This is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood. Kidney failure is divided into two general categories, acute and chronic.  

Acute kidney failure (acute kidney injury) occurs suddenly and may be the result of injury, infections, loss of large amounts of blood/fluids, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged.

Chronic renal failure means kidney function has slowly worsened over a number of years and the kidneys do not get better but stay the same or slowly get worse. When chronic renal failure has progressed to end stage kidney disease (ESKD), it is considered irreversible and unable to be cured.

End Stage Kidney Disease (ESKD)

End stage kidney disease (ESKD) has many causes but no cure. When almost all kidney function is lost, dialysis or kidney transplantation (in those appropriate for these) must be used to maintain life.  Specialist input from a skilled physician (renal/kidney physician, also called nephrologist) is necessary. 

Regular blood tests and urine tests are necessary to see how fast your kidney problem is progressing. The kidney physician will look at many issues, like your fluid balance, the concentration of waste products in your body and the influence of renal disease on many of your body's functions such as blood pressure, bones and red blood cell production.

Together with the physician you will discuss when the moment has come to seriously think about one of the options, as mentioned below. He/she will then refer you to a pre-dialysis nurse specialist. This is a nurse with special skills who will discuss with you the options that there are in dialysis, looking at your specific situation. Additionally, it may be appropriate to consider kidney transplantation.

You can discuss the pros and cons of the type of treatment with your healthcare team and choose the best type for you and your medical condition.  Dialysis treatment may change over time e.g. you may start on peritoneal dialysis (PD) and then switch to haemodialysis (HD) in the unit or at home.