Hi,
Not all patients with chronic kidney disease eventually need to undergo dialysis.
Chronic kidney disease encompasses different disorders of the kidney. To mention some: diabetes, high blood pressure, different types of inflammation of the kidneys, allergies, urine flow problems, rare diseases, etc. Many of them can progress to kidney failure with consequent need for dialysis, but others not, especially if we detect them early and we treat them promptly.
Thus, the first step is to identify what is the cause of your chronic kidney disease, so your doctor can suggest further diagnostic and treatment plans, and can advise you more accurately on its prognosis, including your chances of developing kidney failure.
In general, we advise patients to modify any risk factor (i.e. lifestyle habit) involved in disease progression, for example, avoid smoking, getting better control of the underlying disease like diabetes, high blood pressure, etc. This works in some patients, in occasions to halt the progression, in others at least delays the occurrence of kidney failure for as long as possible.
For some diseases, especially the ones related to inflammation or allergy in the kidneys, patients need to undergo special treatments with powerful anti-inflammation drugs, which sometimes successfully can halt the disease, but sometimes the disease is too aggressive or severe damaged has been already caused to the kidneys, that the expectations of recovery and to avoid dialysis are low.
Also, the status of your kidney problem is important to know your chances to progress into kidney failure. For example, if the disease is detected early and is amenable to modification of habits and medications to protect the kidneys, the chances of disease progression could be low. But if detected late or your percentage of kidney function is already quite low, you will have higher chances as the time passes by.
There are other important factors to determine your chances to develop kidney failure, which vary patient to patient, so I recommend you to address your concerns with and be evaluated by a specialist kidney doctor.
I appreciate how significant this worry can be for you or your family, and for patients in your condition. So, I always do my best to prevent or retard kidney disease progression, and help my patients understanding this process and walk the path hand in hand with them. However, many times despite all the efforts, the kidneys still give up and go into failure.
For patients suffering total kidney failure, dialysis is one of the management options, but some patients can undergo kidney transplantation. I explain this further in a different question on this series.
Finally, for some patients who are very ill or extremely weak, frail and elderly, dialysis might be too taxing (dialysis it is a strong therapy) or even too risk, therefore, dialysis is not an option any longer and the focus of medical care is to continue with medications and to ensure the patient is as comfortable as possible, especially at the end of life.
Dr Francisco, wishing your kidneys hold for as long as possible and you do not need to encounter total kidney failure.
