Kidney Transplantation
Transplant Pathway
- Referral and evaluation
- Living donation coaching
- Long-term management
Failing kidneys and treatment options
When kidneys begin to fail, understanding your choices makes 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.
Common paths for kidney failure planning
Every person's medical situation, lifestyle, and goals are different. These are the pathways your nephrology team may discuss as kidney function becomes very low.
Preparing for kidney failure involves several milestones. These sections explain how we partner with you at each one.
Home Dialysis Options
Flexibility & Freedom
- Different treatment rhythm
- Greater independence
- Steadier fluid removal
Conservative & Supportive Care
Focus on Comfort
- Active symptom control
- Slowing progression
- Hospice and palliative care partnership
Watch an educational presentation
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Kidney Transplantation
Transplant Pathway
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.
Navigating the transplant journey
Evaluation, referral, and long-term follow-up
A kidney transplant can be an effective treatment for kidney failure for people who are medically eligible. Our team helps patients understand referral, evaluation, and post-surgical follow-up in coordination with transplant centers.
- 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.
Home Dialysis Options
Flexibility & Freedom
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.
Considering home dialysis
More flexibility when clinically appropriate
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.
In-Center Hemodialysis
Structured Care
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).
Understanding in-center hemodialysis
Structured support in a dialysis center
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.
Conservative & Supportive Care
Focus on Comfort
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.
Conservative care and shared decision making
Your goals, your care pathway
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: Medications may be used to help with itching, pain, nausea, shortness of breath, swelling, or anemia when appropriate.
- Slowing progression: Diet guidance, medication review, and lab monitoring may still be part of care when they match the person’s goals.
- Hospice and palliative care partnership: Supportive teams may help with comfort-focused care at home when appropriate.
The four paths side by side
| Path | Where it happens | Schedule | Day to day |
|---|---|---|---|
| Kidney Transplantation | Placed in your body | Evaluation can begin before you ever need to start dialysis | Requires taking daily medications to protect and preserve the donor kidney |
| Home Dialysis Options | In your own home | Peritoneal Dialysis (PD): typically done daily while sleeping. Home Hemodialysis (HHD): usually 4-5 times a week | May offer more flexible scheduling |
| In-Center Hemodialysis | In a clinical center | Typically three times a week for about 4 hours per session | No medical equipment, supplies, or medical training required at home |
| Conservative & Supportive Care | Comfort-focused care at home when appropriate | Avoids the physical strain, travel, and schedule demands of dialysis treatments | Shaped around your personal goals, comfort, and quality of life |
Early planning with nephrology
The foundation of a safe transition
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.
Questions to bring to your nephrology team
Treatment choices are medical and personal. Before choosing a path, it can help to ask how each option may fit your kidney trend, heart health, support at home, work schedule, transportation, insurance coverage, and personal goals.
- Which options are medically realistic for me right now, and which may need preparation?
- What symptoms, lab changes, or access planning steps should I watch for?
- Should I learn more about transplant referral, home dialysis training, in-center schedules, or conservative supportive care?
- How do I coordinate next steps with my family, primary care provider, insurance plan, and local clinic?
For local help, visit our West Tennessee locations, review insurance information, or start a referral yourself. You can also learn how planning connects with chronic kidney disease care, dialysis care, and transplant care.
Common planning questions
When should kidney failure planning start?
Planning often starts before a crisis, especially when eGFR is trending very low or symptoms are changing. Your nephrology team can explain which conversations are appropriate for your stage, health history, and goals.
Do I have to choose dialysis right away?
Not always. Some people need urgent treatment, while others have time to compare transplant, home dialysis, in-center dialysis, and conservative supportive care. Ask your nephrology team what timing your labs and symptoms suggest.
Can family members come to treatment option discussions?
Yes. Many patients find it helpful to bring a trusted family member or support person, especially when discussing home support, transportation, work schedules, insurance, and personal goals.
Does The Kidney Experts help patients across West Tennessee?
Yes. The Kidney Experts serves patients in Jackson, Dyersburg, Union City, Covington, and surrounding communities. Our team can help you prepare questions for visits and referrals when appropriate.
Important clinical disclaimerThe 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.
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.