Kidney Failure Treatment

How is Kidney Failure Diagnosed?

Kidney failure is diagnosed by a nephrologist by conducting a few tests and procedures. Common tests to used to diagnose kidney failure are as follows:

• Serum creatinine

• Estimated glomerular filtration rate (eGFR)

• Blood urea nitrogen (BUN)

• Urinalysis

• Urine albumin-to-creatinine ratio

• Electrolyte and blood chemistry tests

• Kidney ultrasound or other imaging studies

• Kidney biopsy in selected cases

How is Kidney Failure Treated Based on Severity?

Treatment for kidney failure depends on kidney function, symptoms, complications, the underlying cause, overall health and whether kidney replacement therapy is required. Kidney failure generally refers to kidney function falling to a very low level, and treatment planning may begin before dialysis is required.

The table below explains the usual treatment approach for kidney failure according to the degree of kidney dysfunction and the need for kidney replacement therapy:

Treatment decisions should not be based on eGFR alone. Symptoms, biochemical abnormalities, complications, nutritional status, overall health and the patient's preferences also influence when kidney replacement therapy is considered. Dialysis does not cure kidney failure, but it can replace part of the filtering function of the kidneys and help manage waste and excess fluid.

Types of Kidney Failure and Their Treatment

Kidney failure may develop as part of acute kidney injury or long-term kidney disease. The treatment approach depends on whether kidney function is expected to recover and whether permanent kidney replacement therapy is required.

The table below explains how treatment may differ according to the type or clinical setting of kidney failure:

Acute kidney injury may improve when its underlying cause is successfully treated, whereas established chronic kidney failure generally requires long-term treatment. The healthcare team assesses the expected recovery of kidney function before deciding whether dialysis needs to continue.

Other Treatments for Kidney Failure

The main treatments for kidney failure are dialysis, kidney transplantation and conservative kidney management. Additional medical treatments may be used to manage complications such as fluid overload, anaemia, abnormal electrolyte levels and high blood pressure.

Other treatments recommended for kidney failure are as follows:

Oral Medications for Kidney Failure

Medicines used in kidney failure vary according to the underlying cause, remaining kidney function and complications. A doctor may prescribe:

• ACE inhibitors or angiotensin receptor blockers (ARBs), where appropriate

• Diuretics

• Phosphate binders

• Iron supplements

• Sodium bicarbonate

• Potassium-lowering medicines

• Vitamin D or vitamin D analogues

• Diabetes medicines, where appropriate

• Statins, where indicated

• Erythropoiesis-stimulating agents when prescribed for anaemia

Medication doses may need to be adjusted as kidney function changes because the kidneys are involved in clearing many medicines from the body. Patients should consult their doctor before starting, stopping or changing medicines, including over-the-counter products and supplements.

Ayurvedic and Alternative Treatments for Kidney Failure

Ayurvedic and alternative treatments do not cure or help in managing kidney failure. However, some supportive treatments may help in improving the overall health of the patient and support proven treatment.

For instance, yoga and meditation can help manage stress associated with managing the treatment of the disease. They can also help lower blood pressure.

Do not take any herbal products without consulting your doctor, as they may interfere with your medicines or treatment.

Home Care for the Treatment of Kidney Failure

Home care can support treatment adherence, symptom management and prevention of avoidable complications associated with kidney failure. However, it cannot replace dialysis, transplantation or prescribed medical treatment. Some of the home care measures to manage kidney failure are:

• Take prescribed medicines exactly as directed.

• Follow the recommended fluid intake.

• Follow the renal diet advised by a healthcare professional.

• Limit sodium intake as recommended.

• Monitor blood pressure regularly.

• Monitor blood glucose if advised by the doctor.

• Attend dialysis sessions as scheduled, if applicable.

• Monitor body weight for signs of fluid retention when advised.

• Avoid non-steroidal anti-inflammatory drugs (NSAIDs) unless specifically approved by a doctor.

• Avoid unapproved medicines, herbal products and supplements.

• Stay physically active according to medical advice and individual ability.

• Seek medical attention for worsening swelling, severe weakness, confusion or breathing difficulty.

• Attend scheduled appointments and blood tests.

How Long Does Treatment of Kidney Failure Take?

