This topic provides
information about chronic kidney disease. If you are looking for information
about sudden kidney failure, see the topic
Acute Kidney Injury.
What is chronic kidney disease?
Having chronic
kidney disease means that for some time your
kidneys have not been working the way they should.
Your kidneys have the important job of filtering your blood. They remove waste
products and extra fluid and flush them from your body as urine. When your
kidneys don't work right, wastes build up in your blood and make you
sick.
Chronic kidney disease may seem to have come on suddenly.
But it has been happening bit by bit for many years as a result of damage to
your kidneys.
Each of your kidneys has about a million tiny
filters, called nephrons. If nephrons are damaged, they stop working. For a
while, healthy nephrons can take on the extra work. But if the damage
continues, more and more nephrons shut down. After a certain point, the
nephrons that are left cannot filter your blood well enough to keep you
healthy.
One way to measure how well your kidneys are working is to figure out your glomerular filtration rate (GFR). The GFR is usually calculated using results from your blood creatinine (say "kree-AT-uh-neen") test. Then the stage of kidney disease is figured out using the GFR. There are five stages of kidney disease, from kidney damage with normal GFR to kidney failure.
There are things you can do to slow or stop the damage to
your kidneys. Taking medicines and making some lifestyle changes can help you
manage your disease and feel better.
Chronic kidney disease is
also called chronic renal failure or chronic renal insufficiency.
What causes chronic kidney disease?
Chronic
kidney disease is caused by damage to the kidneys. The most common causes of
this damage are:
Uncontrolled high blood pressure over many years.
High blood sugar over many years. This happens in uncontrolled type 1 or type 2 diabetes.
Other things that can lead to chronic kidney disease
include:
A narrowed or blocked renal artery. A renal artery carries
blood to the kidneys.
Long-term use of medicines that can damage the
kidneys. Examples include
nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib and ibuprofen.
What are the symptoms?
You may start to have
symptoms only a few months after your kidneys begin to fail. But most people don't have symptoms early on. In fact, many don't have symptoms for as long as
30 years or more. This is called the "silent" phase of the disease.
How well your kidneys work is called kidney function. As your kidney
function gets worse, you may:
Urinate less than normal.
Have
swelling and weight gain from fluid buildup in your tissues. This is called edema (say
"ih-DEE-muh").
Feel very tired or sleepy.
Not feel
hungry, or you may lose weight without trying.
Often feel sick to
your stomach (nauseated) or vomit.
Have trouble sleeping.
Have headaches or trouble
thinking clearly.
How is chronic kidney disease diagnosed?
Your
doctor will do blood and urine tests to help find out how well your kidneys are
working. These tests can show signs of kidney disease and
anemia. (You can get anemia from having damaged
kidneys.) You may have other tests to help rule out other problems that could
cause your symptoms.
Your doctor will do tests that measure the amount of urea (BUN) and creatinine in your blood. These tests can help measure how well your kidneys are filtering your blood. As your kidney function gets worse, the amount of nitrogen (shown by the BUN test) and creatinine in your blood increases. The level of creatinine in your blood is used to find out the glomerular filtration rate (GFR). The GFR is used to show how much kidney function you still have. The GFR is also used to find out the stage of your kidney disease and to guide decisions about treatment.
Your doctor will ask questions about any
past kidney problems. He or she will also ask whether you have a family history of kidney disease and
what medicines you take, both prescription and over-the-counter drugs.
You may have a test that lets your doctor look at a picture of your
kidneys, such as an
ultrasound or
CT scan. These tests can help your doctor measure the
size of your kidneys, estimate blood flow to the kidneys, and see if urine flow
is blocked. In some cases, your doctor may take a tiny sample of kidney tissue
(biopsy) to help find out what caused your kidney
disease.
How is it treated?
Chronic kidney disease is
usually caused by another condition. So the first step is to treat the disease
that is causing kidney damage.
Diabetes and high blood pressure
cause most cases of chronic kidney disease. If you keep your blood pressure and
blood sugar in a target range, you may be able to slow or stop the damage to your
kidneys. Losing weight and getting more exercise can help. You may also need to
take medicines.
Kidney disease is a complex problem. You will
probably need to take a number of medicines and have many tests. To stay as
healthy as possible, work closely with your doctor. Go to all your
appointments. And take your medicines just the way your doctor says to.
