Kidney failure treatment is primarily determined by the underlying cause(s) of kidney failure and the severity of kidney (renal) failure.
Treatment of kidney failure incorporates dietary changes, lifestyle adjustments, medications to treat underlying conditions, dialysis and kidney transplant.
In the very early stages, kidney failure treatment may only require changes to diet and some lifestyle changes, such as quit smoking and exercising regularly.
Medication may also be required to treat any associated underlying condition, such as diabetes or hypertension.
If kidney failure (renal failure) is caused by bacterial infection, antibiotics may be required.
In order to determine the most appropriate treatment of renal failure, the severity and underlying cause(s) must first be ascertained.
Typically, renal failure is diagnosed and treated by a nephrologist (a doctor who specializes in treating the kidneys).
In the very early stages of kidney failure, a patient may not exhibit any noticeable symptoms. In these cases, signs of renal failure may only be discovered by a doctor during routine medical examinations. He may then recommend further assessment of the kidneys to determine the level of kidney function and the underlying cause(s) of renal failure.
Someone who is suspected of having kidney failure will first undergo extensive blood and urine tests. These tests will analyze the chemical composition of these two substances (blood and urine) and assess how efficiently the kidneys are removing waste and toxic products from the blood.
The main job of the kidneys is to remove waste products and toxic chemicals from the blood and eliminate them from the body, via the urine. In order to test kidney function, doctors consider and the quantity and composition of the chemicals excreted by the kidneys.
In some cases, a full assessment of the kidneys is necessary to properly diagnose the underlying condition and to determine the most appropriate kidney failure treatment. This may require the use of magnetic resonance imaging (MRI), computed tomography (CT) scan, ultrasound, x-rays, renal biopsy, and arteriogram (the recording of an arterial pulse) of the kidneys.
These tests help to determine the underlying cause of kidney failure and the level of remaining kidney function.
The treatment of kidney failure can be quite complex, depending on the overall medical status of the patient and the severity and cause(s) of renal failure. For instance, pre-renal conditions (i.e. conditions that do not cause kidney damage, but affect kidney function) may be treated with replacement fluids given through a vein, blood transfusion, diuretics (substance that increases urine formation and excretion), or other medications.
Post-renal conditions (conditions that cause obstruction of the urinary tract) and intra-renal conditions (conditions that cause direct injury to the kidneys) may require surgery and/ or medication.
When kidney failure is mild to moderate, the kidneys can still perform their functions adequately. There is no need for dialysis or surgery but steps must be taken to either halt or considerably slow down the decline in kidney function. In most cases, treatment is required for underlying conditions (such as hypertension and diabetes) that may be causing the kidneys to fail. Typical treatments for mild to moderate kidney failure may include the following:
In most cases, these treatments can effectively minimize the harmful effects of mild to moderate kidney failure. When kidney failure becomes more severe, however, these basic treatments may not be adequate and other measures may be required.
For severe cases of renal failure, diet, exercise and medication for underlying conditions may not be enough. Once kidney function has declined significantly, more extensive kidney failure treatment may become necessary.
Dialysis is a standard treatment protocol for patients with severe renal failure. Dialysis helps to remove waste products and toxins from the blood, when the kidneys are no longer able to do so. There are three basic types of dialysis: hemodialysis (or haemodialysis), hemofiltration (or haemofiltration), and peritoneal dialysis.
Hemodialysis (commonly referred to as dialysis) is a primary kidney failure treatment. It is administered in both acute and chronic kidney failure cases. Dialysis involves circulating the blood outside of the body through an extra corporeal circuit (ECC) or dialysis circuit. This circuit is made up of plastic tubing, a filter known as a dialyzer (or artificial kidney), and a dialysis machine.
The machine monitors and maintains blood flow and administers dialysate. Dialysate is a sterile chemical solution that is used to draw waste products out of the blood.
Hemodialysis patients usually require three sessions per week and the duration of one session is approximately three (3) to four (4) hours.
Hemofiltration is another renal failure treatment that helps to remove toxins and waste products from the blood. It is also known as continuous renal replacement therapy (CRRT). This procedure is a slow continuous blood filtration therapy and is used mainly to control acute kidney failure, in critically ill patients.
Peritoneal dialysis is generally administered to patients with chronic kidney failure. It can also be uses by patients with acute kidney failure, once they are stable and not in immediate crisis.
This procedure uses the patient's peritoneum as a blood filter.
The peritoneum is the membrane (thin flexible skin-like tissue) that lines the abdominal cavity.
A flexible tube-like instrument (called a catheter) is surgically inserted into the patient's abdomen, which is used to fill the abdominal cavity with dialysate (a sterile chemical solution that is used to draw waste products out of the blood).
A kidney transplant is the only effective long term treatment for patients with chronic end stage renal disease (ESRD). ESRD is the most severe form of renal failure, where the kidneys no longer function or function at less than 10% of their capacity.
Most patients who receive a kidney transplant have an excellent chance of extending their life and also enjoying a much better quality of life. Studies have indicated that the typical patient will live 10-15 years longer with a kidney transplant than if they stayed on dialysis.
Treatment of kidney failure should always be supervised by a qualified and competent health care professional. Proper assessment and diagnosis of the patient's health status and the severity of renal failure is necessary, before any kidney failure treatment can be prescribed.