heart rhythms. Examples of foods high in potassium include bananas, oranges, nuts and potatoes.
Calcium: Adequate intake is necessary to maintain healthy bones and avoid problems with parathyroid function (function of a gland in that neck that helps regulate calcium).  
Phosphorus restriction: Decreasing phosphorus intake is recommended to protect bones. Eggs, beans, cola drinks and dairy products are examples of foods high in phosphorus.
Other important measures that you can take include:
Carefully follow prescribed regimens to control your blood pressure and/or diabetes, Stop smoking, lose excess weight, and Limit your consumption of alcohol.
In chronic kidney disease, several medications can be toxic to the kidneys and may need to be avoided or given in adjusted doses. Among over-the-counter medications, the following need to be avoided or used with caution:
Certain analgesics - Aspirin; non steroidal anti-inflammatory drugs (NSAIDs, Laxatives and antacids containing magnesium and aluminum such as milk of magnesia ,Ulcer medication H2-receptor antagonists - Cimetidine, ranitidine (decreased dosage with kidney disease) ,Decongestants like pseudo ephedrine especially if you have high blood pressure ,Alka Seltzer, since this contains a lot of salt ,Herbal medications
If you have a condition such as diabetes, high blood pressure, or high cholesterol underlying your chronic kidney disease, take all medications as directed and see your health care provider as recommended for follow-up and monitoring.
The complications of chronic kidney disease may require medical treatment.
Fluid retention can be treated with any of a number of diuretic medications, which remove excess water from the body. These drugs are not suitable for all patients, however.
Anemia can be treated with injections of a human hormone, erythropoietin.
High blood pressure can be treated with any of a large number of drugs.
Calcium deficiency can be treated with calcium supplements.
In end-stage renal disease, kidney functions can be replaced only by dialysis or by kidney transplantation. There are two types of dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis involves circulation of blood through a filter on a dialysis machine. Blood is cleansed of waste products and excess water. The acid levels and the concentration of various minerals such as sodium and potassium in the blood are normalized. The blood is then returned to the body.
Long-term dialysis requires access to a blood vessel so that the machine has a way to remove and return blood to the body. This may be in the form of a dialysis catheter or an arteriovenous fistula or graft.
A dialysis catheter may be either temporary or permanent. These catheters are either placed in the neck or the groin into a large blood vessel. These catheters are prone to infection and may also cause blood vessels to clot or narrow.
The preferred access for hemodialysis is an arteriovenous fistula wherein an artery is directly joined to a vein. The vein takes two to four months to enlarge and mature before it can be used for dialysis. Once matured, two needles are placed into the vein for dialysis. One needle is used to draw blood and run through the dialysis machine. The second needle is to return the cleaned blood.
An arteriovenous graft is placed in patients who have small veins or in whom a fistula has failed to develop. The graft is made of artificial material and the dialysis needles are inserted into the graft directly.
These venous access devices usually can be placed with local anesthesia on an outpatient basis.
Hemodialysis typically takes 3-4 hours and is needed 3 times a week.
Peritoneal dialysis utilizes the lining membrane (peritoneum) of the abdomen as a filter to clean blood and remove excess fluid. A catheter is implanted into the abdomen by a minor surgical procedure. Peritoneal dialysis may be performed manually or by using a machine to perform the dialysis at night.
About 2 to 3 liters of dialysis fluid are infused into the abdominal cavity through this catheter. This fluid contains substances that pull wastes and excess water out of neighboring tissues.  
The fluid is allowed to dwell for two to several hours before being drained, taking these unwanted wastes and water with it.  
The fluid typically needs to be exchanged 4 to 5 times a day.  
Peritoneal dialysis offers much more freedom compared to hemodialysis since patients do not need to come to a dialysis center for their treatment. You can carry out many of your usual activities while undergoing this treatment. This may be the preferable therapy for children.