Diagnosis: „Renal failure“
Hearing the phrase ‘you have renal failure’, can be a frightening moment. These feelings are usual. Lots of questions will come to mind – the most important of all: 'What will happen to me?' Eventhough the news is life changing, there is also real cause for optimism thanks to modern medicine. It is important to understand that it will take time, but you will get back to enjoying your life. This page offers answers for patients who have just been diagnosed with renal failure. Your doctor will provide support and advice with regard to the selection of the most appropriate treatment and medication in your present situation. Do not hesitate to ask, if you have any questions.
What is “renal failure” and why does it happen?
The kidneys are vital organs. They are responsible for the removal of waste products from the body, the regulation of body fluids and the production of some hormones. When kidneys can no longer perform these functions at sufficient capacity, the result is kidney disease, also called renal failure. Usually, renal failure occurs as the result of a gradual decrease in the efficiency of the kidneys over a long period (chronic renal failure). Many conditions can lead to chronic renal failure; the most frequent include diabetes, chronic kidney inflammation, high blood pressure and vascular damage. In some cases it is the consequence of sudden kidney failure (i.e. acute renal failure).
There are three main types of treatment
Modern medicine can compensate the effects of renal failure, allowing people to live an active life despite the failure of a vital organ. However, until now there is no possibility to cure renal failure. Become an active and well-informed patient by learning as much as possible about all the treatment options. Consider your habits and lifestyle when choosing your optimal treatment option. Please do not hesitate to consult your doctor or healthcare team on these issues.
Treatment options
Frequently asked questions: dialysis
Why do I need dialysis?
You need dialysis because you have suffered renal failure. Your kidneys have stopped – or almost stopped working. The kidneys are the body’s filter system for getting rid of toxins and chemicals that the body does not need and that might harm you. Renal failure, if left untreated, is fatal, but modern medicine has provided us with life-saving treatments, including hemodialysis.
How long has dialysis been available?
Hemodialysis and peritoneal dialysis have been done since the mid-1940s. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. Continuous ambulatory peritoneal dialysis (CAPD) began in 1976. Thousands of patients have been helped by these treatments. Dialysis is now a safe procedure, with thousands of patients receiving treatment around the world.
Will dialysis help cure the renal failure?
No. Dialysis treatment only replaces several kidney functions.That’s why it is commonly called renal replacement therapy. However, there are currently a lot of different treatments for kidney failure and more and more treatments are under investigation. In general, these treatments only help to slow down progressive kidney function loss and cannot completely stop this loss or reverse it. That’s why we need kidney replacement therapies like hemodialysis or kidney transplantation.
Is dialysis uncomfortable?
Renal failure is uncomfortable, life-threatening and accompanied by various severe symptoms. Dialysis therapy helps significantly to improve all of these disadvantages, but it cannot cure the renal failure. Frequent communication with your medical support staff in an open atmosphere will help you to get the most appropriate and convenient therapy.
Will dialysis keep me well?
We cannot promise that you will feel as well on dialysis as you did before renal failure, as there is no real substitute for your own healthy kidneys. But to keep you as well as possible your treatment will consist of three main elements: dialysis, diet and drugs. The hemodialysis diet is quite strict and can take some time getting used to. There will be limits on your intake of fluid, and you will need to be careful of foods high in sodium and potassium. But with imagination you can still cook tasty meals. You can find more information on this website. Your care team will also explain your diet to you in detail. There are a number of drugs which you need to take to help prevent some of the complications of dialysis. However, there will be times when you will feel tired and fed-up. This is the same as with any chronic condition. But with care and by following the advice you are given, you will be able to carry out most normal activities.
Medication
As a hemodialysis or peritoneal dialysis patient, you will have different medications prescribed for different purposes. You should always be aware of all medication you take, meaning that you should know their names, purposes and how they are administered. Whenever you have problems with your medications or any questions, do not hesitate to contact your doctor or nursing staff in your renal care center. Impaired renal function and hemodialysis can drastically alter the effects of medication. Consult your doctor before making any changes to your current medication.
The following medications are used most frequently:
Antihypertensives
Many patients suffer from high blood pressure (hypertension). Hypertension can harm you. Therefore, blood pressure has to be regulated with appropriate medication and carefully monitored especially during treatment.
Erythropoietin (EPO)
Erythropoietin, often referred to as EPO, is a hormone produced by the kidneys that stimulates the bone marrow to produce red blood cells. Since the production of erythropoietin in chronic kidney disease patients is reduced, the number of red blood cells is also reduced. This is the main aspect leading to a condition known as renal anemia. Synthetic erythropoietin can be given intravenously or through the skin as a substitute for natural erythropoietin in order to maintain an adequate number of red blood cells. It may also be given through the bloodlines of the dialysis machine during the dialysis treatment.
Iron
Iron is a vital building block of hemoglobin, the key protein found in normal red blood cells. Without iron, it is difficult for the body to create enough healthy red blood cells. This is why iron supplementation is mostly necessary in addition to EPO. Iron is usually supplied by an intravenous infusion at the renal care center.
Phosphate binders
Our kidneys normally excrete the phosphate that is absorbed with food. In chronic renal failure, this no longer happens. Therefore, phosphate levels in the body increase and, in combination with other substances, cause irritation to blood vessels, bone and sometimes the skin. A major side effect of increased phosphate levels can be arteriosclerosis, i.e. calcification of the blood vessels, which leads to heart disease. Dialysis helps in this regard, but it can only eliminate some of the excess phosphate. This means that phosphate levels in the body must be lowered further by means of a low phosphate intake and appropriate medications, known as phosphate binders. These medications ‘bind’ the phosphate in the gut so that it cannot be absorbed into the bloodstream.
Vitamin D
Vitamin D is activated in the kidneys and is needed for multiple functions in the body. For example, it is needed for healthy bones. People with kidney disease are often prescribed vitamin D in a pre-activated form as their kidneys cannot activate the vitamin D anymore.
