You may choose to treat your kidney failure with dialysis, to have a kidney transplant, or to have no treatment. Dialysis is a process that filters your blood when your kidneys no longer can. It isn't a cure, but it can help you feel better and live longer. A kidney transplant may be the best choice if you are otherwise healthy.
With a new kidney, you would feel much better and be able to live a more normal life. But you may have to wait for a kidney that is a good match for your blood and tissue type. After the transplant, you would need to take medicines to keep your body from rejecting the new kidney. And you would need to see your doctor often and have blood tests to check how you're doing. Not having dialysis or a transplant also is an option for people with kidney failure.
Older adults or those with other serious health problems may decide instead to take medicines and make changes to their diet as their doctor recommends. Whatever you decide, discuss it with your family, friends, and medical team. Deciding when to start dialysis can be confusing. Even the experts don't always agree on the best time to start or how long to wait. Waiting usually means 6 months to a year.
But how long you can wait depends on several things, including your age and overall health aside from your kidneys. Guidelines for doctors about when to start dialysis include kidney failure symptoms, problems controlling blood pressure, problems controlling fluid, and problems with nutrition. You and your doctor may decide to start dialysis before these problems are happening to you. Your GFR isn't the only thing you and your doctor will look at in deciding when you should start dialysis.
You will also consider:. Dialysis can help you feel better before you start to have bad symptoms. It may improve your ability to get good nutrition and reduce the chances of going into the hospital from complications of kidney failure.
It also may lower blood pressure in people who have high blood pressure. Many experts recommend starting dialysis before you have any complications of kidney failure. That's because many of the complications can be deadly, such as not getting good nutrition, having too much fluid, or having too many wastes building up in your body.
Even if you don't start dialysis, you may want to plan for dialysis if your kidney function is getting worse. You could have surgery months ahead of time to create a place, called an access, to take the blood from your body to the dialysis machine. Dialysis—whenever it's started—can cause side effects. The longer you have dialysis, the longer you expose yourself to the chance of side effects. Hemodialysis can cause low blood pressure and heart problems, such as sudden cardiac arrest.
Peritoneal dialysis increases the risk of infection in the lining of your belly peritonitis. If you wait, you won't have as many limits on your time and lifestyle. Hemodialysis takes about 12 or more hours a week, usually in a dialysis center. Peritoneal dialysis needs to be done about 4 times a day, although it often can be done while you sleep. If you decide to start dialysis, it may help to know that it's common to feel a little overwhelmed and even scared at first.
It's a big change in your life. But if you choose to start dialysis, you can make good choices in your lifestyle to help you get the most from it. These stories are based on information gathered from health professionals and consumers.
They may be helpful as you make important health decisions. For years now, I've been worrying about when I might need dialysis. Even though my labs results are still okay, and my doctor says I could wait a little longer, I don't feel that great.
I'm tired all the time. My doctor agreed it would be okay for me to start dialysis now and see if I start to feel better. I'm just not ready to have dialysis. My test results are right on the edge, and I know I'd probably feel better if I did it. But I feel like having dialysis is giving up, like my life as I know it is over. It would depress me. I know I might have to do it sometime.
But I'm just going to try to do everything my doctor asks me to so I can go as long as I can without it. I feel pretty good. But my lab results have dropped a lot, so I know my kidneys are getting worse. I don't want to wait till I have symptoms, because by that point I could feel really sick. So I'm going to start dialysis while I'm still feeling okay. I have a couple of family members who are interested in donating a kidney for me. They are having tests to see if one of them is a good match.
The rest of my health is pretty good. So I'm not going to have dialysis yet. Your personal feelings are just as important as the medical facts. Private insurance generally covers treatment for kidney failure whenever your doctor says it is needed.
If you are not having symptoms, you may be able to wait a bit longer before you begin dialysis. However, some doctors believe that starting dialysis as soon as Medicare or insurance covers it is wise, since it can take a long time to recover if you let yourself get very ill. Since chronic kidney failure often happens slowly, sometimes people do not even know how bad they feel, until they start dialysis and begin to feel much better.
Learning about the types of dialysis and transplant options will help you make a choice that is best for you. Any type of dialysis will require surgery — usually outpatient — to allow access for your treatments, and this should be done well in advance to allow time for healing.
Dialysis is paid for with your health insurance and Medicare even if you are under age After 30 — 33 months, Medicare pays first and your health plan is secondary. Ask your dialysis or transplant center to help you figure out what your insurance will pay and how much you will be expected to pay out-of-pocket.
You can also call DaVita Guest Services at from 6 a. The chances that your kidneys will get better depend on what caused your kidney failure. Kidney failure is divided into two general categories, acute and chronic. When you have kidney failure your body cannot get rid of extra water and waste products. Dialysis is the removal of the water and waste products. Dialysis is one of the options for managing kidney failure. Dialysis filters out toxins, wastes and extra fluid. It doesn't replace your kidneys, nor does it return your kidney function to normal.
However, it does help to improve your health and help people continue to live even after their kidneys have failed. Starting dialysis, and being on it for a period of time, can be overwhelming and a major life adjustment. If your kidneys are failing or have failed, dialysis is incredibly important, especially it it's the treatment plan you've decided upon with your health professional.
Dialysis helps to remove waste products and extra fluid from the blood. If you choose to go on dialysis, it usually is performed for the rest of your life up until the point you receive a transplant. If you decide dialysis isn't the right option for you, you may elect for comprehensive conservative care. While you're on dialysis, it's an ongoing process, and it's important that you don't miss a session. This may mean that you have to make adjustments to your work and home life, although there are home treatments available.
In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life.
If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney. Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes. In hemodialysis, an artificial kidney hemodialyzer is used to remove waste and extra chemicals and fluid from your blood.
To get your blood into the artificial kidney, the doctor needs to make an access entrance into your blood vessels. This is done by minor surgery to your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula. However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin.
This is called a graft. Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment. A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you. In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen belly to make an access.
During the treatment, your abdominal area called the peritoneal cavity is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate.
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