Dr. Syed Affan Ul Haq Hashmi, 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.

Kidney stones can be smooth or jagged and are yellow to brown in color. They are mostly comprised of the minerals calcium, oxalate, and phosphorus. Examining the stones to see what they are made of can show what caused the stone to be formed in the first place. For example, a stone made of mostly calcium, which is the most common type, can happen any time the urine becomes too concentrated due to dehydration or a blockage in the kidney. A uric acid stone forms when acid levels in the urine get too high, usually due to excessive consumption of animal protein such as meat and fish. A struvite stone is a sign of certain infections, and a cystine stone can be due to a genetic disorder that raises the risk of kidney stones.

The most common symptom of kidney stones is pain, either in the back or lower abdomen, or severe pain when urinating. There may also be blood in the urine. Treatment for kidney stones depends on how large the stone is. Very small stones can pass out of the body on their own, and they do not require treatment other than drinking adequate water and taking pain killers. Larger stones need to be broken apart and removed. The main treatment options are:

• Shock wave lithotripsy, which uses sound wave vibrations to break apart the stone
• Percutaneous nephrolithotomy, or the use of a very tiny tool (like a wire inserted through the back) to break apart and remove the stone
• Ureteroscopy, a thin tube inserted through the urethra and bladder to the stone, where tiny tools can grasp the stone and remove

People who have had one kidney stone are at risk of developing another. To reduce this risk, patients are given instructions specific to the type of stone they developed. Generally the instructions will include drinking more water to dilute the urine, but it may also involve lowering sodium intake or eating less meat.

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 peritoneal dialysis can be vital for those with renal dysfunction. Peritoneal dialysis may be a more convenient alternative to hemodialysis, which requires going into a clinic.