This information is aimed at people who have been told that their kidneys are failing and that they may need dialysis or transplantation to stay alive. We have produced it in a question and answer format and hope you will find it useful and informative.
Like most people, you've probably taken your kidneys a bit for granted. Realising that you have serious problems is never easy.
We believe that if you have a good understanding of the function of your kidneys, of what can go wrong, and of what can be done to help you, this will help
Kidney failure - what is it?
Our kidneys, we have two usually, have many functions. They remove waste products from the blood and also remove excess fluid. They do this by acting as a filter, thus producing urine. They also help control our blood pressure, the level of minerals in our bones and the production of red blood cells.
If the kidneys fail the filtering must be done artificially and your blood pressure may have to be controlled by medication. End stage renal failure (ESRF) is when kidney function is so bad that you are likely to die within weeks or months unless special treatment such as dialysis or transplantation is given. This is now also called Stage 5 renal failure, but some recent documents use 'established renal failure' (ERF) too. This is maybe because they don't like the sound of 'end stage'.
You will also find that your diet will have to be modified, as will the amount of fluid you drink. No treatment can fully compensate for natural kidney functioning.
Why have I got it?
About 1 in 10,000 people in Scotland start dialysis for end stage kidney failure each year. There are many causes. If you have any questions about the cause of your kidney disease, please ask your doctors. When you understand what has gone wrong it becomes easier to understand the treatment. More information on many of the causes of kidney failure is available in our EdRenINFO section.
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What are the treatments for kidney failure?
In the early stages of kidney failure, long before dialysis is required, conservative (medical) treatment is sufficient to keep you fit and well. This form of treatment involves drugs and a special diet. Many people never need more than this. See our page on chronic renal failure and its progression.
There may be a time, however, when this is not enough and renal replacement treatment needs to be considered. This can be by dialysis, or for some people a kidney transplant is also a possibility. Others choose to have none of these - see below.
With advances in treatment and drugs you can look forward to a fairly good lifestyle, working and enjoying family life and most leisure activities as before - but this depends on your age and general health too.
While the renal team will do all they can to help you cope with your condition, you have a major part to play. A little motivation, a positive outlook and a bit self-discipline go a long way!
Treatment occurs at special kidney centres, or renal units. These have teams of specially trained staff knowledgeable in kidney disease, transplantation and dialysis. They are made up of doctors, nurses, dietitians, social workers, pharmacists, technicians and others.
What are the treatment choices?
There are several different options. More information on each of these is available by following the links below. Individual units will always have information on these, and will be able to help with which ones may be more suitable for you.
Peritoneal dialysis (CAPD, APD) Treatment that can usually be carried by you in your own home or at work. More info
Haemodialysis Uses machines and takes three half days of every week. Usually at a dialysis centre. More info
Kidney transplant The best treatment by far if it is suitable for you. More info
No dialysis The best option for some people may be not to have dialysis. More info
Your treatment before end stage
What support can I get while on dialysis
As mentioned previously, the aim is for you to be able to lead a fairly normal life. Most patients see dialysis as a necessary nuisance! They dialyse to live, not live to dialyse.
There may be times, however, when you want an arm to lean on, and there is quite a bit of support around for both you and your family. The type of support will vary locally, although there are also national patient support organisations (some are listed below).
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