Lifestyle changes are an important part of your treatment. Taking these
steps can help slow down kidney disease and reduce your symptoms. These steps may also
help with high blood pressure, diabetes, and other problems that make kidney
disease worse.
Follow a diet that is easy on your kidneys.
A dietitian can help you make an eating plan with the right amounts of salt
(sodium) and protein. You may also need to watch how much fluid you drink each
day.
Make exercise a routine part of your life. Work with your
doctor to design an exercise program that is right for you.
Do
not smoke or use tobacco.
Do not drink alcohol.
Always talk to your doctor before you take
any new medicine, including over-the-counter remedies,
prescription drugs, vitamins, or herbs. Some of these can hurt your kidneys.
What happens if kidney disease gets worse?
When
kidney function falls below a certain point, it is called
kidney failure. Kidney failure affects your whole
body. It can cause serious heart, bone, and brain problems and make you feel
very ill. Untreated kidney failure can be life-threatening.
When you have kidney failure, you will probably have
two choices: start
dialysis or get a new kidney (transplant). Both of
these treatments have risks and benefits. Talk with your doctor to decide which
would be best for you.
Dialysis is a process that filters your
blood when your kidneys no longer can. It is not a cure, but it can help you
feel better and live longer.
Kidney transplant may be the best
choice if you are otherwise healthy. With a new kidney, you will feel much
better and will 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. And you will
have to take medicine for the rest of your life to keep your body from
rejecting the new kidney.
Making treatment decisions when you are very ill is hard.
It is normal to be worried and afraid. Discuss your concerns with your loved
ones and your doctor. It may help to visit a dialysis center or transplant
center and talk to others who have made these choices.
The cause of
chronic kidney disease isn't always known. But any
condition or disease that damages blood vessels or other structures in the
kidneys can lead to kidney disease. The most common causes of chronic kidney
disease are:
Diabetes.
High blood sugar
levels caused by diabetes damage blood vessels in the kidneys. If the blood
sugar level remains high over many years, this damage gradually reduces the function of the
kidneys.
High blood pressure (hypertension). Uncontrolled high blood pressure damages blood vessels, which can lead to damage in the kidneys. And blood pressure often rises with chronic kidney disease,
so high blood pressure may further damage kidney function even when another
medical condition initially caused the disease.
Other conditions that can damage the kidneys and cause
chronic kidney disease include:
Having a narrowed or blocked renal artery. A renal
artery carries blood to the kidneys.
Long-term use of
medicines that can damage the kidneys. Examples
include
nonsteroidal anti-inflammatory drugs (NSAIDs), such as
celecoxib and ibuprofen, and certain
antibiotics.
Diabetes and high blood pressure are the most common causes
of chronic kidney disease that leads to
kidney failure. Diabetes or high blood pressure may
also speed up the progression of chronic kidney disease in someone who already
has the disease.
Symptoms
Many people who develop
chronic kidney disease don't have symptoms at first.
This is known as the "silent" phase of the disease.
As your kidney
function gets worse, you may:
Urinate less than normal.
Have
swelling and weight gain from fluid buildup in your tissues (edema).
Feel very
tired.
Lose your appetite or have an unexpected weight loss.
Feel nauseated or vomit.
Be either very sleepy or unable to sleep.
Have
headaches, or have trouble thinking clearly.
Have a metallic taste in your mouth.
Have severe
itching.
What Happens
At first with chronic kidney disease, your kidneys are still able to regulate the balance of fluids, salts, and
waste products in your body. But as kidney function decreases, you will start to have other problems, or complications. The worse your kidney function gets, the more complications you'll have and the more severe they will be.
When kidney function falls below a certain point, it is called
kidney failure. Kidney failure has harmful effects
throughout your body. It can cause serious heart, bone, and brain problems and
make you feel very ill.
After you have kidney failure, either
you will need to have dialysis or you will need a new kidney. Both choices have
risks and benefits.
Complications of chronic kidney disease
Anemia. You may feel weak, have pale skin, and feel tired, because the kidneys can't produce enough of the hormone (erythropoietin) needed to make new red blood cells.
Electrolyte imbalance. When the kidneys can't filter out certain chemicals, such as potassium, phosphate, and acids, you may have an irregular heartbeat, muscle weakness, and other problems.
Uremic syndrome. You may be tired, have nausea
and vomiting, not have an appetite, or not be able to sleep when substances build up in your blood. The substances can be
poisonous (toxic) if they reach high levels. This syndrome can
affect many parts of your body, including the intestines, nerves, and heart.
