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End-Stage Renal Disease (ESRD)

 

Treatments, Therapies, and Recovery

Although no cure for kidney disease exists, there are different methods to slowing its progression and helping your kidneys work for as long as possible.

If your kidney disease is the result of diabetes or high blood pressure, you need to make sure you're doing everything recommended by your doctor to treat the diabetes or high blood pressure. 

Diet

Minor therapies to help slow the progression of kidney disease include diet and medication. Eating less protein can help give your kidneys some relief because foods rich in protein generate a lot of waste for your kidneys to clean.

Medication

Some medications can help relieve the symptoms of chronic kidney disease, and others can help control the causes of chronic kidney disease.

Medications that help relieve the symptoms of chronic kidney disease include:

  • Diuretics can helps reduce swelling
  • Medications that treat anemia can help reduce fatigue
  • Calcium and vitamin D supplements can help keep your bones strong

Medications that help control the causes of chronic kidney disease include:

  • Medications for high blood pressure 
  • Medications that reduce cholesterol

Dialysis

There are only two treatments for ESRD: dialysis and kidney transplant.

Dialysis treatment uses a machine to filter waste and extra water from your blood, attempting to replace many important functions of your kidney.  Two types of dialysis: include hemodialysis and peritoneal dialysis.

If you undergo hemodialysis, your blood will be sent through a tube to a machine that cleans it by removing the wastes and extra fluid that your kidneys would normally remove. You need to visit a dialysis center several times each week to have hemodialysis performed.

If you undergo peritoneal dialysis, some fluid is put into your abdomen. This fluid will absorb the chemicals, other waste, and extra fluid that your kidneys usually remove. After a while, this extra fluid drains out of your body. In many cases, you'll be able to learn how to put this fluid in and drain it yourself, which means that you can perform peritoneal dialysis yourself, without needing to visit the doctor's office or a dialysis center.

Kidney transplant

When you receive a kidney transplant, your failed kidneys are replaced with new ones. Kidneys are frequently donated by deceased donors through organ donation programs. And, since people only need one kidney to be completely healthy, a kidney can also be donated by a living person. 

Kidneys are often donated by close friends or relatives, but also by complete strangers as part of kidney chains, where somebody who wants to donate a kidney to a close friend or relative but doesn't share the same blood type instead donates their kidney to a complete stranger. Another stranger then donates a kidney to the person who originally needed one. Kidney chains effectively and efficiently benefit dozens of individuals who need kidneys. The longest kidney chain on record resulted in 30 people receiving kidney donations.7

What should I do after I've been treated for end-stage renal disease?

Once your chronic kidney disease has become end-stage, you'll need to either receive a kidney transplant or undergo dialysis continually. Without dialysis or a transplant, life expectancy for those with ESRD is usually only several months.

After you've received a kidney transplant, you'll need several weeks to recover. You'll also need to take immunosuppressant medicine daily after your transplant to help prevent your body from rejecting the new kidney.

 

References

  1. https://medlineplus.gov/ency/article/000500.htm (MedlinePlus: End-stage kidney disease)
  2. http://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/home/ovc-20207456 (Mayo Clinic: Chronic kidney disease)
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582781/
    (Guidelines for the management of chronic kidney disease)
  4. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5608a2.htm
    (Prevalence of Chronic Kidney Disease and Associated Risk Factors—United States, 1999 - 2004)
  5. http://webarchive.nationalarchives.gov.uk/20170106081009/http://www.apho.org.uk/resource/item.aspx?RID=63798
    (CKD estimates - Neoerica 210209)
  6. https://www.kidney.org (National Kidney Foundation)
  7. http://www.nytimes.com/2012/02/19/health/lives-forever-linked-through-kidney-transplant-chain-124.html
    (New York Times: 60 Lives, 30 Kidneys, All Linked)