Can Kidney Disease Be Reversed? What the Evidence Shows

https://youtu.be/kXbD4q8NbmQ

No, you cannot regrow kidney filters that have scarred or died, and there is no cure for chronic kidney disease. But the two numbers that actually define kidney health, your filtering score and the protein in your urine, can genuinely move in the right direction. A five-year study in PLOS Medicine found that about one in five people with kidney disease reached remission, meaning their numbers came back into the normal range.

Watch the video above for the four things that actually move your kidney numbers, the claims worth being skeptical of, and the exact tests to request at your next appointment.

Why "reversal" is the wrong word

People come into clinic terrified after watching a video that promises to reverse kidney disease at any stage with one tea, one nutrient, or one protocol. A kidney diagnosis is frightening, and the promise of a quick fix is appealing. Here is the version I would give my own family.

Kidney damage means two things: filters that are scarred, and filters you have lost. You are born with about a million tiny filters in each kidney, and once they scar or die, they do not grow back. That is why a major review in The Lancet describes chronic kidney disease as a progressive condition with no cure. If "reverse" means regrowing what you lost and erasing the scars, that is not real, no matter who promises it.

But two things that get lumped under that word are worth everything, and they are the two numbers you actually want to watch.

The two kidney numbers that matter

Your filtering score. This is a blood test based on a waste product called creatinine, and your doctor uses it to calculate your estimated glomerular filtration rate, or eGFR. It reflects how well your kidneys are filtering.

Your urine protein. Damaged filters leak protein that healthy filters hold back, so a urine test for protein, often reported as a urine albumin-to-creatinine ratio, tells you whether that leak is happening and how much.

When people say their kidney numbers improved, this is what they mean: the protein leaking into the urine drops, and the filtering score holds steady or climbs. Hold onto those two tests, because you will want to ask for them by name at your next visit.

What the five-year data actually shows

This is the part the doom-and-gloom corner of the internet tends to get wrong. In a five-year study of everyday people with kidney disease published in PLOS Medicine, about one in five people met the definition of remission at some point, meaning their numbers moved back into the normal range. A third of participants stayed stable, and only about two in 1,000 progressed all the way to kidney failure over five years. Follow-up research in Nephrology Dialysis Transplantation found that people who had even one remission period tended to do better afterward. Kidney disease is not a straight line down for most people.

Picture someone in an early stage: protein leaking into the urine, filtering score starting to slip. They get their blood pressure and blood sugar under real control, they start one of the kidney-protective medicines below, and six months later, the protein leak has dropped and the filtering score has steadied. Nothing regrew. No scar was erased. But the trajectory bent, and that bend is the difference between reaching dialysis and never getting close. That is not a miracle. It is what the evidence says happens when the right levers get pulled early.

What genuinely moves these numbers

There are four things that move kidney numbers, and none of them are exciting, which is exactly why nobody sells them to you.

Treat the cause. The two biggest causes of kidney disease are high blood pressure and high blood sugar. Getting those under control is the single most powerful thing most people can do, because it takes the foot off the kidney's neck.

Use the medicines that actually protect the kidneys. Two drug classes have real trial evidence behind them. ACE inhibitors and ARBs, the blood pressure pills whose names end in "-pril" or "-sartan," lower blood pressure and cut the protein leaking from the kidneys. SGLT2 inhibitors, whose names end in "-flozin," were first developed for diabetes, but in the DAPA-CKD and EMPA-KIDNEY trials, both published in The New England Journal of Medicine, they slowed kidney decline and cut the risk of the disease worsening by roughly a quarter to a third, even in people without diabetes. I go into more depth on exactly which medications to ask about in 3 Medications That Dramatically Cut Kidney Failure Risk. These drugs are not right for everyone, so ask your doctor whether they fit your situation.

Fix what is fixable. Sometimes kidney numbers improve substantially once the underlying driver is treated, whether that is relieving a blockage or clearing an infection like hepatitis C, which a Kidney International study showed slowed kidney decline after treatment.

Diet and daily habits. A plant-predominant, low-salt, sensible-protein pattern can help preserve kidney function, a pattern also described in The Lancet. Stopping routine anti-inflammatory painkillers like ibuprofen, and stopping smoking, also make a dramatic difference in preserving what you have.

Claims worth being skeptical of

When a video promises to reverse kidney disease at any stage with one food, one tea, or one special protocol, be skeptical. No single food or supplement reverses kidney disease. What these videos call reversal is usually one of two things: someone in an early stage who improved from the real basics above, or normal fluctuation in the numbers that would have happened anyway.

Some of it is not just useless, it is dangerous. Several supplements marketed for kidney health can raise potassium or phosphorus to levels that are genuinely risky when your kidneys are already struggling. Run anything you are considering by your doctor first.

The blood pressure pill myth, debunked

Some popular kidney videos claim the opposite of what the evidence shows: that high blood pressure has nothing to do with kidney disease, and that even kidney-protective blood pressure pills are destroying your kidneys. High blood pressure and high blood sugar are two of the biggest causes of kidney disease, and that is not seriously in dispute. In large randomized trials, ACE inhibitors, ARBs, and SGLT2 inhibitors cut protein leaking into the urine, slow kidney decline, and reduce major kidney events, including in people without diabetes.

Can a particular medicine be wrong for a particular person's kidneys? Of course, which is exactly why you never start or stop a drug on your own. Decide with your doctor, not with a video.

Takeaways

1.       Book a visit and ask for the two tests by name: a blood test for kidney function (creatinine, and ideally cystatin C too) and a urine test for protein.

2.       Bring your blood pressure and blood sugar readings, and ask your doctor which kidney-protective medication, if any, makes sense for you.

3.       Cut routine anti-inflammatory painkillers, and if you smoke, make quitting the priority.

When to see a doctor

If you have not had your kidney function checked in the last year, especially with diabetes, high blood pressure, or a family history of kidney disease, this is worth raising at your next visit.

Watch next

For a closer look at what is really behind a falling creatinine number, and what looks like kidney improvement but is not, watch Your Creatinine Dropped? Here's What Actually Happened.

Want more support protecting your kidneys?

Download the free Kidney Health Guide at guides.selfprinciple.org/kidney.

This content is for educational purposes only and is not medical advice. Always consult your healthcare provider for individual care. Never start, stop, or change the dose of any prescription medication without consulting your physician. The views expressed are Dr. Hashmi's own and do not represent his employer.

Dr. Sean