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Treatment Options for End Stage Renal Failure



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The kidneys filter and remove waste products from the blood. When the kidneys fail, waste products accumulate in the blood and result in high blood pressure, fluid overload, and eventually death. End stage kidney failure is dependent on dialysis. No one can survive without kidneys except through dialysis, doing nothing means certain death. The question is dialysis or kidney transplant?

Kidney transplant

For younger kidney patients with a longer life ahead of them, getting a kidney transplant is definitely a better option. Getting a new kidney means the end of dialysis, no more dietary restrictions, and practically a new lease of life. However, getting a suitable donor kidney is no easy task. Many people wait for many years for suitable donor. Moreover, a kidney transplant surgery is a major surgery which someone elderly or frail may not be able to survive.

After the transplant, the body may reject the new kidney, even resulting in transplant failure. In order to prevent rejection of the grafted kidney, one has to take immunosuppressant medicines for the rest of one’s life. Immunosuppressant medications such as steroids have side effects like diabetes and hypertension.

Dialysis

For older patients, and for younger ones while waiting for a suitable donor kidney, dialysis is life saving. Dialysis is a process where a machine takes out the blood, filters it and removes the waste products, and then returns the “clean” blood to the body’s circulation.

Because healthy kidneys work 24 hours a day, 7 days a week, hemodialysis cannot completely take the place of the kidneys. Therefore there are dietary restrictions when one is a kidney dialysis patient. One must avoid foods high in potassium and phosphate, as well as restrict the amount of fluid taken each day.

There are two types of kidney dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis

Hemodialysis is performed at a dialysis center, often three times a week, for 3 to 5 or more hours. Vascular access is necessary for hemodialysis, this can be a fistula or a graft. The advantage of hemodialysis is that trained professionals are available at dialysis centers to help.

However, hemodialysis is not without complications. One might feel giddy or unwell after a dialysis session because of changes in blood volume as blood is taken out of the body and then replaced. There may be problems with the vascular fistula or graft, such as blockage or infection or bleeding after dialysis.

Peritoneal dialysis

Peritoneal dialysis uses the lining of the abdomen, called the peritoneal membrane, to filter the blood. During peritoneal dialysis, a tube is used to fill the abdomen with the dialysis solution, and after the dialysis, the tube is used to drain the dialysis solution from the abdomen. Peritoneal dialysis is usually performed four times a day for 4 to 6 hours each time.

The advantages of peritoneal dialysis are that it does not require vascular access and can be done in one’s own home. Because peritoneal dialysis is performed more often than hemodialysis, it is thought to be more efficient.

The disadvantage of peritoneal dialysis is that one can get peritonitis, which is an infection of the peritoneal membrane. Peritonitis is a real risk in peritoneal dialysis, and can easily occur if one is not careful during the filling and draining procedure and introduces bacteria via the tube into the abdomen.

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  • InfoBoxCallToAction ActionArrowhttp://kidney.niddk.nih.gov/kudiseases/pubs/choosingtreatment/