Advanced and irreversible kidney failure means that the kidneys can no longer perform its functions well enough. This can result in many symptoms that include fatigue, decrease appetite, metallic taste, nausea, vomiting, weight gain and swelling from excess fluid retention, breathing difficulty, itching, sleep disturbances and in late stages changes in level of consciousness. When this occurs, the patient shall need renal replacement therapy.
Renal replacement therapy or dialysis is a life sustaining treatment that is offered when the kidneys are too damaged to continue to work properly. Dialysis options include hemodialysis, home hemodialysis, nocturnal hemodialysis, and peritoneal dialysis. The decision of what type of dialysis to pursue is a personal decision that is undertaken with the support and guidance of your nephrologist. Many factors are taken into consideration, including your preferences, level of independence, social supports, and overall health status. Hemodialysis does not prevent or reverse kidney failure. It can replace some of the functions of healthy kidneys, but not all. Read on the next section on dialysis for further details.
People often don’t understand the correct timing of dialysis and only after a sudden occurrence of hypokalemia or similar experience, go for unplanned dialysis. Unplanned dialysis may lead to infection. Therefore it is better to coordinate with one’s nephrologist and go for planned dialysis and get an AV Fistula procedure performed for future dialysis requirement, if need be. Some patients don’t even need to undergo dialysis if they undergo a successful kidney transplant but having a AV fistula helps.
In case of kidney failure, kidney transplant may be resorted to by the nephrologist subject to availability of matching medical parameters of the donee and donor of kidney.