When Is A Kidney Replacement Therapy Needed? Nephrologist Shares Everything In Detail

Kidney replacement therapy is essential to restore kidney functions and prevent further organ damage.  Read this article to know more.

Written by: Chanchal Sengar Updated at: 2023-01-19 12:24

Kidneys play a vital part of your health. They clean blood by filtering wastes from your blood and removing out of your body by urine. Their function is important in maintaining your health and well-being, also protecting your heart and other organs. Kidney disease attack the filtering units of your both kidneys and impact their ability to eliminate wastes and excess fluids. A kidney replacement therapy replaces normonal functions of a kidney to aid patients but do everyone with a renal disease require this therapy? We reached out to Dr. Arun Kumar Ponna, Consultant Nephrologist, Yashoda Hospitals, Hyderabad to understand requirements for a renal replacement.

What Are The Types Of Kidney Injury?

Acute kidney injury: This is reversible kidney failure that occurs rapidly over few days. This may be a result of low blood pressure, infection, diseases that specifically fight the kidney filters. Acute kidney injury would generally improve by treating the cause. Sometimes, dialysis treatment may be required for a period, but kidney function often recovers.

Chronic kidney disease (CKD): This is the damage to kidneys or a decreased in kidney function that cannot be repaired, possibly progressive and long lasting. The damage can range from mild to severe, and sometimes this can progress to kidney failure. Most common factors contributing to CKD are Diabetes, hypertension, family history of kidney disease, and autoimmune (fighting against our own kidneys). There are three phases of kidney disease: early (30-60%), advanced (< 30%) and end-stage renal disease, which is the progression to kidney failure which means your kidneys no longer filter the waste in your blood. 

Also Read: Kidney Cancer In Children: Types, Causes, Symptoms and Treatment

How Do We Detect Kidney Disease?

You usually have no symptoms in early stages. There are two simple tests to assess the functioning of kidneys and indicate kidney damage. Serum creatinine (a waste product that our kidneys must filter out) is measured in the blood, which allows to calculate eGFR (Glomerular filtration rate) to estimate kidney function and a urine test to detect protein in your urine. This is time for you to visit a kidney doctor (Nephrologist). Fortunately, if diagnosed early, we can take steps to preserve their remaining kidney function or to slow down the progression to kidney failure

How You Deal When Your Disease Advances?

When your kidneys work at less than 30% of normal function, you need to have a close follow up with a nephrologist. Treatment may include diet changes, good blood pressure and diabetes control, and medications. 

When your kidney function is below 15-20% of normal, it is the time when your kidney doctor discusses treatment options for kidney failure with you. There is no one size those fits all, and the doctor will help you to make the right choice for your health, lifestyle, and personal circumstances.

Also Read: How To Take Care Of Your Kidney Post Transplant

What Is Kidney Replacement Therapy?

When your kidneys completely stop functioning, buildup of waste products and excess fluids in body will make feel tired and less energetic. At this point you would need treatment options to take over the job of cleaning your blood. At this point you will need to begin dialysis or have a kidney transplant. 

In India, Incidence of CKD is around 10% of total population, and 1-2% of them would progress to ESRD. The number of people requiring dialysis or kidney transplant have doubled over last few years.

What is Dialysis?

  • Hemodialysis is where a machine filters your blood by sending your blood to a dialysis machine, usually three times a week. 
  • Peritoneal dialysis is where a fluid is put in your belly to clean your body and then removed several times a day or overnight.
Also Read:  Why Regular Screenings Are A Must For Patients Undergoing Dialysis

Kidney Transplant

A kidney transplant is a surgery where a surgeon puts in a donated kidney. This is considered best treatment for most people. A transplanted kidney can do 60% to 80% of what a normal kidney does, while dialysis can do only some things of what a normal kidney does. Compared to dialysis patients, people who have had transplants usually have more energy and most people would be able to return to work, eat more comfortably, and exercise.

What If You Chose Not To Go For The Treatment?

It’s important to go for kidney replacement therapy and without that, toxic waste and fluids build up in the body, that make you more tired, may make it more difficult to breathe, eventually would lead to a coma state and death. 

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