Heart disease. Chronic
kidney disease speeds up hardening of the arteries (atherosclerosis) and increases the risk of
stroke, heart attack,
and heart failure. Heart disease is the most common cause
of death in people with kidney failure.
Bone disease (osteodystrophy). Abnormal levels of substances, such as calcium, phosphate, and vitamin D, can lead to bone
disease.
Fluid buildup (edema). As kidney function gets worse, fluids and salt build up in the body. Fluid buildup can lead to heart failure and pulmonary edema.
What Increases Your Risk
Some of the things that lead
to
chronic kidney disease are related to your age and
your genetic makeup. You may be able to control other things that increase your
risk, such as dietary habits and exercise.
Things you cannot control
The main risk factors
for chronic kidney disease are:
Age. The kidneys begin
to get smaller as people get older.
Race. African-Americans
and Native Americans are more likely to get chronic kidney disease.
Being male. Men have a
higher risk for chronic kidney disease than women do.
Family history. Family history is a factor in the development
of both
diabetes and
high blood pressure, the major causes of chronic
kidney disease.
Polycystic kidney disease is one of several inherited
diseases that cause kidney failure.
Things you may be able to control
You may be able
to slow the progression of chronic kidney disease and prevent or delay kidney failure by controlling things that increase
your risk of kidney damage, such as:
High blood pressure,
which gradually damages the tiny blood vessels in the kidneys.
Diabetes. A persistently high
blood sugar level can damage blood vessels in the kidneys. Over time, kidney
damage can progress, and the kidneys may stop working altogether.
Eating protein and fats. Eating a diet
low in protein and fat may reduce your risk for kidney
disease.
Call 911 or other emergency services if you have
chronic kidney disease and you develop:
A very slow heart rate (less than 50 beats a
minute).
A very rapid heart rate (more than 120 beats a
minute).
Chest pain or severe shortness of
breath.
Severe muscle weakness.
To check your heart rate, see the
instructions for
taking a pulse.
Call your doctor immediately
if you:
Have symptoms of
uremic syndrome, such as increasing fatigue, nausea
and vomiting, loss of appetite, or inability to sleep.
Vomit blood
or have blood in your stools.
Call your doctor if you:
Are feeling more tired or
weak.
Have swelling of the arms or
feet.
Bruise often or
easily or have unusual bleeding.
Are being treated with
dialysis and you:
Have belly pain while you are being treated with peritoneal
dialysis.
Have
signs of infection at your catheter or
dialysis access site, such as pus draining from the
area.
Have any other problem that your dialysis instruction manual
or nurse's instructions say you should call about.
If you have uncontrolled weight loss, discuss this with
your doctor during your next visit.
Watchful waiting
A wait-and-see approach is not a good idea if
you could have chronic kidney disease. See your doctor. If you have been
diagnosed with chronic kidney disease, follow your treatment plan. And call
your doctor if you notice any new symptoms.
Who to see
Health professionals who can diagnose and treat
chronic kidney disease include:
After you are diagnosed with chronic kidney disease, blood
and urine tests can help you and your doctor monitor the disease.
Tests to check kidney function
When kidney
function is decreased, substances such as
urea,
creatinine, and certain
electrolytes begin to build up in the blood. The
following tests measure levels of these substances to show how well your kidneys are working.
A blood creatinine test helps to estimate the glomerular filtration rate (GFR) by measuring the level of creatinine in your blood. The doctor can use the GFR to regularly check how well the kidneys are working and to stage your kidney disease.
A blood urea nitrogen (BUN) test measures how much nitrogen from the waste product urea is in your blood.
BUN level rises when the kidneys aren't working well enough to remove urea from the blood.
A fasting blood glucose test is done to measure your
blood sugar. High blood sugar levels damage blood vessels in the
kidneys.
Blood tests measure levels of waste products and
electrolytes in your blood that should be removed by your kidneys.
A blood test for
parathyroid hormone (PTH) checks the level of PTH, which helps control calcium and phosphorus levels.
Urinalysis (UA) and a urine test for
microalbumin, or other urine tests, can measure protein in your
urine. Normally there is little or no protein in urine.
Tests for anemia
If the kidneys don't produce
enough of the hormone
erythropoietin needed to make red blood cells,
anemia can develop. The following tests help monitor anemia:
A reticulocyte count shows how many red
blood cells are being produced by the bone marrow.
Iron studies show your level of iron, which is needed for
erythropoietin to work the way it should.
