Prevention of Glomerular Disease
In some cases, the cause of glomerular disease remains a mystery. It can also be genetic. Either way, these cannot be prevented, so mitigating the disease process itself is the best way to delay the progression that could put one at risk for kidney failure.
As far as the identifiable causes, prevention of these is important, as is prevention of their progression. (This strategy also favorably impacts the glomerular disease from unknown causes).
Prolonged hyperglycemia is toxic to all vasculature, including that of the kidney. Diabetic vasculitis of the glomerular tuft of capillaries can best be prevented by strict glycemic control and maintaining a target hemoglobin A1c level of <7-8%. Diabetic stability also prevents atherosclerotic disease of the large vessels perfusing the kidneys–the renal arteries, and is protective of systemic (body-wide) obstructions to blood flow. Hyperglycemia also makes infections of the urinary tract more likely and more virulent, so good glycemic control helps prevent the scarring of kidney tissue that can occur from infection.
Cardiovascular Disease (CVD)
CVD risks the health of all blood vessels and all of the tissues they reach. With the progression of CVD (atherosclerosis, dyslipidemia, hypertension), the kidney can suffer vascular compromise as can any other organ. Decreased renal perfusion from partial atherosclerotic obstruction will decrease kidney function, and that dysfunction can progress further to injure the kidney permanently. Preventing CVD severity is a valid prevention of kidney disease and an excellent strategy to stop a vicious cycle:
CVD → kidney disease → worsening of hypertension → worsening of kidney disease → worsening of CVD → etc.
Within this vicious cycle are the toxic contributions from diabetes, worsening both CVD and kidney disease simultaneously.
Stone obstructions decrease perfusion of glomeruli to cause glomerular disease. Prompt elimination of the stone via passage, removal, or fragmentation for passage can prevent glomerular damage.
Any infection can become blood-borne, causing the signs and symptoms of sepsis. In the blood stream, bacteria can reach distant organs, including the kidneys (pyelonephritis); alternately, a rising (vertical) infection from the bladder can reach the kidneys. Promptly treating infections with appropriate antibiotic therapy can prevent glomerular and other kidney damage.
Some medications that are toxic to the kidney and/or liver are unavoidable, such as in life-threatening sepsis when the benefit outweighs the risk or in infections that are resistant to the safer antibiotics. Many infections, however, allow a choice of numerous medications. Equally efficacious drugs that have no anti-renal toxicity can be chosen to avoid risk to the kidneys.