Educational Guide

Failing kidneys and treatment options

When kidneys begin to fail, understanding your choices can make the next conversation feel less overwhelming. Our nephrology team explains each path in plain language so you can plan with your family, your goals, and your medical situation in mind.

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Watch an educational presentation

This video introduces the main choices people may discuss with a nephrology team when kidney function becomes very low.

Educational Presentation

Failing Kidneys and Different Treatment Options

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The Core Pathways

Common paths for kidney failure planning

Every person’s medical situation, lifestyle, and goals are different. These are common pathways your nephrology team may discuss as kidney function becomes very low.

Transplant Pathway

Kidney Transplantation

A surgical procedure where a healthy kidney from a living or deceased donor is placed in your body. For some people, transplant can offer more independence and longer-term stability than dialysis.

  • Pre-emptive transplant: Evaluation can begin before you ever need to start dialysis.
  • Living donor options: A kidney can come from a compatible family member, friend, or paired exchange.
  • Immunosuppressants: Requires taking daily medications to protect and preserve the donor kidney.
  • Comprehensive evaluation: Includes physical, psychological, and financial readiness checks.
About Transplant Planning
Flexibility & Freedom

Home Dialysis Options

Dialysis performed in your own home. Home therapies may offer more flexible scheduling and can feel less disruptive for people who are medically suited for them.

  • Peritoneal Dialysis (PD): Uses the lining of your abdomen to clean your blood; typically done daily while sleeping.
  • Home Hemodialysis (HHD): Uses a smaller, user-friendly machine to clean your blood at home, usually 4-5 times a week.
Explore Home Therapies
Structured Care

In-Center Hemodialysis

Hemodialysis treatments performed in a clinical center by trained nurse and technician teams, typically three times a week for about 4 hours per session.

  • No medical equipment, supplies, or medical training required at home.
  • Direct, continuous observation by clinical staff during every treatment session.
  • Regular, fixed treatment schedules (e.g., Mon/Wed/Fri or Tue/Thu/Sat).
Understand In-Center Dialysis
Focus on Comfort

Conservative & Supportive Care

A medical pathway focused on managing symptoms, maintaining comfort, and aligning care with personal goals when dialysis or transplant may not be the right fit.

  • Shaped around your personal goals, comfort, and quality of life.
  • Active medication management to control swelling, anemia, and waste buildup.
  • Avoids the physical strain, travel, and schedule demands of dialysis treatments.
Read About Supportive Care

In-Depth Education

Understanding the Steps of Care

Preparing for kidney failure involves several key milestones. Explore these detailed sections to learn how we partner with you on each step.

The foundation of a safe transition

Early planning with nephrology

The most important step in managing failing kidneys is early planning. Meeting with a nephrologist when your eGFR is still above 15-20 allows you to learn about your choices, prepare your body, and make decisions without the pressure of an emergency.

Pre-emptive transplant evaluation: You can be listed for a transplant before ever starting dialysis.

Vascular access preparation: Creating a fistula or graft months ahead ensures it is healed and ready if hemodialysis is chosen.

Home therapy training: Learning peritoneal dialysis or home hemodialysis techniques early builds confidence.

Guide 1

More flexibility when clinically appropriate

Considering home dialysis

When it is clinically appropriate, we encourage patients to learn about home dialysis options. Home therapies can offer more flexibility and may feel less disruptive for people who are medically suited for them.

Different treatment rhythm: Home therapies are often done more frequently, which may reduce some large fluid shifts.

Greater independence: You control your schedule, travel easier, and can often continue working or enjoying hobbies.

Steadier fluid removal: Your care team can explain how treatment schedule and fluid goals affect symptoms and energy.

Guide 2

Evaluation, referral, and long-term follow-up

Navigating the transplant journey

A kidney transplant is often the most effective treatment for kidney failure. Our team guides you through every step of the transplant process, from referral to post-surgical care.

Referral and evaluation: We connect you with regional transplant centers and help coordinate the extensive medical workup.

Living donation coaching: We help you and your family learn how to share your story to find living kidney donors.

Long-term management: Once you receive your kidney, we manage your anti-rejection medications and monitor your kidney function.

Guide 3

Structured support in a dialysis center

Understanding in-center hemodialysis

In-center hemodialysis may be the right fit when a person needs a consistent treatment schedule and clinical staff present during each treatment. Your nephrology team can explain access planning, transportation, schedule expectations, and how dialysis center care fits into the rest of your medical plan.

Predictable schedule: Most people attend treatment on a recurring weekly schedule set by the dialysis center.

Clinical support: Nurses and technicians are present during treatment and can help monitor symptoms or access concerns.

Planning still matters: Preparing access and transportation early can make the transition less stressful.

Guide 4

Your goals, your care pathway

Conservative care and shared decision making

Dialysis is not the right choice for every person. For some patients, particularly those with other serious medical conditions, a medical management plan focused on comfort and quality of life may be the most appropriate choice.

Active symptom control: We prescribe medications to relieve itching, pain, nausea, and shortness of breath.

Slowing progression: We continue to use diet and medications to help preserve whatever natural kidney function remains.

Hospice and palliative care partnership: We work alongside specialized supportive teams to ensure your comfort at home.

Guide 5

Important Clinical Disclaimer

The educational materials, video presentation, and care options discussed on this page are provided for general informational and educational purposes only. They do not constitute medical advice, clinical guarantees, or definitive treatment recommendations. Every patient’s medical profile, kidney function trends, and personal health goals are unique. You should never make changes to your medical care, diet, or medications without directly consulting a qualified physician or your nephrology team.

Treated Like Family • Built For Impact

Let Our Care Team Guide You

Making decisions about kidney failure treatments can feel overwhelming. You do not have to walk this path alone. Our medical team can help you understand your choices, coordinate with transplant centers when appropriate, or talk through a supportive care plan.

Contact Our Team Call (731) 300-6155