A serum ferritin test measures the protein that binds to iron in your body.
Other tests
Your doctor may use other tests to
monitor kidney function or to find out whether another kidney disease
or condition is contributing to reduced kidney function.
An
ultrasound of the kidney (renal ultrasound) helps estimate how long you may have had chronic
kidney disease. It also checks whether urine flow from the
kidneys is blocked. An ultrasound also may help find causes
of kidney disease, such as obstruction or
polycystic kidney disease.
A
kidney biopsy may help find out the cause of chronic
kidney disease. After a kidney transplant, a doctor may use this test if he or she suspects the organ is being rejected by your body.
Early screening for chronic kidney disease
Experts
recommend screening tests for chronic kidney disease in high-risk groups, such
as people with
diabetes or
high blood pressure. Kidney disease runs in families, so close
family members may also want to have their kidney function tested. Being diagnosed with kidney
disease before it has progressed gives you the best chance to control the
disease.
To learn more about screening if you already have diabetes or high blood pressure, see:
The goal of treatment for
chronic kidney disease is to prevent or slow
further damage to your kidneys. Another condition such as
diabetes or
high blood pressure usually causes kidney disease, so
it is important to identify and manage the condition that is causing your
kidney disease. It is also important to prevent diseases and avoid situations
that can cause kidney damage or make it worse.
Treatment to control kidney disease
Control the disease that's causing the kidney damage
One of the most important parts of treatment is to control the disease that
is causing kidney damage. You and your doctor
will create a plan to aggressively treat and manage your condition to help
slow any more damage to your kidneys.
If you have
diabetes, it is important to control your blood sugar
levels with diet, exercise, and medicines. A persistently high blood sugar
level can damage the blood vessels in the kidneys. For more information about kidney disease caused by diabetes, see the topic
Diabetic Nephropathy.
If you have high blood pressure, it is also important to keep your blood pressure in your target range, for example less than 130/80. To learn ways to help control your blood pressure, see the topic High Blood Pressure.
If other conditions or diseases are causing kidney damage,
such as a blockage (obstruction) in the urinary tract or long-term use of
medicines that can damage the kidneys, you and your doctor will work out a treatment plan.
Take medicines if prescribed
You may be prescribed a blood pressure
medicine, such as an
ACE inhibitor or an
angiotensin II receptor blocker (ARB). These medicines
are used to reduce protein in the
urine and help manage high blood pressure.
Have a healthy lifestyle
You can take steps at home to
help control your kidney disease. For example:
Follow a diet that is healthy for your kidneys.
A dietitian can help you make an eating plan with the right amounts of salt
(sodium), fluids, and protein.
Make exercise a routine part of your life. Work with your
doctor to make an exercise program that's right for you.
Don't use substances that can harm your kidneys, such as alcohol, any kind of tobacco, or illegal drugs. Also, be sure
that your doctor knows about all prescription medicines, over-the-counter medicines,
and herbs that you are taking.
Go to all follow-up visits
Your doctor
will use blood and urine tests to regularly check how well your kidneys are
functioning and whether changes to your treatment plan are needed. These tests are critical to help monitor your disease. The tests
include:
Tests to measure the amount of protein in your
urine, to find out whether your medicines need to be
adjusted.
Treat any complications
As the disease gets worse, your symptoms-such as fatigue, nausea, and loss of appetite-may occur more often or
become more severe. Work with your doctor to create a treatment plan to help
control these symptoms.
If you develop anemia, you may need to take medicine called
erythropoietin (EPO). It helps your body make new red
blood cells and may help improve your appetite and
general sense of well-being.
You may also need an iron supplement if you have an
iron deficiency.
When your
kidney function has fallen below a certain point, it is called
kidney failure. Kidney failure has harmful effects
throughout your body. It can cause serious heart, bone, and brain problems and
can make you feel very ill.
After you have kidney failure, either
you will need to have dialysis or you will need a new kidney. Both choices have
risks and benefits.
Dialysis
Dialysis is a process that does the work of healthy
kidneys by clearing wastes and extra fluid from the body and restoring the
proper balance of chemicals (electrolytes) in the blood. You may use
dialysis for many years, or it may be a short-term measure while you are
waiting for a kidney transplant.
Kidney transplant is often a better treatment option than dialysis for kidney failure,
because it may allow you to live a fairly normal life. But there are some
drawbacks. For example, you will probably need to have dialysis
while you wait for a kidney.
