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Treatment Choices for Kidney Failure

When your kidneys fail (Stage 5 CKD), they cannot remove enough extra water and wastes from your blood to keep you healthy. You will need treatment to take over the work that your kidneys can no longer do.

There are several different kinds of treatment for kidney failure, and most people are able to choose a treatment that fits their lifestyle. Your choice will depend on your individual situation. Talk with your nephrologist about which treatment options will work for you.

Planning ahead can give you more choices over time.

Your choices may include:

  • Kidney transplant – A transplant replaces your failed kidneys with one healthy one from a donor. It can take time to find a kidney that is a good match for your blood and tissue type. Talk to your nephrologist about how to start the transplant process.

    To learn more about transplants, visit:

  • Hemodialysis (HD)– In HD your blood is cleaned by a filter. To do HD, you need a special blood vessel (called a vascular access). A surgeon can make one by connecting a vein to an artery in your arm (a fistula). Or, you can use an artificial access called a graft. During dialysis, two needles are placed into the blood vessel. Tubing connects to the needles and takes your blood to the filter and back to you. Only about ½ cup of blood is outside your body at any time.
    • Nocturnal HD is done while you sleep at night. You can do it at home (3-6 nights/week) or in a dialysis center (3 nights/week). Each treatment lasts for about 8 hours. To do nocturnal HD at home, you will need training. Training takes a few weeks. Many programs require a care partner to be trained, too, and be on hand during home treatments.
    • Short daily HD is done 5-7 days/week for 2-3 hours at a time in your own home. Your dialysis center will provide you with a small home dialysis machine (about the size of a microwave), and they will train you to set it up and do your own treatments. You can choose what time of day to do the treatments. Training takes 2-3 weeks. Many programs require a care partner to be trained, too, and be on hand for the treatments.
    • In-center HD is done at a dialysis center three times a week (Monday, Wednesday, Friday, or Tuesday, Thursday, Saturday). Each treatment lasts 3-4 hours, and you will usually have the same time slot for all your treatments. Staff at the center will set up and run the dialysis equipment.. If you want to travel, you will need to plan a few months ahead to get a treatment time in a center in the town you are visiting.

    To learn more about hemodialysis, visit:

  • Peritoneal Dialysis (PD) – PD cleans your blood inside your body. It uses the lining of your abdomen (the peritoneum) as a filter. To do PD, a plastic tube is placed by a surgeon through the wall of your belly or chest and into your abdomen. Once it heals, you use the tube (called a catheter) to fill your belly with sterile fluid. Wastes and water from your blood flow into the fluid. Then you drain out the used fluid and put fresh fluid in. This is called an exchange. Learning how to do PD exchanges takes 1-2 weeks You must follow the steps closely to prevent infection. There are two ways to do PD:
    • By hand – Most people who choose PD, first learn to do their exchanges by hand. This is called continuous (all the time) ambulatory (walking around) PD, or CAPD, because the fluid in your abdomen is working all day long, while you do your daily activities. Most CAPD patients do four exchanges a day: breakfast, lunch, dinner, and bedtime. Each exchange takes about 30 minutes.
    • By cycler machine – With this method, a small machine called a cycler is used to do a series of exchanges while you sleep at night. This is called continuous cycling PD (CCPD) or automated PD (APD). Some people may need to do a mid-day exchange to get enough dialysis. You do not need to buy the cycler if you choose CCPD. The center provides it and trains you.

      To learn more about peritoneal dialysis, visit:

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*The Kidney TRUST does not give medical advice, diagnose medical conditions, or recommend treatment. Results and information are for educational purposes only. They are not a substitute for professional medical advice. Please check with a doctor if you need a diagnosis or information about your health.