If I Have Kidney Disease, Will I Need Dialysis?
In the early stages of chronic kidney disease (CKD), you do not need dialysis. The stages of chronic kidney disease can last for many years. But if your kidneys fail, you will need dialysis or a kidney transplant to keep you alive.
When Should I Start Dialysis?
National Kidney Foundation guidelines recommend you start dialysis when your kidney function drops to 15 percent or less — or if you have severe symptoms caused by your kidney disease, such as shortness of breath, fatigue, muscle cramps, nausea or vomiting. Your doctor will help you decide when to start dialysis, based on your symptoms and the results of lab tests that measure how much kidney function you have left.
Insurance and other funding bodies or sponsors (e.g. Jabatan Perkhidmatan Awam, SOCSO, etc.) may cover treatment for kidney failure whenever your doctor determines it is needed. If you are not having symptoms, you may be able to wait to start dialysis. Since chronic kidney failure often happens slowly, sometimes people do not realize how bad they have been feeling until they start dialysis and begin to feel much better.
It is important to start getting ready for dialysis or a transplant well in advance — when your kidney disease reaches stage 4 or 5. Learning about the types of dialysis and transplant options will help you make the choice that is best for you. Any type of dialysis will require surgery to allow access for your treatments, and this should be done well in advance to allow time for healing before dialysis begins.
8 Ways to Prepare for Dialysis
Whether it is your first treatment or your fiftieth, it is always good to have a game plan for dialysis. Here are eight ways to help you prepare and to maintain your quality of life on dialysis.
- Be a good student
Stay in the know about your condition and learn from your kidney care team.
- Have conversations
Talk to loved ones and friends about your need for dialysis and how you are feeling. Getting support early and often can help you feel prepared for dialysis.
- Decisions, decisions … about dialysis
Discuss your treatment options with your nephrologist so you can work together to find just the right fit.
- Patients to the rescue
Reach out to people who can relate to what you are going through. Current dialysis patients can help you navigate the ins and outs of dialysis preparation.
- From point A to point B
Map out which centers and medical facilities are close to where you live or work, so you can plan comfortable and convenient transportation. Find a center near you.
- All-access pass to dialysis
To receive dialysis, you will need to undergo a procedure to place an access, which allows your blood to travel to and from the dialysis machine. Your nephrologist will discuss how to prepare for the access-placement surgery once you decide on a treatment. Ask your nephrologist for more information.
- Keep your job
Staying on the job when you need dialysis is vital to your well-being, both mentally and financially. Talk to your employer about how your job can be tailored to your needs once you begin treatment.
- Kidney-friendly eating
Pay attention to what you eat. Create a kidney-friendly diet and stick to it. You will be eating foods that are both delicious and kidney-friendly in no time.
Take Your Medicines, Take Control
People on dialysis often take quite a few medications, and the timing of when they are taken truly matters. For instance, you may be prescribed phosphate binders to take when you eat, and a renal vitamin to take at a different time. Follow this advice to make maintaining a daily medication routine easier:
- Listen and learn: Make a list of your medications, including over-the-counter vitamins and supplements, and talk to your doctor about why each one was prescribed, when they should be taken and the vital role they play in your kidney care.
- Stay organized: Try using a medication organizer and take each medication at the same time every day (unless your physician directs otherwise).
- Stick to it: If you experience side effects, speak with your physician before you stop taking any medications. Also, refill necessary prescriptions on time to avoid running out of medication.
Know Your Medicine Cabinet
Medications to avoid include over-the-counter painkiller pills such as ibuprofen, naproxen and some supplements that have been known to damage kidneys.
Dig into the Dialysis Diet
There are two things to know about the dialysis diet: first, it’s different from the food choices you may already be making, and second, you should try not to make a lot of changes at once. Some people on the dialysis diet start out focusing on what they “can’t” eat. While there are certainly foods and beverages to avoid, remember that following dialysis nutrition guidelines is a way to take control of your health and have a better quality of life. Think of the dialysis diet as an opportunity to try new things. Planning meals and sharing them with your family can be fun and enjoyable.
Prepare Yourself and Your Healthcare Team
One of the most important things you can do to ease your transition to dialysis is to keep everyone on your healthcare team informed. Your primary care doctor, diabetes doctor, cardiologist—all of them need to know when you start dialysis, as it may affect your labs, your health goals, and the medications they prescribe.
When it comes to treating kidney failure with dialysis, you have certain options. From dialyzing at home to getting treated at a center, discover which one could better suit your lifestyle.
Peritoneal dialysis (PD)
PD is a needle-free treatment done at home that uses the lining of the abdomen (or belly) to filter waste from the blood. It is the treatment most likely your natural kidney function. Some of the potential benefits of PD include:
- Control of your own treatment and a more flexible schedule
- Greater ability to pursue personal interests
- Preservation of remaining kidney function, leading to enhanced clinical outcomes
- Better transplant outcomes
In-center haemodialysis requires you to visit a dialysis center three times per week. It uses a machine to filter your blood and clear toxins from your kidneys. In-center haemodialysis offers several potential benefits, which include:
- The chance to socialize with other patients and staff
- A personalized care team
- No supplies to store at home