Adapted from Chinese medical literature for American patients
Understanding the Possibility of Cure
Human medicine currently recognizes over 30,000 different diseases, with the vast majority being difficult to completely cure. Among these, 7,000 are rare diseases with no effective treatments available.
So, is it possible to completely cure chronic kidney disease (CKD)? To answer this question, we need to consider multiple factors:
Disease Complexity: Chronic kidney disease encompasses dozens of different conditions with hundreds of distinct pathological types. The severity and treatability vary significantly—some kidney diseases can be cured, while others are difficult to eliminate completely.
Medical Care Quality: Differences in diagnostic capabilities, treatment approaches, and physician expertise directly impact treatment outcomes and patient prognosis.
Individual Patient Factors: Economic circumstances, mental health, lifestyle choices, and health literacy all significantly influence kidney disease management and recovery.
The Bottom Line: Complete cure of chronic kidney disease is possible, but only achieved by some patients under specific circumstances.
The Five Prerequisites for Potential Cure
1. Curable Kidney Disease Type
Which types of kidney disease can potentially be cured?
Nephrotic Syndrome:
- Minimal Change Disease: Patients who achieve complete remission without recurrence may maintain normal kidney function for life
- Membranous Nephropathy (Stage 1-2): When edema resolves, protein levels normalize, and kidney function remains completely normal, this can be considered clinical cure or even complete cure
Chronic Nephritis:
- IgA Nephropathy (Grades 1-3): When visible blood in urine stops recurring, protein levels remain low, and kidney function stays normal, cure is possible
- Henoch-Schönlein Purpura Nephritis: When purpura episodes stop, protein and microscopic blood levels remain low, and kidney function and blood pressure stay normal
- Mild Mesangial Proliferative Nephritis: When proteinuria completely resolves without negative impact on kidney function
Important Note: When kidney cells are significantly scarred or kidney function has declined, while clinical remission may be possible, complete cure becomes much more challenging.
2. Avoid Using Corticosteroids Alone
Corticosteroids are commonly used in kidney disease treatment, especially for patients with significant protein loss. While effective, steroids may cause resistance (poor response) or dependence (disease returns when reduced or stopped).
Best Practice: Never use steroids as monotherapy for nephrotic syndrome. Always combine with immunosuppressive medications to improve effectiveness, reduce side effects, and lower recurrence rates.
3. Eliminate Kidney Disease Triggers
Patients must carefully avoid factors that can cause disease flares or prevent healing:
- Infections: Colds, flu, and other infections
- Lifestyle Factors: Excessive fatigue, sleep deprivation, poor stress management
- Dietary Issues: High sodium, high fat, excessive protein intake
- Harmful Habits: Smoking, excessive alcohol consumption, lack of exercise
4. Integrate Complementary Approaches
While conventional Western medicine serves as the primary treatment for significant protein loss and progressive kidney disease, it has limitations in preventing recurrence.
The Challenge: Some patients experience symptoms like poor sleep, restlessness, and rapid heartbeat. Using powerful medications like steroids in these cases may actually increase recurrence risk.
Complementary Solutions:
- Integrative approaches can help balance the body’s systems
- May reduce medication side effects
- Can improve drug sensitivity and immune function
- Often significantly reduces recurrence rates
Note for American readers: This may include integrative medicine approaches, mind-body therapies, nutritional counseling, and other evidence-based complementary treatments as appropriate.
5. Consistent Follow-Up Care
Kidney disease treatment is typically a long-term process, with most patients requiring 1-2 years of treatment.
Recommended Schedule:
- Routine visits: Every 3 months
- As-needed visits: Immediately for any concerning symptoms
Treatment Duration by Condition:
Nephrotic Syndrome (minimal change, membranous, mesangial proliferative):
- Typical treatment: “Steroids + immunosuppressants + supportive care”
- Duration: 1.5-2 years typically
- Gradual medication tapering when stable without steroid dependence and normal blood pressure
Nephritis (chronic glomerulonephritis, IgA nephropathy, non-IgA mesangial proliferative):
- Duration varies: 3 months to over 1 year depending on severity
Critical Period: The first 18 months require careful attention. Even mild kidney diseases can recur, so patients should not become complacent.
Long-term Monitoring: Even after successful treatment and medication discontinuation, follow-up every 3-6 months is essential to ensure stability.
Achieving Long-Term Success
When all five prerequisites are met, patients have an excellent chance of completely overcoming chronic kidney disease. Maintaining 2-5 years without recurrence typically indicates a high probability of lifelong remission—essentially a complete cure.
Even for patients with advanced disease where cure isn’t possible, following prerequisites 2-5 can significantly help control progression and improve quality of life.
Frequently Asked Questions
Q: How do we know if kidney disease is completely cured? Do we need another kidney biopsy?
A: Biopsy shows tissue damage but not underlying causes. After kidney healing, if patients are re-exposed to original triggers—environmental toxins, nephrotoxic substances, nutritional excess—disease can return.
Many patients who relapse years later aren’t experiencing recurrence of old disease, but rather new kidney damage from ongoing or new exposures. Previous kidney damage may have completely healed, but new triggers cause fresh injury.
This is why repeat biopsy after clinical cure isn’t necessary or predictive. Instead, focus on eliminating modifiable risk factors to prevent future kidney damage.
Conclusion
The primary goal in treating chronic kidney disease should be clinical remission—achieving controlled symptoms and lab values that allow patients to return to normal life and work.
While complete cure is a worthy goal and achievable for some patients, it’s important to maintain realistic expectations. Not all patients can achieve complete cure, and pursuing unproven “miracle cures” should be avoided.
For Healthcare Providers: Strive for cure when possible, but don’t demand it at the cost of appropriate, evidence-based care.
For Patients: Steady, consistent cooperation with your healthcare team through the critical 3-5 year period offers the best chance for long-term success.
This information is for educational purposes only and should not replace professional medical advice. Always consult with qualified healthcare providers for diagnosis and treatment decisions.
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