To learn more about kidney transplants, see Surgery.
Making treatment
decisions when you are very ill is difficult. It is normal to be fearful and
worried about the risks involved. Discuss your concerns with your family and
your doctor. It may be helpful to visit the dialysis center or transplant
center and talk to others who have chosen these options.
Palliative care
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life-not just in your body but also in your mind and spirit.
You can have palliative care along with treatment to cure your illness. You can also have it if treatment to cure your illness no longer seems like a good choice.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
Chronic kidney disease progresses to
kidney failure when damage to the kidneys is so severe
that
dialysis or a kidney transplant is needed to control
symptoms and prevent complications and death. Many people have successful
kidney transplants or live for years using dialysis. But at this point you may
wish to talk with your family and doctor about health care and other legal
issues that arise near the end of life.
A time may come when your
goals or the goals of your loved ones may change from treating or curing your
disease to maintaining comfort and dignity. You may find it helpful and
comforting to state your health care choices in writing (with an
advance directive such as a living will) while you are
still able to make and communicate these decisions. Think about your treatment
options and which kind of treatment will be best for you.
You may wish to write
a
durable power of attorney or choose a
health care agent, usually a family member or loved
one, to make and carry out decisions about your care if you become unable to
speak for yourself. You also have the option to refuse or stop treatment. For
more information, see the topic
Care at the End of Life.
Prevention
Chronic kidney disease may sometimes be prevented by controlling the other diseases or
factors that can contribute to kidney disease. People who have
already developed
kidney failure also need to focus on these things to
prevent the complications of kidney failure.
Keep your blood pressure below 130/80. Learn to
check your blood pressure at home.
Stay at a healthy weight. This can help you
prevent other diseases, such as diabetes, high blood pressure, and heart
disease. For more information, see the topic
Weight Management.
Control your cholesterol levels. For more information, see the topic
High Cholesterol.
Don't smoke or use
other tobacco products. Smoking can lead to
atherosclerosis, which reduces blood flow to the
kidneys and increases blood pressure. For more information on how to quit, see
the topic
Quitting Smoking.
Home Treatment
There are many things you can do at
home to slow the progression of chronic kidney disease.
Lifestyle changes
Keep your blood pressure below 130/80. Learn
to check your blood pressure at home.
Stay at a healthy weight. This can also reduce
your risk for
coronary artery disease, diabetes,
high blood pressure, and
stroke. For more information, see the topic
Weight Management.
Follow the eating plan your dietitian created for you. Your
eating plan will balance your need for calories with your need to limit certain
foods, such as sodium, fluids, and
protein.
Make exercise a routine part of your life. Work
with your doctor to design an exercise program that is right for you. Exercise
may lower your risk for diabetes and high blood pressure.
Don't smoke or use other
tobacco products. Smoking can lead to
atherosclerosis, which reduces blood flow to the
kidneys and increases blood pressure. For more information on how to quit, see
the topic
Quitting Smoking.
Don't drink alcohol or
use illegal drugs.
What to avoid
Avoid taking
medicines that can harm your kidneys. Be sure that
your doctor knows about all prescription drugs, over-the-counter drugs, and herbs you are taking.
Avoid
dehydration by promptly treating illnesses, such as
diarrhea, vomiting, or fever, that cause it. Be especially careful when you
exercise or during hot weather. For more information, see the topic
Dehydration.
Avoid products containing magnesium, such as
antacids like Mylanta or Milk of Magnesia or laxatives like Citroma. These products increase your risk of
having abnormally high levels of magnesium (hypermagnesemia), which may
cause vomiting, diarrhea, or both.
Avoid X-ray tests that require IV
dye (contrast material), such as an angiogram, an
intravenous pyelogram (IVP), and some CT scans. IV dye
can cause more kidney damage. Make sure that your doctor knows about any tests that you are scheduled to have.
Medications
Although medicine cannot reverse
chronic kidney disease, it is often used to help treat
symptoms and complications and to slow further kidney damage.
Medicines to treat high blood pressure
Most people who have chronic kidney disease have problems with high blood pressure at some time during their disease. Medicines that lower blood pressure help to keep it in a target range and stop any more kidney damage.
You may need to try several blood pressure medicines
before you find the medicine that controls your blood pressure well without
bothersome side effects. Most people need to take a combination of medicines to
get the best results. Your doctor may order blood tests 3 to 5 days after
you start or change your medicines. The tests help your doctor make sure that your medicines are working
correctly.
