To treat AKI, you have to treat the cause (such as blood pressure that is too high or too low, a kidney stone or high blood sugar). Sometimes you need dialysis for a short time.
With CKD, treating the cause (such as high blood pressure and/or high blood sugar) can slow the disease. The goal is to prevent CKD from turning into advanced kidney disease, or end stage kidney disease (ESKD, formerly known as end stage renal disease, ESRD).
When kidney function falls below 10% of normal, dialysis or a kidney transplant is usually needed, especially if you have signs of uremia (a buildup of waste in the blood), like nausea, loss of appetite, weight loss and itching.
Dialysis
Dialysis is a way to remove extra salt, acid, potassium and waste products from the blood. The 2 types of dialysis are hemodialysis and peritoneal dialysis.
Hemodialysis: For hemodialysis, a tube (catheter) is stuck into one of the veins in your neck or leg. Preferably, an access, or arteriovenous fistula, is constructed in the arm. Hemodialysis is most often done 3 times a week for 3 to 4 hours at a time.
Peritoneal dialysis: Peritoneal dialysis is done through a tube permanently set in your belly. Fluid is then run into the abdomen, takes out the extra salt and potassium and water, and then removed. Most exchanges of fluid can be done by an automated “exchanger” while you sleep.
Most adults have dialysis done in an outpatient hemodialysis center. Most children have peritoneal dialysis done at home. Peritoneal dialysis has a number of advantages and is becoming more frequently used in adults in the US.
Kidney Transplant
A kidney transplant is when a surgeon puts a healthier kidney from another person into your body. Kidney transplant is the best way to treat many patients with end stage kidney disease.
Kidneys for transplant come from people who have agreed to donate their kidneys when they die (deceased donors) or donated by healthy people (living donors). Living donors are most often family members of the patient. There is a shorter wait time to surgery for a transplant from a living donor. (This is because there is a waiting list for kidneys from deceased donors and not enough donors.) Also, patients with kidneys donated by living donors live longer (and the kidneys last longer) than those with kidneys from deceased donors or who just stay on dialysis.
With modern medical techniques, the living kidney donor doesn't need to be a blood family member to get a good result.
About 90,000 patients are on the wait list for deceased donor kidney transplants in the U.S. But only 10,000 deceased donor kidney transplants are done each year due to the lack of donated kidneys. Another 6,000 kidney transplants are done each year from living kidney donors.
More Information
To learn more about kidney health, check out the below resources:
National Kidney Foundation (NKF)
American Association of Kidney Patients (AAKP)
American Kidney Fund (AKF)
Diabetes and high blood pressure are the most common causes of chronic kidney disease (CKD). Your health care provider will look at your health history and may do tests to find out why you have kidney disease. The cause of your kidney disease may affect the type of treatment you receive.
Diabetes
Too much glucose, also called sugar, in your blood damages your kidneys’ filters. Over time, your kidneys can become so damaged that they no longer do a good job filtering wastes and extra fluid from your blood.
Often, the first sign of kidney disease from diabetes is protein in your urine. When the filters are damaged, a protein called albumin, which you need to stay healthy, passes out of your blood and into your urine. A healthy kidney doesn’t let albumin pass from the blood into the urine.
Diabetic kidney disease is the medical term for kidney disease caused by diabetes.
High blood pressure
High blood pressure can damage blood vessels in the kidneys so they don’t work as well. If the blood vessels in your kidneys are damaged, your kidneys may not work as well to remove wastes and extra fluid from your body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle.
More information is provided in the NIDDK health topic, High Blood Pressure and Kidney Disease.
Other causes of kidney disease
Other causes of kidney disease include
Learn about diabetes, high blood pressure, and other diseases and health conditions that give you a higher chance of having kidney disease and kidney failure
Risk factors are things that give you a higher chance of having a condition, such as kidney disease. Having one of these risk factors does not mean that you will get kidney disease. But if you do, and you find and treat kidney disease early, you may be able to prevent it from getting worse.
Are you at risk?
Anyone can get kidney disease, but some people have a higher probability because they have one or more risk factors. Diabetes and high blood pressure are the leading risk factors for kidney disease in the U.S. If you have any of these risk factors, ask your doctor how often they should check how well your kidneys are working and look for signs of kidney disease.
Diabetes is the leading risk factor for kidney disease and the most common cause of kidney failure. High blood sugar from diabetes damages your kidneys and lowers their ability to filter waste and fluid from your blood. Over time, this causes kidney disease. If you have diabetes, healthy eating, being active and taking medicine can help slow or avoid damage to your kidneys.
High blood pressure is a leading risk factor for kidney disease and the second most common cause of kidney failure, after diabetes. When you have high blood pressure, the force of your blood flowing through the tiny blood vessels in your kidneys can cause damage. High blood pressure can also be a symptom of kidney disease. Keeping your blood pressure under control can help prevent kidney disease or keep it from getting worse.
