What Happens If My Kidneys Fail Completely?

Complete and irreversible kidney failure is sometimes called end-stage renal disease, or ESRD. If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia. Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly.

Untreated uremia may lead to seizures or coma and will ultimately result in death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplantation.

Dialysis

The two major forms of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, your blood is sent through a filter that removes waste products. The clean blood is returned to your body. Hemodialysis is usually performed at a dialysis center three times per week for 3 to 4 hours at a time.

In peritoneal dialysis, a fluid is put into your abdomen. This fluid captures the waste products from your blood. After a few hours, the fluid containing your body’s wastes is drained away. Then, a fresh bag of fluid is dripped into the abdomen. Patients can perform peritoneal dialysis themselves. Patients using continuous ambulatory peritoneal dialysis (CAPD) change fluid four times a day. Another form of peritoneal dialysis, called continuous cycling peritoneal dialysis (CCPD), can be performed at night with a machine that drains and refills the abdomen automatically.

Transplantation

A donated kidney may come from an anonymous donor who has recently died or from a living person, usually a relative. The kidney that you receive must be a good match for your body. The more the new kidney is like you, the less likely your immune system is to reject it. Your immune system protects you from disease by attacking anything that is not recognized as a normal part of your body. So your immune system will attack a kidney that appears too “foreign.” You will take special drugs to help trick your immune system so it does not reject the transplanted kidney.

Points to Remember

• Your kidneys are vital organs that keep your blood clean and chemically balanced.

• The progression of kidney disease can be slowed, but it cannot always be reversed.

• End-stage renal disease (ESRD) is the total loss of kidney function.

• Dialysis and transplantation can extend the lives of people with ESRD.

• Diabetes and high blood pressure are the two leading causes of kidney failure.

• You should see a nephrologist regularly if you have renal disease.

• Chronic kidney disease (CKD) increases the risk of heart attacks and strokes.

• If you are in the early stages of renal disease, you may be able to save your remaining renal function for many years by:

• Controlling your blood glucose

• Controlling your blood pressure

• Following a low-protein diet

• Maintaining healthy levels of cholesterol in your blood

• Taking an ACE inhibitor or an ARB

• Quitting smoking