End-Stage Renal Disease

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This article is for people whose kidneys fail to work. This condition is called end-stage renal disease (ESRD). Today, there are new and better treatments for ESRD that replace the work of healthy kidneys. By learning about your treatment choices, you can work with your doctor to pick the one that's best for you. No matter which type of treatment you choose, there will be some changes in your life. But with the help of your health care team, family, and friends, you may be able to lead a full, active life. This article describes the choices for treatment: hemodialysis, peritoneal dialysis, and kidney transplantation. It gives the pros and cons of each. It also discusses diet and paying for treatment. It gives tips for working with your doctor, nurses, and others who make up your health care team. It provides a list of groups that offer information and services to kidney patients. It also lists magazines, books, and brochures that you can read for more information about treatment. You and your doctor will work together to choose a treatment that's best for you. This article can help you make that choice. When Your Kidneys Fail Healthy kidneys clean the blood by filtering out extra water and wastes. They also make hormones that keep your bones strong and blood healthy. When both of your kidneys fail, your body holds fluid. Your blood pressure rises. Harmful wastes build up in your body. Your body doesn't make enough red blood cells. When this happens, you need treatment to replace the work of your failed kidneys. Treatment Choice: Hemodialysis Purpose Hemodialysis is a procedure that cleans and filters your blood. It rids your body of harmful wastes and extra salt and fluids. It also controls blood pressure and helps your body keep the proper balance of chemicals such as potassium, sodium, and chloride. How it Works Hemodialysis uses a dialyzer, or special filter, to clean your blood. The dialyzer connects to a machine. During treatment, your blood travels through tubes into the dialyzer. The dialyzer filters out wastes and extra fluids. Then the newly cleaned blood flows through another set of tubes and back into your body. Getting Ready Before your first treatment, an access to your bloodstream must be made. The access provides a way for blood to be carried from your body to the dialysis machine and then back into your body. The access can be internal (inside the body -- usually under your skin) or external (outside the body).

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