For most people, the need for dialysis comes on slowly. Many people start dialysis when their kidney function glomerular filtration rate is between 5 and When kidney function is this low, you may have symptoms from kidney failure and starting dialysis may help relieve them. Starting dialysis can help you regain your appetite and maintain your strength, which is harder to rebuild than it is to retain. Your health care provider can help you decide the best time to begin treatment.
Chronic kidney disease - Treatment - NHS
Kidney transplant is surgery to place a healthy donor kidney into your body. When you have a transplant, surgeons usually leave your old kidneys in place and connect the donated kidney to an artery and a vein in your groin. The surgeon also transplants the ureter from the donor to let urine flow from your new kidney into your bladder.
The transplanted kidney takes over the job of filtering your blood. Your body normally attacks anything it sees as foreign, so to keep your body from attacking the donor kidney, you will need to take immunosuppressants —also called anti-rejection medicines.
Log in menu
Like all strong medicines, anti-rejection medicines have side effects. A transplant center can place you on the waiting list for a donor kidney if you have permanent kidney damage and your kidney function is 20 or less. Watch a video about having a kidney transplant.
Learn about kidney transplant. Conservative management for kidney failure means that your health care team continues your care without dialysis or a kidney transplant. The focus of care is on your quality of life and symptom control. The decision to start dialysis is yours. For most people, dialysis may extend and improve quality of life. For others who have serious conditions in addition to kidney failure, dialysis may seem like a burden that only prolongs suffering.
You have the right to decide how your kidney failure will be treated. You may want to speak with your family, doctor, counselor, or renal social worker—who helps people with kidney disease—to help you make this decision. If you decide not to begin dialysis treatments, you may live for a few weeks or for several months, depending on your health and your remaining kidney function. Many of the complications of kidney failure can be treated with medicines, but only dialysis or transplant can filter wastes from your blood.
As your kidney function declines, you may want to consider adding hospice, or end-of-life, care.
You can have hospice care in a facility or at home. The hospice program is designed to meet end-of-life physical and emotional needs. Hospice care focuses on relieving pain and other symptoms. Whether or not you choose to use hospice, your doctor can give you medicines to make you more comfortable.
Your doctor can also give you medicines to treat the problems of kidney failure, such as anemia or weak bones. You may restart dialysis treatment if you change your mind. The pros and cons of conservative management depend on your current health status. Weigh the pros and cons with the help of your doctor. Learn about conservative management. All of the treatment options for kidney failure require changes and limit what you may eat and drink.
Hemodialysis has the most restrictions. You will need to watch how much water and other liquids you get from food and drinks. You will also need to avoid getting too much sodium a part of salt , potassium, and phosphorus. You may find it difficult to limit phosphorus because many foods that are high in phosphorus also provide the protein you need. Hemodialysis can remove protein from your body, so you will need to eat foods with high-quality protein such as meat, fish, and eggs. Avoiding foods such as beans, peas, nuts, tea, and colas will help you limit your phosphorus.
You may also need to take a pill called a phosphate binder with your meals. Phosphate binders keep phosphorus in your food from entering your bloodstream. Read about nutrition and eating right on hemodialysis. Like hemodialysis, peritoneal dialysis requires limits on sodium and phosphorus. You may need to take a phosphate binder. The liquid limitations in peritoneal dialysis may not be as strict as those for hemodialysis.
In fact, you may need to drink more water and other liquids if your peritoneal dialysis treatments remove too much fluid from your body. Peritoneal dialysis removes potassium from the body, so you may need to eat potassium-rich foods such as potatoes, tomatoes, oranges, and bananas. Peritoneal dialysis removes even more protein than hemodialysis, so eating foods with high-quality protein will be important.
You may need to limit calories because your body will absorb sugar from the dialysis solution. Kidney transplantation has the fewest restrictions on your diet. You will need to limit sodium because it can raise your blood pressure. Medicines that you take after the transplant can cause you to gain weight, so you may need to limit calories.
The diet for conservative management limits protein.
Protein breaks down into waste products the kidneys must remove. Limiting protein may reduce the amount of work the kidneys have to do so they will last longer. Find out how the treatment changed their lives and the lives of those closest to them. If you plan to keep working, think about which treatment can make that easier. If spending time with family and friends means a lot to you, ask which treatment would give you the most free time. Find out which treatment would give you the best chance of feeling good and living longer. You may wish to speak with your family, friends, health care team, spiritual advisor, or mental health counselor as you decide.
View a chart comparing hemodialysis, peritoneal dialysis, and kidney transplantation. You can change your mind.
Medicare, the federal health insurance program , and private health insurance cover most of the cost. Medicare covers kidney failure no matter what your age. If you need more help to pay for treatment, state Medicaid programs provide funds for health care based on financial need. Your social worker can help you find more ways to pay for treatment.
Register to download PDF
You can make your treatment plans and wishes clear to health care providers and family members with an advance directive. During a medical crisis, you might not be able to tell your health care team and loved ones how you want to be treated or cared for. An advance directive is a written legal statement or document with your instructions either to provide or not provide certain treatments, such as dialysis, depending on what else is happening with your health.
Advance directives may include. A living will is a document that describes the conditions under which you would want to refuse treatment. If you choose to have a DNR order, your doctor will place the order in your medical chart. A durable power of attorney for health care decisions, or a health care proxy, is a document that names a person you choose to make health care decisions for you if you cannot make them for yourself. Make sure the person you name understands your values and will follow your instructions. A DNR order is a legal form that tells your health care team you do not want CPR or other life-sustaining treatment if your heart were to stop or if you were to stop breathing.
Each state has its own laws on advance directives. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Kidney Failure What is Kidney Failure?
What are my treatment options for kidney failure? What are the basics about hemodialysis? What are the basics about peritoneal dialysis? Does dialysis cure kidney failure? When do I have to start dialysis? What are the basics about kidney transplant? What are the basics about conservative management?
Chronic Kidney Disease in the United States, 12222
Can I eat the same foods with any kidney failure treatment? How can I decide which treatment is right for me? Can I stop or change my treatment once I start? What are some ways to pay for kidney failure treatment? What is an advance directive, and why would I want to prepare one?
Talk to your health care provider about treatment options before you need treatment. How soon should I start learning about what type of treatment to have? Start learning early about treatment options—before you need one. Learn about treatment options before you need treatment for kidney failure.
Hemodialysis uses a machine to move your blood through a filter outside your body, removing wastes. Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing wastes.