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Why kidney replacement therapy?

If your kidneys are no longer able to cleanse your body of toxins and excess water, there are different treatment options available to prolong your life and several ways to maintain your quality of life as much as possible.

Don't feel intimidated by new terminology! Your physician will explain your therapy options in easy-to-understand language.

Tip: The more informed you go into conversations with your physician, the better you can follow the explanations and ask questions.

An overview of the most common therapy options can be found on our therapy options page.

Finding the best option

Each form of treatment has its own advantages and disadvantages and not every therapy may be suitable for you. Together with your physician, you will decide which treatment suits your personal situation best. For this purpose, an intensive discussion will take place with your physician, in which your physical health, the course of your illness, the home environment, and your own wishes and needs will be considered.

After the conversation, you will have time to think about your options and decide on a suitable treatment option. Try to involve your relatives and friends in the discussion!

Kidney replacement therapy decision aid tool for patients

A decision aid tool might support you and your family to compare different treatment options based on your lifestyle needs and have more meaningful discussions with healthcare professionals. While the decision aid tool provides valuable information to patients and their families, it is important to note that it does not replace the advice and support of healthcare professionals.

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Brief overview - therapy options

Dialysis

A treatment for kidney failure that removes unwanted toxins, waste products and excess fluid by filtering your blood. The treatment is regularly performed 3 - 7 days each weeka depending on your medical condition and therapy.

Peritonial Dialysis (PD)

A treatment that uses the lining of the abdomen to filter waste from the blood. With this method, blood never leaves the body. PD treatments are typically performed at home.

Continuous Ambulatory PD (CAPD)

Continuously done with a machine.
Typically, 3 - 5 fluid exchanges are done per day at home.

Automated PD (APD)

Automated treatment that uses a machine to perform the fluid exchanges. APD treatments are typically done at home.

Hemodialysis (HD)

A treatment where the patient's blood is filtered outside the body through a dialyser or "artificial kidney". The cleaned blood is then returned to the bloodstream.

In-center HD

Treatment takes place in a dialysis center. The medical staff will prepare, perform and monitor the treatment.

Home HD (HHD)

Treatment is performed in the comfort of the patient's own home, with the help of a care partner, if necessary.

Transplantation

A major surgery during which a patient with kidney failure receives a new kidney - either from a living or deceased donor.

Conservative care

Focus on sustaining the quality of life, not extending life. Therapy is based on relief from discomfort and the pain of kidney failure symptoms, such as swelling and shortness of breath.

Below, you will find brief information on the individual therapy options. Do not worry! At this point, you do not need to understand everything in detail. Try to learn the main features of each therapy as much as you can. You can decide together with your medical team as well as family and friends on a suitable therapy option.

Kidney transplant

A transplant may be considered as the most optimal renal replacement therapy if suitable for the patient.

If a suitable donor kidney (either from a deceased organ donor or from a living donor) is available and the tests performed indicate that the kidney matches to the patient, it can be transplanted. A single kidney is usually sufficient to maintain filter functions. After the transplant, medications that suppress the immune system are taken so that the new kidney is well accepted by your body. Other medications are also prescribed to make transplantation as flawless as possible.

Unfortunately, the waiting time for a donor kidney may be quite long and finding a suitable donor may be difficult, which is why dialysis treatment is often necessary to bridge the gap.

Dialysis

Dialysis is the most common choice to treat end stage kidney disease. It represents a substitution of different functions of the human kidney. Together with your physician you will find ways of integrating the treatment into your everyday life.

Peritoneal dialysis

The term peritoneal dialysis (PD) is derived from the peritoneum, which describes the thin, protective structure around the abdominal organs. It is a unique enclosed space in the abdomen, the abdominal cavity.

In peritoneal dialysis, the peritoneum is used as a natural filter to cleanse the body of waste materials and excess water. This requires a surgically created PD catheter.

Peritoneal dialysis can be carried out independently at home or any other suitable place.

Hemodialysis

In hemodialysis (HD) procedures, the blood is cleansed outside the body using a special machine and an artificial filter. This requires a surgically created vascular access. The cleansed blood is continuously returned to the patient.

Home-hemodialysis

Home hemodialysis (HHD) is carried out in your own home or any other suitable place using the same technique as HD, with some adjustments. This requires having the devices at home and sufficient knowledge to carry out therapy.

Conservative care

You have the right to make your own choices about how to treat kidney failure and may also choose not to start or discontinue dialysis or transplantation. With conservative care your health care team continues your care without dialysis or kidney transplantation. Only your symptoms are treated by taking medication and, if necessary, by a supportive form of nutrition. Conservative care is not considered a life-prolonging measure and won’t cure kidney disease. Patients with complete kidney failure will die, if they do not receive a renal replacement therapy, such as dialysis or transplantation.

Learn more about how to create your personal support network in the next section

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