In end-stage kidney disease, kidney function can be replaced only by a transplant or dialysis. Planning for dialysis and transplantation usually starts in Stage 4 of chronic kidney disease (GFR less than 30 ml/min).
Most patients are candidates for both hemodialysis and peritoneal dialysis (see below). There are few differences in outcomes between the two procedures.
Your physician or an educator will discuss the appropriate options with you and help you make a decision that will match your personal and medical needs.
It is best to choose your type of dialysis after understanding both procedures and matching them to your lifestyle, daily activities, schedule, distance from the dialysis unit, support system, and personal preference.
Your doctor will consider multiple factors when recommending the appropriate point to start dialysis, including your laboratory work and your actual or estimated glomerular filtration rate, nutritional status, fluid volume status, the presence of symptoms compatible with advanced kidney failure, and risk of future complications.
Kidney transplantation or dialysis is usually performed before individuals are very symptomatic or at risk for life-threatening complications.
Aggressive Medical Management for End Stage Kidney Disease
In the recent years kidneys doctors are learning and also research is showing that kidney transplant or dialysis is not for all patients with kidney failure. Older patients, especially older than 75-80 years-old or very frail,malnourished and debilitated, with multiple other organs disease may not benefit of dialysisor transplant. On the contrary theseprocedurescan increase burden on patients, caregivers without affecting positively patient’s quality of life. In this group of patients we offer aggressive medicalmanagement and support, which has been demonstrated to be an effective approach. If you are getting close to kidney failureTalk to your RMA Kidney provider about this alternative.