End-Stage Renal Disease

Introduction
What is kidney failure?
How do you get kidney failure?
How can my doctor tell if I have kidney failure?
Will my kidney failure get better?
Dialysis
Kidney Transplantation

End Stage Renal Disease affects over 80,000 Americans each year. While there is no known cure, kidney transplants are the most effective way to combat the disease while bettering the quality of life for the patient.

Healthy kidneys clean your blood by removing excess fluid, minerals and wastes. They also make hormones that keep your bones strong and your blood healthy. But if the kidneys are damaged, they don't work properly. Harmful wastes can build up in your body. Your blood pressure may rise. Your body may retain excess fluid and not make enough red blood cells. This is called kidney failure.

If your kidneys fail, you need treatment to replace the work they normally do. The treatment options are dialysis or a kidney transplant. Each treatment has benefits and drawbacks. No matter which treatment you choose, you'll need to make some changes in your life, including how you eat and plan your activities. But with the help of healthcare providers, family and friends, most people with kidney failure can lead full and active lives.

The kidneys are a pair of organs located just behind the stomach. They filter bacteria and extra salt and water from the body. The kidneys stop working when illness or injury keeps them from filtering properly. In kidney failure, these bacteria and salts build up and can have bad effects on the heart, brain, lungs, and other organs. This may even cause serious illness or death.

Kidney failure can happen quickly (days) or more slowly (months or years). Many illnesses can cause kidneys to fail, including diabetes and high blood pressure. Most people with chronic kidney failure need to take medicines, and many need dialysis.

Some people with kidney failure are very sick and need to be in the hospital. About 10 percent of the time, it is because of a severe allergic reaction to medicines. This is called interstitial nephritis (say: in-ter-STI-shul nef-RYE-tus).

Your doctor will check your symptoms and medical history. Blood and urine tests are also helpful. If these tests aren't definite, your doctor may need to do an ultrasound or take a biopsy of the kidney. A biopsy is where a tiny piece of the kidney is removed and examined under a microscope.

Most people with interstitial nephritis get better. Their kidneys start working normally after a few weeks. Some people may need a year to get better. Your previous health, the severity of your illness, and the results of a kidney biopsy (if you have one) will help your doctor predict how long it will take for you to get better.

• Stopping the medicines that cause the illness or that might hurt your kidneys.
• Treating infections and other problems such as diabetes and high blood pressure.
• Other treatments such as steroids.
• Kidney dialysis, where a machine takes up the work of the kidneys.

• DO NOT use any prescription medicines, over-the-counter medicines, herbal or nutrition supplements without talking to your doctor.
• Take your medicines for diabetes and high blood pressure regularly, and follow your doctor's instructions.
• Let your doctor know about any reactions or allergies to medicines.

When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

There are two main types of dialysis: hemodialysis and peritoneal dialysis. Both types filter your blood to rid your body of harmful wastes, extra salt and water. Hemodialysis does that with a machine. Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood. Each type has both risks and benefits. They also require that you follow a special diet. Your doctor can help you decide the best type of dialysis for you.

A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work of the two kidneys that failed, and you no longer need dialysis.

During a transplant, the surgeon places the new kidney in your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Often, the new kidney will start making urine as soon as your blood starts flowing through it. But sometimes it takes a few weeks to start working.

Many transplanted kidneys come from donors who have died. Some come from a living family member. The wait for a new kidney can be long. People who have transplants must take drugs to keep their body from rejecting the new kidney for the rest of their lives.