Treatment duration for kidney failure varies according to the underlying cause, response to treatment, remaining kidney function and treatment selected. Acute kidney injury may require treatment for days or weeks if kidney function recovers, whereas established kidney failure often requires long-term management.

The table below explains the approximate duration and frequency of the major treatment options used for kidney failure:

The duration of dialysis cannot be predicted for every patient. Some people may receive dialysis temporarily while recovering from acute kidney injury, whereas people with established kidney failure may require long-term dialysis unless they receive a successful kidney transplant.

Kidney Failure Treatment Side Effects

Side effects and treatment-related complications vary according to the therapy being used for kidney failure. Some of these side effects of kidney failure treatment may include:

• Haemodialysis: Low blood pressure, muscle cramps, headache or fatigue during or after treatment.

• Peritoneal Dialysis: Peritonitis or infection around the dialysis catheter.

• Kidney Transplantation: Bleeding, infection, surgical complications and other complications related to the transplant.

• Immunosuppressive Medicines: Increased susceptibility to infections and medicine-specific adverse effects.

• Medicines Used for Kidney-related Complications: Side effects vary according to the medicine and dose.

• Dialysis Access: Infection, bleeding or clotting may occur with some types of dialysis access.

Patients should report persistent or severe side effects to their doctor so that the cause can be assessed and treatment adjusted when necessary.

Lifestyle Changes for the Treatment of Kidney Failure

Lifestyle measures can support medical treatment for kidney failure and help manage fluid balance, blood pressure, blood glucose and other factors that affect overall health. Some common lifestyle changes recommended by doctors to manage kidney failure are as follows:

• Follow the renal diet recommended by a healthcare professional.

• Limit sodium intake as advised.

• Follow prescribed fluid restrictions.

• Restrict potassium or phosphorus only when advised by the doctor.

• Take medicines on schedule.

• Attend dialysis sessions consistently, if applicable.

• Stay physically active according to medical advice.

• Maintain blood pressure and blood glucose within the target range advised by the healthcare team.

• Avoid smoking.

• Avoid unapproved medicines, herbal products and supplements.

• Attend regular medical appointments and recommended blood tests.

Dietary restrictions are not identical for every person with kidney failure. The appropriate intake of fluids, protein, potassium, phosphorus and other nutrients depends on kidney function, blood test results and the treatment being received.

Triggers That Can Worsen Symptoms of Kidney Failure

Certain triggers may worsen fluid retention, electrolyte disturbances or other symptoms in people with kidney failure. These include:

• Excessive fluid intake when fluid restriction has been prescribed

• High-sodium foods

• Foods high in potassium when potassium restriction is advised

• Foods high in phosphorus when phosphorus restriction is advised

• Missing or delaying dialysis sessions

• Dehydration

• Uncontrolled high blood pressure

• Uncontrolled blood glucose

• NSAID use without medical advice

• Unapproved herbal medicines or supplements

• Smoking

• Excessive alcohol consumption

Not every trigger applies to every patient. Dietary restrictions and fluid requirements should be based on individual medical advice rather than general restrictions.

Treatment Cost of Kidney Failure in India

The cost of kidney failure treatment in India varies according to the treatment required, hospital, city, duration of care and the overall health of the patient. Haemodialysis may cost around ₹750 to ₹5,000 per session, although government-supported facilities may offer lower rates. Monthly dialysis expenses can vary substantially according to the number of sessions and the facility. Peritoneal dialysis may cost around ₹20,000 to ₹40,000 per month, while kidney transplantation can involve an initial cost of approximately ₹5 lakh to ₹15 lakh.

Does Health Insurance Cover Treatment of Kidney Failure in India?

Yes. Health insurance may cover the cost of hospitalisation, dialysis and kidney transplantation resulting from kidney failure. Outpatient expenses, medicines and tests may be covered only if the policy comes with an OPD cover. However, a waiting period may apply if the condition is pre-existing, i.e. diagnosed before buying the policy.

Kidney failure is also covered by critical illness insurance plans that pay a lump sum benefit on the diagnosis of the condition. However, a waiting period of up to 90 days may apply before raising a claim.

Patients should check their policy documents to know the policy's terms, coverage limits, waiting periods, exclusions, sub-limits and pre-existing disease conditions.