How Is Kidney Failure Treated?

Kidney failure occurs when 85%–90% of your kidney function is lost. When this happens, your kidneys can’t function well enough to keep you alive.

The only definitive cure for permanent kidney failure is transplantation. However, until that can be done, treatments are available that can help alleviate symptoms, address complications, help you feel better, get you healthier, and allow you to live a longer life. These treatments include dialysis, diet and lifestyle factors, conservative management, and more.

This article will review the various treatments available for kidney failure. Knowing your options can help you talk with your healthcare provider to establish what might work best for you.

Diet and Exercise

Although kidney failure can be treated in a variety of ways, lifestyle changes can be made to encourage health and wellness. If you opt for conservative management of kidney failure, the focus will be on quality of life and symptom control without dialysis (a procedure to remove waste products and excess water from the blood) or kidney transplantation.

Healthy kidneys help to filter out waste and balance salt and minerals in the body.

Failing kidneys can't do this, so changing your diet may help you reclaim and maintain a healthy balance of salts, minerals, and nutrients. The best diet for you will depend on the treatment you’ve chosen, so talk with your healthcare provider about any appropriate dietary changes.

There are general steps you can take to make some changes in your diet, including:

• Avoid too much salt: Buy fresh food, use seasonings instead of salt, swap lower-sodium options for favorites, and rinse canned foods before eating.
• Eat the right amount of protein: Eating smaller portions of proteins means your kidneys won't have to work as hard.
• Add heart-healthy foods to your diet: Avoid deep-frying. Instead, grill or bake your food, trim fat from meat, and limit saturated and trans fats.
• Opt for foods with lower phosphorus levels: When phosphorus levels rise in your body, calcium levels fall, making your bones weaker. Good choices include fresh fruits and vegetables, bread or pasta, corn and rice cereals, and light-colored sodas.
• Be mindful of potassium levels in foods: Too much potassium can interfere with nerve and muscle functioning and can also cause problems with heart rhythm. Foods to choose include apples, peaches, carrots, white pasta, rice milk, and white rice.

A nutritionist who specializes in medical nutrition therapy can help you create a dietary plan to provide you with necessary nutrients while also keeping in mind your kidney failure and how it affects you.

Exercise can be very helpful in slowing down the progression of chronic kidney disease, but talk with your healthcare provider before starting an exercise program if your kidneys are failing.

Things to keep in mind when starting an exercise program (with the approval of your healthcare provider) include:

• Continuous exercises like walking or swimming allow you to move many large muscle groups continuously. Low-level strength exercises may also be beneficial.
• Start off exercising for a short amount of time, and work your way up to 30-minute sessions. If you want to go 45 minutes or longer, feel free, but listen to your body and stop if needed.
• Exercise at least three days a week to benefit.
• You should be able to talk while exercising and not be so sore afterward that you can't work out in your next session. Start slowly, and build the level of intensity.
• Wait at least one hour after a meal to exercise and avoid exercising less than an hour before bedtime. Avoid being outside for workouts when it's hot.
• Stop your workout if you're short of breath, have chest pain or an irregular heartbeat, feel sick to your stomach, or are light-headed or dizzy.

Ask your healthcare provider when it's safe to start exercising again if any of the following occur:

• You've changed your dialysis schedule.
• Your physical health has changed.
• You have bone or joint problems.
  

Over-the-Counter (OTC) Therapies

There are no over-the-counter medications to treat kidney failure.

That being said, certain OTC medications do have the potential to do further harm to the kidneys in people with kidney disease, especially if taken when dehydrated or with low blood pressure.

Nonsteroidal anti-inflammatory drugs (NSAIDs), in fact, may lead to kidney injury when taken under these conditions. NSAIDs include medications like Advil or Motrin (ibuprofen) and Aleve (naproxen). Brand names can vary, so always check with your healthcare provider before taking them.

Antacids can interfere with electrolyte balances, so ask your healthcare provider before using them, as well.

If you need cold medication or pain relievers for other health-related issues, talk with your healthcare provider about which medications are safe to take, as this is not an extensive list. Depending on any underlying health conditions you have, your provider may recommend avoiding additional OTC medications.

