Kidney failure treatment

There is no cure for end-stage renal disease. Patients whose kidney disease has progressed to the point that their kidneys are failing cannot survive without treatment. That being said, many people live long, productive lives while undergoing treatments for kidney failure.

The two main treatments for kidney failure are dialysis and kidney transplant.

Dialysis

Dialysis is an artificial filtering treatment that helps rid the body of wastes and excess fluids when the kidneys can no longer do so. However, dialysis cannot perform all the functions of healthy kidneys. Because of this, you may experience some of the health problems associated with kidney failure despite undergoing dialysis treatments.

There are two types of dialysis:

• Hemodialysis: Also called “hemo²⁹,” this treatment involves using a machine to filter wastes and excess fluid from the blood. Hemodialysis can be performed at home or at a dialysis center.

• Peritoneal dialysis: This type of dialysis³⁰ involves using a thin tube (catheter) to fill the lining of the abdomen with a cleaning solution called dialysate. Dialysate absorbs wastes and excess fluids and eventually drains from the body, carrying the wastes with it. Peritoneal dialysis can be performed at home or at work in a clean, private area. If you are unsure whether dialysis is a good option for you, talk to your healthcare provider about a time-limited trial. This allows you to try dialysis for a set amount of time, after which you will decide whether dialysis is a good fit for you and your treatment goals.

Kidney transplant

A kidney transplant involves surgically replacing your kidney with a healthy donor organ. Transplanted kidneys can come from living donors (usually someone you know) or deceased donors.

Receiving a kidney transplant means you will have a new, healthy organ that can perform all its normal functions. It is not necessary to undergo dialysis before receiving a kidney transplant. After receiving a transplant, however, you will need to take medications for the rest of your life to keep your body from rejecting the new organ.

Medical management and palliative care for kidney failure

Some patients may choose not to receive dialysis or transplants. This is often the case in patients who are too weak or elderly for the strain of dialysis or a kidney transplant.

In this case, an approach called medical management³¹ may be used.

Kidney failure medication

Medical management does not treat the underlying cause of kidney failure or the condition itself. Rather, it is aimed at managing symptoms and providing as much comfort as possible until a patient’s body is no longer able to function.

Acute kidney failure treatment

While some people may be able to recover from the condition at home, acute kidney failure typically requires hospitalization. However, many people who develop the condition are already being hospitalized. The duration of your stay in the hospital will depend upon the cause of your condition, the severity of the condition, and how quickly your kidneys recover.

Treating³² acute kidney failure involves two main approaches: treating the underlying cause of your kidney damage and treating the complications caused by the condition until your kidneys recover.

The treatment you receive for your underlying condition will depend upon the condition itself. Once your healthcare provider has identified what has caused your acute kidney failure, they will determine the proper course of treatment for the particular complications you’re experiencing. These treatments may include:

• Balancing fluids in the blood: If your acute kidney failure is caused by severe dehydration, your provider may recommend receiving intravenous (IV) fluids to keep you hydrated. Conversely, if your acute kidney failure causes an excess of fluids, you may be given diuretics to help you expel them.
• Controlling potassium: Damage to the kidneys may prevent them from filtering potassium to the blood, which can result in hyperkalemia. End-stage renal disease patients with hyperkalemia are often treated³³ by limiting their potassium intake and undergoing dialysis. The blood’s potassium levels usually adjust to normal during maintenance dialysis sessions (usually done a few times a day).

• Maintaining blood calcium: Acute kidney failure may cause the levels of calcium in your blood to drop. If needed, calcium can be added to dialysate to rebalance electrolytes such as calcium during maintenance dialysis sessions.
• Dialysis: Temporary hemodialysis may be used to treat patients with acute kidney failure. Dialysis can help remove toxins and excess potassium from the blood.

Kidney failure prevention

To help reduce your risk³⁴ of developing kidney disease and kidney failure:

• Manage your blood glucose: If you have diabetes, talk to your healthcare provider about setting a goal for your blood sugar. You can help yourself reach and maintain this goal by checking your blood glucose level regularly and using the results to guide healthy decisions about diet, physical activity, and medication. Your provider will be able to determine how frequently you should be checking your blood sugar level.
• Manage your blood pressure: Having consistently high blood pressure can do damage to your kidneys. You can help prevent kidney damage by keeping your blood pressure at or under the goal set by your provider. The blood pressure goal for most people with diabetes is generally 140/90, while the recommended blood pressure goal is typically 130/80 for people without diabetes.
• Maintain a healthy weight: If you're already at a healthy weight, you can help maintain it by eating right and getting plenty of physical activity. If you need to lose weight, talk with your provider about strategies for healthy weight loss. This generally requires increasing your daily physical activity and reducing your caloric intake.
• Don't smoke: Smoking cigarettes can do damage to your kidneys and worsen existing kidney damage. If you're a smoker, talk to your provider about strategies for quitting. Support groups, counseling, medications, and nicotine replacement products are all available to help you to quit.
• Manage your medical conditions with your provider's help: If you have diseases or conditions that increase your risk of kidney problems, work with your healthcare provider to control them.

As always, you should ask your healthcare provider about the best ways of managing your condition. While these practices may help, they cannot replace professional medical treatment.