The kidneys filter the blood to remove wastes and extra fluids, control the body’s chemical balance, regulate blood pressure, keep bones healthy, and help make red blood cells.

Kidney disease is a condition that can be caused by diabetes, high blood pressure, autoimmune conditions, infection, trauma, overdose or long-term use of certain medications, or a variety of other diseases. It should be noted though that diabetes and uncontrolled high blood pressure are the two main causes of kidney disease.

The costs of dialysis or a kidney transplant are high. But, some form of insurance whether it is private or group insurance, Medicare, or Medicaid covers almost all kidney patients.

Kidney disease usually will not get better and is likely to get worse. Diabetes and high blood pressure, which are major causes of kidney disease, cause scarring which doesn’t go away. The aim of treatment is to prevent further damage.

Neither hemodialysis nor peritoneal dialysis itself is painful; however, there are some side effects of each that can cause discomfort.

It is possible to feel well enough to work while on dialysis and make your treatment schedule fit your job. Research shows that people on dialysis who keep their jobs feel better, having better general health and energy. A job can also give you a sense of purpose, a place to be, an identity and income.

A nephrologist is a physician who has been trained in the diagnosis and management of kidney disease.

The evaluation to determine if a person needs dialysis begins with the medical history, including your health in the past and current symptoms of kidney failure such as a decreased appetite, weight loss, nausea or vomiting, fluid retention, and shortness of breath. Blood and urine tests will be ordered. Two of the most important blood tests are the BUN and Creatinine tests which measure kidney function.

Once you and your doctor decide it is time to go on dialysis, he will discuss many things with you, including the various types of dialysis, what you can expect during the procedure and the need to create an access.

There are two types of dialysis, hemodialysis and peritoneal dialysis, both of which remove waste and excess water from the blood. Hemodialysis removes waste and water by circulating the blood outside the body through an external filter called a dialyzer and then returning the filtered blood. In peritoneal dialysis, waste and water are removed from the blood inside the body using the peritoneal membrane inside the abdominal cavity.

If you are starting hemodialysis treatments in the next several months, you need to work with your health care team to learn how the treatments work and how to get the most from them. One important step before starting regular hemodialysis sessions is preparing a vascular access, which is the site on your body where blood is removed and returned during dialysis. To maximize the amount of blood cleansed during hemodialysis treatments, the vascular access should allow continuous high volumes of blood flow.

There are 3 types of vascular access, an AV fistula, an AV Graft, or a Central Venous Catheter. Each is created surgically. The fistula and graft are considered to be permanent because they are placed under the skin and are intended to be used for many years. A catheter can be placed if a patient needs to start hemodialysis before a fistula is created. A catheter can also be used on a permanent basis if a patient is unable to have a fistula or graft but due to high risk and incidence of bloodstream infections should always be a last resort. Fistulas are the gold standard for hemodialysis.

Developing kidney failure means you have some decisions to make about your treatment. You may choose to forgo treatment. If you choose to receive treatment, your choices include hemodialysis, which requires a machine used to filter your blood outside your body; peritoneal dialysis, which uses the lining of your belly to filter your blood inside the body; and kidney transplantation, in which a new kidney is placed in your body. Each treatment has advantages and disadvantages.

Home hemodialysis is exactly as it sounds, patients receiving their dialysis treatments at home rather than at an in-center clinic. Instead of having to go to a dialysis center 3 times a week for 4 hours, patients usually follow a schedule of dialyzing 5-6 times a week for 2.5-3 hours. Some of the benefits include less stress on the heart, better blood pressure control, more energy, improved appetite, and quicker recovery time after treatment. Research has shown that patient who dialyze at home have a higher quality of life.

Peritoneal dialysis is the most common form of at-home dialysis. PD is needle-free but requires surgical insertion of a soft plastic tube called a catheter into your abdomen. PD uses the thin membrane that lines the abdomen called the peritoneum to perform dialysis treatments. A fluid called dialysate fills the abdomen and pulls wastes and extra fluid from the blood using the peritoneal membrane as a filter. Once the wastes have been absorbed, the dialysate is drained and the abdomen is filled with fresh dialysate.

Dialysis treatments are a renal replacement therapy, replacing some of the functions of the kidney; it does not heal your kidneys. Depending on the cause of your kidney disease, (obstruction, infection, medications), additional treatment will be required. The chance of your kidneys healing and of you getting off of dialysis depends on the amount of scarring of your kidneys that has occurred.

There is no limit to how long a person can live on dialysis. The life expectancy for someone on dialysis can vary widely depending on their age, other health concerns, and how well they follow their treatment plan. With good care, it is possible for someone to live for many years on dialysis.

A renal diet consists of limiting one’s intake of potassium, fluids, protein, phosphorus and salt. This diet was created for individuals with various stages of kidney disease in order to limit the progress and symptoms of the disease.

If you are on hemodialysis or peritoneal dialysis you can still exercise or participate in many sports, taking care to avoid any sport or activity that could damage your access. Anemia may make you feel tired but exercise will enable your body to use oxygen more efficiently and help you feel better.

The first step is to talk to the health care team to determine if you are a candidate for transplant. You will then be referred to a transplant center for testing to determine if you are healthy enough for the procedure and to make sure that the kidney you will be getting is a good match for you.