Dr. Jianling Tao, MD

No cure currently exists for kidney failure; however, medical treatment can permit people to live healthy and long lives. A nephrologist (kidney doctor) determines the most effective treatments for patients with kidney failure.

Dialysis is a well-known treatment for kidney failure that uses a machine to filter and clean waste from the blood. Patients attend regular dialysis sessions to replace their lost kidney function. Some patients with kidney failure are unable to survive without having dialysis every few days.

More advanced kidney failure may be treated by kidney transplant surgery. Deceased donor kidney transplant surgery provides kidney failure patients with a healthy kidney from a recently deceased person. Living donor kidney transplant surgery provides a kidney from a donor who is still alive. As most people have two kidneys, kidney failure patients' relatives or friends may offer to donate one of their kidneys. Kidney transplants can dramatically improve kidney function and lower or eliminate the need for dialysis.

People with kidney failure are advised to eat a nutritious diet, monitor and lower blood pressure, and to best manage diabetes. Exercise and a tobacco-free lifestyle may also help patients with kidney failure.

For hemodialysis (the more common form of dialysis), a patient will visit a hospital or clinic and be connected to a dialysis machine by a needle attached to a tube that draws blood from the arm. The drawn blood is transferred to the dialysis machine, where it is filtered and separated until clean. Waste products from the blood pass into a fluid called dialysate, which is pumped out of the machine into a waste receptacle. The machine also measures and helps ensure the blood has the appropriate level of fluid, electrolytes, and pH. A tube delivers the cleaned blood back into the patient's body. A dialysis session like this will typically last for three to four hours, with a patient undergoing dialysis around three times per week.

A second method of dialysis is known as peritoneal dialysis. Unlike hemodialysis, peritoneal dialysis can be performed at home by oneself after an initial surgery. To start, a physician (generally a surgeon) will make a small incision in the lower abdomen and insert and surgically attach a catheter (thin tube). At home, the patient connects a pump to the abdomen catheter, delivering dialysate (dialysis fluid) from a bag hanging on a wheeled stand. This fluid enters the peritoneal cavity (greater abdomen area containing the stomach, liver, and intestines) and collects waste through osmosis, where waste in the blood moves across a membrane and into the dialysate. This process continues for several hours until the fluid concentration is equal between the blood and dialysate, at which point the fluid can be drained. The fluid can then be passed through a machine called a cycler, which removes waste and allows for the dialysate to be reused. This process is repeated about four times per day. Dialysis patients must limit the amount of fluid they consume prior to receiving dialysis and should also avoid eating salty foods. The cycler cannot filter more than a certain amount of waste products from the blood.

Kidneys are important organs, and dialysis treatments are vital for those with renal dysfunction. For many, dialysis is not so much a medical procedure but a part of their normal life.