Medicines to treat symptoms and complications of chronic kidney disease
Medicines may be used to treat symptoms and complications of
chronic kidney disease. These medicines include:
Erythropoietin (EPO) therapy and
iron replacement therapy (iron pills or intravenous iron) for
anemia.
Medicines for
electrolyte imbalances.
Diuretics to
treat fluid buildup caused by chronic kidney disease.
ACE inhibitors and ARBs. These may be used if you have protein in your urine (proteinuria) or have heart failure. Regular blood tests are required to make sure that these
medicines don't raise potassium levels (hyperkalemia) or make kidney function
worse.
Medicines used during dialysis
Both
erythropoietin (EPO) therapy and iron replacement therapy may also be used
during dialysis to treat anemia, which often develops in advanced chronic
kidney disease.
Erythropoietin (EPO) stimulates the
production of new red blood cells and may decrease the need for blood
transfusions. This therapy may also be started before dialysis is needed, when
anemia is severe and causing symptoms.
Iron therapy can help increase levels
of iron in the body when EPO therapy alone is not effective.
Talk with your doctor about what
types of
immunizations you should have if you have chronic
kidney disease, such as hepatitis B, flu (influenza), and pneumococcal vaccines.
Also, be sure to discuss
medicine precautions. Make sure to tell your doctor
about all prescription drugs, over-the-counter drugs, and herbs you are
taking.
Surgery
Kidney transplant
If you have
chronic kidney disease that progresses, you may have
the option of a
kidney transplant. Most experts agree that it is the
best option for people with
kidney failure. In general, people who have kidney
transplants live longer than people treated with dialysis.
You will probably be considered a good candidate if
you don't have significant heart, lung, or liver disease or other diseases, such as
cancer, which might decrease your life span.
There are some drawbacks. You may have to wait for a kidney to be donated. If so, you will need to
have dialysis while you wait. Also, it may be hard to find a good
match for your blood and tissue types. Sometimes, even when the match is good,
the body rejects the new kidney.
After a kidney
transplant, you will have to take medicines called immunosuppressants.
These medicines, such as cyclosporine or tacrolimus, help prevent your body
from
rejecting your new kidney.
It is very important to take your medicines
exactly as prescribed. This will help keep your body from rejecting your new
kidney.
You will need to take medicines for the rest of your
life.
Because these medicines weaken the function of your
immune system, you will have an increased risk for serious infections or cancer.
Even if you take your medicines, there is a chance that
your body will reject your new kidney. If this happens, you will have to resume
dialysis or have another kidney transplant.
The success of the transplant also depends on what kind of donor kidney
you are receiving. The closer the donor kidney matches your genetic makeup, the
better the chances that your body will not reject it.
For more general information about transplant, see the
topic
Organ Transplant.
What to think about
A kidney transplant doesn't
guarantee that you will live longer than you would have without a new
kidney.
Other Treatment
Dialysis
Dialysis is a
mechanical process that performs the work that healthy kidneys would do. It
clears wastes and extra fluid from the body and restores the proper balance of
chemicals (electrolytes) in the blood. When
chronic kidney disease becomes so severe that your
kidneys are no longer working properly, you may need dialysis. You may use
dialysis to replace the work of the kidneys for many years. Or dialysis may be a
short-term measure while you are waiting for a kidney transplant.
Hemodialysis uses a man-made membrane
called a dialyzer to clean your blood. You are connected to the dialyzer by
tubes attached to your blood vessels. Before hemodialysis treatments can begin,
a surgeon creates a site where blood can flow in and out of your body. This is
called the dialysis access. Usually the doctor creates the access by joining an
artery and a vein in the forearm or by using a small tube to connect an artery
and a vein. An access may be created on a short-term basis by putting a small
tube into a vein in your neck, upper chest, or groin.
Peritoneal dialysis uses the lining of your belly, which is called the
peritoneal membrane, to filter your blood. Before you
can begin peritoneal dialysis, a surgeon needs to place a catheter in your
belly to create the dialysis access.
If
you have severe chronic kidney disease but have not yet developed
kidney failure, talk to your doctor about which type
of dialysis would be best for you.
Learning about dialysis (predialysis education) is an important step in
preparing for dialysis. Most dialysis clinics offer predialysis services to
help you know about your choices.
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Credits
ByHealthwise Staff Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerTushar J. Vachharajani, MD, FASN, FACP - Nephrology
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