Prescriptions

Prescription medications may be needed in kidney failure. They can help address complications caused by failing kidneys. Medications may include:

• Erythropoiesis-stimulating agents (ESAs): These help to prevent and treat anemia (lack of healthy red blood cells to carry oxygen throughout the body), which occurs because the kidneys don’t make enough erythropoietin (EPO, a protein) for red blood cells.
• Phosphate binders: The kidneys can’t remove excess phosphorus, which can weaken the bones. These drugs help reduce the amount of phosphate your body absorbs.
• Calcium and vitamin D: Levels of calcium and vitamin D may be abnormal because the kidneys can’t keep the correct balance in the body.
• Blood pressure medication: High blood pressure can occur when the kidneys fail, furthering the kidney damage.
• Potassium binders: When the kidneys don’t work properly, they don’t remove enough potassium from the blood, which can cause problems with the heart and muscles. These drugs attach to excess potassium and help your body excrete it.
• Iron supplements: These help prevent anemia, a common complication of kidney failure.
  

Surgeries and Specialist-Driven Procedures

The surgery and specialist-driven procedures for kidney failure include:

• Kidney transplant
• Hemodialysis
• Peritoneal dialysis

Kidney Transplant

A kidney transplant is a surgical procedure in which a healthy donor kidney is placed in your body. The donor's kidney takes over the duty of filtering waste from the failing kidneys. This is the definitive cure for end stage renal disease.

However, sometimes the transplanted kidney may be rejected by your body and you may again need to go back on dialysis. To prevent this possibility from happening, you'll have to take medications for as long as the donor's kidney works to lower the chances of your body rejecting it. These medications may cause other health issues, though.

That being said, a kidney transplant can help you live a longer and healthier life.

Hemodialysis

In hemodialysis, a machine is used to filter your blood outside your body. The filtered blood is then returned to your body. This process removes waste and extra fluid, helps control blood pressure, and can help restore the balance of minerals like potassium and sodium to your body.

Along with diet, medicine, and fluid restrictions, this procedure can help you feel a lot better. A hemodialysis procedure is done at a dialysis center or, less frequently, at home.

Peritoneal Dialysis

In peritoneal dialysis, which is done at home, the lining (peritoneum) of the abdomen is used to filter out waste and excess fluid.

In surgery, a catheter is permanently placed in the abdomen (belly). For the dialysis process, a dialysis solution is emptied through the catheter into the abdomen. After it's empty, you disconnect the catheter. The solution then soaks up all the waste and excess fluid. After several hours, the dialysis solution is drained through another tube into a bag. Then the process is started again with a fresh solution.

The two different kinds of peritoneal dialysis are:

• Continuous ambulatory peritoneal dialysis (CAPD): One exchange takes 30-40 minutes, several times a day, and you sleep with the solution in your belly at night.
• Automated peritoneal dialysis: A machine called a cycler does three to five exchanges at night. You also may need to do one exchange during the day without the machine.

Your healthcare provider will go over the differences with you and help you determine which kind is most appropriate for your lifestyle and disease.

Complementary and Alternative Medicine (CAM)

Complementary medicine is used along with conventional medicine, while alternative medicine is used instead of conventional medicine.

While many of the following therapies are forms of complementary or alternative treatments, the difference is in how they're used—either instead of traditional medical treatments or with traditional medical treatments. CAM therapies include:

• Acupuncture
• Relaxation techniques
• Meditation
• Yoga
• Massage therapy
• Reiki
• Dietary supplements

Although many supplements or herbs are natural, they can still interfere with medication and have adverse effects on your kidneys. It’s important to check with your healthcare provider about any complementary or alternative therapies you're interested in before trying them.

Summary

Treatment options for kidney failure include lifestyle changes like diet and exercise, prescription medication, dialysis, CAM therapies, and kidney transplant.

These treatments can rid your body of waste; maintain a healthy balance of salts, minerals, protein, and electrolytes; and ease the load on your kidneys so they don't have to work harder.

A Word From Verywell

Kidney failure can be overwhelming. Fortunately, treatments often prove beneficial. Still, what works best for one person may not be right for another. Work with your healthcare provider to create a treatment plan that will ensure better health for you.