Kidney failure is often treated with dialysis. Other options include medical therapy, which helps preserve kidney function, lessen symptoms, and enhance quality of life, and kidney transplantation, which treats renal failure.
When you have chronic kidney disease (CKD), your kidneys deteriorate and become less efficient at filtering blood. In the US, there are an estimated 37 million persons with CKD; many of these are undiagnosed.
Chronic kidney disease ends in kidney failure. Your kidneys are unable to adequately filter your blood at this point because your kidney function is less than 15% of its normal level. Wastes and extra fluid start to accumulate in your body as a result.
Dialysis is a common treatment for renal failure that helps flush your blood of waste materials and extra fluid.
Some renal failure patients may decide to forego dialysis in favour of a kidney transplant or medical supervision.
Alternatives to dialysis for kidney failure
There are two alternative treatment options for kidney failure if dialysis is not chosen: medical management or kidney transplant.
The major objectives of medical management include prolonging renal function, reducing symptoms, and enhancing quality of life.
A kidney transplant involves surgically implanting a donor kidney to treat renal failure. A kidney transplant can help your body filter blood more efficiently than dialysis does, but it is not a cure for renal failure.
Medical management for kidney failure
Some patients with renal failure prefer to be treated medically rather than receiving dialysis or a kidney transplant. This kind of care has the following objectives:
- keep your kidneys functioning as long as you can
- ease your symptoms
- control or avoid potential renal failure side effects such as metabolic acidosis and anaemia
- improve your quality of life
- enable you to begin making arrangements for the last care
This kind of care may also be referred to as comfort care, conservative management, or palliative care.
There are two parts to the medical therapy of renal failure. Below, we'll provide an overview of these.
Kidney failure diet
Everyone with CKD must maintain a healthy nutritional intake. You should restrict your intake of some foods to preserve your kidney function if you have renal failure:
- Protein: Consuming excessive amounts of protein can lead to waste products accumulating in the blood, which puts additional strain on the kidneys.
- Salt (sodium): Consuming excessive amounts of salt can raise blood pressure, cause edoema and fluid retention, and worsening renal impairment.
- Potassium: Elevated blood potassium levels may be a symptom of kidney failure. Too much potassium can impair the way your muscles and nerves work and lead to abnormal heart rhythms that can be fatal.
- Phosphorus: Similar to potassium, blood phosphorus levels are typically greater in individuals with kidney disease. A high phosphorus diet may cause weaker bones.
Apart from eliminating waste materials, the kidneys also eliminate surplus fluid. For this reason, if you have kidney failure, you should also be careful about how much water you drink. Excessive water consumption might cause edoema and elevated blood pressure.
To ensure that you obtain the nutrients you need while avoiding those that could exacerbate your disease, you can consult with a nutritionist.
Medications
Kidney failure cannot be precisely treated with medication. However, you can be prescribed drugs to treat symptoms and consequences as well as to keep your kidneys safe.
Examples include:
- prescription drugs for blood pressure reduction
- antiemetic medications to treat vomiting and nausea
- specific kinds of painkillers to reduce discomfort
- topical treatments for irritated skin
- using diuretics sparingly to retain fluid
- medicines that increase the formation of red blood cells in anaemia patients
- supplementing with bicarbonate for metabolic acidosis
- vitamin D pills can improve the condition of your bones
Additionally, you'll need to stop taking or modifying several drugs that can put additional strain on your kidneys.
These include:
- nonsteroidal anti-inflammatory drugs
- certain types of antibiotics
- some types of diabetes medications
- antacids or drugs for upset stomach
- statins for high cholesterol
Kidney transplant
Kidney failure may be treated by a kidney transplant. A functioning kidney from a donor is implanted into your body by a medical team during this surgery. This may improve the function of your kidneys.
After a kidney transplant, you will need to keep taking immunosuppressive drugs to keep your immune system from rejecting the new kidney.
It's also critical to remember that receiving a kidney transplant has a waiting period. Though it might vary, the duration is typically 4-5 years. You will most likely need to begin dialysis during this time.
What is the latest treatment for kidney failure?
The two primary treatments for renal failure remain dialysis and kidney transplantation.
Research on novel or more effective treatments for renal failure is still ongoing in clinical trials. A list of clinical trials that are accepting new participants and evaluating novel therapies for renal failure may be found here.
Furthermore, medications that stop renal disease from worsening and ultimately prevent kidney failure have just received FDA approval.
These medications are SGLT2 inhibitors, a kind of diabetic medication that has been shown in clinical trials to dramatically lower the risk of kidney disease progression in individuals with CKD, whether or not they have diabetes.
The FDA has approved dapagliflozin (Farxiga) and empagliflozin (Jardiance), two SGLT2 inhibitors, to treat renal disease.
FAQs
The answers to some commonly asked questions concerning renal failure treatment without dialysis are provided here.
Can you recover from kidney failure without dialysis?
It differs as each person is unique. Everybody's health situation is different. Depending on their overall health, the severity of their symptoms, and their kidney function, people with renal failure may live for days or weeks without dialysis.
What stage of kidney failure requires dialysis?
The most severe stage of chronic kidney disease (CKD) is called Stage 5, and it is characterised by an estimated glomerular filtration rate (eGFR) of fewer than 15. Patients with Stage 5 CKD are typically seen to be good candidates for kidney transplantation or to begin dialysis treatment.
What is the first stage of kidney failure?
An estimated glomerular filtration rate (eGFR) of 90 or higher and continuous renal damage lasting three months or more are characteristics of people with stage 1 CKD. The term "kidney damage" has several meanings. Having a urine albumin-creatinine ratio (uACR) of 30 or higher for at least three months is a common sign of albuminuria.
Can a failed kidney go back to normal?
Severe renal failure necessitates life-threatening care. Acute renal failure, however, might be curable. You might regain normal or almost normal kidney function if everything else in your body is in good condition.
Takeaway
Dialysis will probably be required while waiting for a kidney transplant, but some people may prefer this option over long-term dialysis.
Another alternative is medical management. Its goals are to prolong kidney function, reduce symptoms, and enhance quality of life.
It is up to each individual how to manage renal failure. Your doctor and you can discuss the advantages and disadvantages of the various options accessible to you.
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