People who are African American, Hispanic or Latino, Native American or Asian American have a higher chance of having kidney disease and kidney failure. Doctors and researchers are not exactly sure why, but they think it may be because diabetes and high blood pressure are more common in these groups.
See more about race, ethnicity and kidney disease
Learn about Kidney failure, also called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD), including symptoms, causes and life expectancy with dialysis or a kidney transplant.
Kidney failure, also called end-stage renal disease (ESRD) or end-stage kidney disease (ESKD), is the fifth and last stage of chronic kidney disease (CKD). Kidney failure cannot be reversed and is life-threatening if left untreated. However, dialysis or a kidney transplant can help you live for many more years.
What is kidney failure?
Kidney failure is when your kidneys have stopped working well enough for you to survive without dialysis or a kidney transplant. Your kidneys have lost their ability to filter waste from your blood. Kidney failure is also called end-stage kidney disease (ESKD) or end-stage renal disease (ESRD). It is stage 5 of chronic kidney disease (CKD).
What are the symptoms of kidney failure?
Symptoms of kidney failure may include:
- Itchy skin or rashes
- Muscle cramps
- Feeling sick to your stomach or throwing up
- Not feeling hungry than normal
- Swelling in your feet and ankles
- Urinating (peeing) more or less than normal
- Foamy, frothy or bubbly-looking urine
- Trouble catching your breath
- Trouble falling or staying asleep
Call your doctor right away if you notice any of these symptoms, especially if you already have kidney problems.
What causes kidney failure?
Kidney failure is usually caused by other health problems that have damaged your kidneys little by little throughout many years, including:
- Smoking tobacco
- Drinking too much alcohol (no more than 1 drink a day for women, and no more than 2 drinks a day for men)
These health problems do not always lead to CKD or kidney failure.
Sometimes a kidney problem called acute kidney injury (AKI) can also cause kidney failure. This type of kidney failure happens quickly, usually within two days, and is most common in people who are already hospitalized for other health problems. AKI is also known as acute kidney failure or acute renal failure.
Talk with your doctor about how to help your kidneys work for as long as possible.
How will I know if I have kidney failure?
To see if you have kidney failure, doctors may do tests:
- eGFR blood test
- Urine test
- Kidney biopsy, which is a procedure where doctors take a small piece of tissue from your kidneys to look at it under a microscope
How do doctors treat kidney failure?
You will need to see a nephrologist (kidney doctor). Your nephrologist will talk with you about your treatment choices, which include:
How long can I live after my kidneys fail?
When your kidneys fail, they cannot get better. Your life expectancy depends on many things, including your age. However, treatment can help people with kidney failure live for many more years:
- Dialysis helps people live for another five to 10 years on average.
- Deceased donor kidney transplants last 10 to 15 years on average.
- Living kidney donor transplants last 15 to 20 years on average.
If you choose not to get treatment for kidney failure, you can get medical management. This is supportive care and treatment to relieve your symptoms, but it will not keep you alive. There is no way to know how long you will live if you choose medical management. Your doctor will help you stay as healthy as possible.
How do I cope with kidney failure?
Learning you have kidney failure can be a shock, even if you have known for a long time that your kidneys were not working well. You may feel sad or anxious.
Reach out for support from your health care team and your family, friends and community. They can help you make changes to feel your best while you get dialysis and may be waiting for a kidney transplant.
To feel your best, your doctors will recommend that you:
- Go to every dialysis visit and consider getting a kidney transplant.
- Have visits with a nephrologist.
- Meet with a dietitian to help you create and follow a kidney-friendly eating plan.
- Keep your blood pressure at a healthy level. They may prescribe blood pressure medicines
- Keep your blood sugar at a healthy level if you have diabetes.
- Be active for 30 minutes on most days of the week.
- Drink less alcohol and quit smoking or using tobacco.
- Learn about mental health and kidney disease.
Starting dialysis often means creating a new normal for yourself and your family. There is a lot to think about, such as choosing a type of dialysis and making time for it in your daily life. Learn about the FIRST30 program for people new to dialysis.
What should I eat when I have kidney failure?
Dialysis does some of the work your kidneys did when they were healthy, but it cannot do everything that healthy kidneys do. You will need to limit what and how much you eat and drink while on dialysis.
Your doctor can help you find a dietitian to create a kidney-friendly eating plan.
Learn what healthy eating means for people in every stage of kidney disease, including those on dialysis or living with a kidney transplant.
Webinar
Depression: The overlooked complication of kidney disease
Living with chronic kidney disease and kidney failure can take a toll on not only your physical health but your mental health, too. But struggling with depression does not need to be every kidney patient's reality. View our webinar to learn more about treatments available for depression and other proven coping methods.