The main treatment options for kidney failure are dialysis and kidney transplant. Medications can help manage symptoms and complications. Each treatment type has pros and cons.

If you have chronic kidney disease (CKD), your kidneys can’t filter your blood as well as healthy kidneys. The Centers for Disease Control and Prevention (CDC) estimates that 37 million people in the United States (about 15% of the U.S. population) have CKD.

Kidney failure is the last stage of CKD and happens when your kidney function has dropped to less than 15% of the typical level. You may also see it called end stage renal disease.

Keep reading to learn about your options for treating kidney failure.

Hemodialysis is a process in which a machine helps filter waste and excess fluids from your blood. This treatment can also help manage your blood pressure and mineral levels.

Before starting hemodialysis, you’ll have a minor surgery to make an opening, or access point, in a blood vessel, typically in your arm. This allows for easy removal and return of blood to your body during dialysis.

During dialysis, the machine removes blood from your body and passes it through a filter called a dialyzer. The machine then returns the newly filtered blood to your body.

You’ll typically have hemodialysis three times per week, with each session lasting about 4 hours. You may choose to have dialysis either at a dialysis center or at home.

You might not be able to have hemodialysis if there’s no easy access to your bloodstream or if you have unstable blood pressure.

Side effects and risks of hemodialysis can include:

Peritoneal dialysis filters blood inside your body rather than through a machine. It uses the tissue that lines your abdominal cavity, called the peritoneum, as the filter. This type of dialysis takes place in your home.

You’ll first have a minor surgery in which healthcare professionals place a soft tube called a catheter in your abdomen. During treatment, this tube slowly fills your abdomen with a dialysis solution made mostly of water and salt.

This solution helps pull waste and excess fluids out of your blood as it flows through the area. After a few hours, the fluid drains out of your body through the catheter.

If you have a condition that affects the structure of your abdominal cavity, such as a fistula, an adhesion, or a hernia, you will not be able to receive peritoneal dialysis. Doctors also may not recommend it for you if you have severe obesity or inflammatory bowel disease.

Side effects and risks of peritoneal dialysis can include:

During a kidney transplant, a surgical team implants a healthy kidney from a donor into your body. You can live with one kidney, and this new kidney takes over filtering your blood.

A kidney transplant is a major surgery and can be hard on your body. Plus, you’ll need to continue to take immunosuppressant drugs after your surgery to lower the risk of your immune system rejecting your new kidney.

For these reasons, if you’re older or have any serious health conditions, you may not be eligible to have a kidney transplant. Additionally, a doctor may not recommend a kidney transplant if you have:

If you’re eligible for a kidney transplant, you’ll likely be placed on a waiting list. Waiting times of 4–5 years are common. While you wait for your transplant, you’ll undergo dialysis to treat your kidney failure.

The possible side effects and risks of a kidney transplant include:

  • bleeding
  • blood clots
  • infections
  • urine leakage into your abdomen
  • cardiovascular disease
  • blockage of your ureter, the tube that takes urine from your new kidney to your bladder
  • side effects from taking immunosuppressant drugs
  • cancers such as melanoma and Kaposi sarcoma
  • rejection of the transplanted kidney

There are no medications that can treat kidney failure directly. However, a variety of medications may help manage the symptoms and complications associated with kidney failure.

Medications doctors may recommend include:

Some people with kidney failure may choose to manage their condition with only medications and diet. This is called conservative management.

How can I prevent kidney failure?

If you have CKD, you can reduce the risk that it will progress to kidney failure by:

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Can kidney damage be repaired?

No. Once your kidneys have been damaged, this damage cannot be repaired.

Can you treat kidney failure without dialysis?

To avoid being on dialysis permanently, you’ll need a kidney transplant. However, due to the potentially long wait time, you’ll likely need to have dialysis until your transplant.

Conservative management is also an option, but it doesn’t treat kidney failure so much as it eases symptoms, prevents complications, and improves quality of life.

How long can a person live with kidney failure?

How long you can live with kidney failure depends on factors such as your age, overall health, and treatment plan.

People who receive dialysis have an average life expectancy of 5–10 years, according to the National Kidney Foundation. A 2021 study found that people who had a kidney transplant had a median survival time of 14.6 years.

Life expectancy with conservative management varies greatly. The authors of a 2022 research review observed median survival times of 1–41 months.

Kidney failure happens when your kidneys can no longer filter waste and excess fluid. It’s the last stage of CKD.

Dialysis and kidney transplant are the main treatment types for kidney failure. Some people may opt for conservative management, which involves only medications and diet changes.

Each treatment for kidney failure has its benefits and risks. Be sure to discuss these with your care team when deciding on a treatment for kidney failure.