Hi,
Progressive and severe injury to the kidneys can cause permanent and irreparable damage to the kidneys, leading to total kidney failure. If total kidney failure is confirmed by your doctor, dialysis will be needed for life. Alternatively, a kidney transplant is another option in these circumstances. And dialysis will be for life because, unfortunately, permanent and severe damage cannot be repaired and the kidney function will not recover.
We use different methods to assess the degree of kidney dysfunction and to confirm if the kidney function is low. When an ultrasound shows small (that is scarred) kidneys and when the kidney function progressively decline through prolonged time until the level of total failure, dialysis will be needed for life. Although kidney biopsy is in theory the best method to check the status of the kidney, in this situation it does not help further and can be of higher risk for the patient.
Only when the doctor has the suspicion that the damage is not permanent, a kidney biopsy could be helpful. However, there are so many factors to consider, that only by seeing a nephrologist and undergoing thorough assessment, proper advice can be given regarding your concern as it is a very significant event for a patient who suffers kidney disease.
Finally, there are cases of temporary kidney failure, what doctors call acute kidney failure, where the patient can need dialysis for a variable period of time and later showing recovery and the dialysis can be stopped. However, these patients need to continue on follow up as they have higher risk of developing progressive kidney disease than normal people.
Please check with your doctor if you are suitable for other options such as kidney transplantation.
Dr Francisco, wishing you the best possible health.
