Can You Avoid Dialysis if You Have Kidney Disease?

Staying in control of your health is important, and if you’ve been diagnosed with kidney disease, you may be wondering how you can avoid dialysis. Kidney disease is progressive and often gets worse over time, so it may be difficult to avoid dialysis entirely. In the early stages, chronic kidney disease (CKD) can be managed without dialysis. Addressing the underlying cause of kidney disease is key to success. In certain cases, the effects of kidney disease may be improved or even reversed.

If CKD progresses to end stage renal disease (ESRD), however, you will need dialysis or transplant to stay as healthy as possible. Fortunately, there are many ways to slow the progression of kidney disease and protect your kidney function.

CKD affects about 15 percent of Americans. To determine which of the five stages of kidney disease you’re in, your nephrologist (kidney doctor) will measure your kidney function. At all stages of kidney disease, your doctor will help you understand how to support your kidney health and work toward your goal of avoiding dialysis.

In the early stages of CKD (stages 1–3), your doctor will likely suggest lifestyle and dietary changes and/or medication adjustments to manage your health and protect kidney function. Addressing the underlying cause of your kidney disease may help you regain function, if possible. It’s important to see a kidney doctor when any signs or symptoms begin to show.

At stage 4, you and your kidney doctor will begin to discuss treatment options alongside lifestyle choices. If your kidney doctor has diagnosed you with stage 5 CKD, your kidney disease has progressed to ESRD. At this point, you and your doctor will discuss treatment options, including dialysis or a kidney transplant.

Healthy kidneys remove waste and toxins, and keep the fluids in your body balanced. Dialysis replaces this function, and there are two types of dialysis: peritoneal dialysis (PD) and hemodialysis (HD).

Peritoneal dialysis uses the blood vessels in the lining of your abdomen, called the peritoneum, and a solution called dialysate. Dialysate enters your abdomen through a peritoneal catheter to clean toxins from your blood. Hemodialysis uses an artificial kidney called a dialyzer as well as dialysate. With hemodialysis, blood flows from your body through a vascular access, gets filtered, then is returned to your body.

If you have kidney disease and need to begin dialysis, there are options that will keep you thriving—especially if you’re interested in exploring the flexibility of home dialysis. With home dialysis, you have more control of your treatments. If prescribed by your doctor, more frequent home hemodialysis sessions may make you feel more energetic, and you may even be able to take fewer medications.

Another option for people with ESRD is kidney transplant. Transplant is the closest thing to natural kidney function because a living or deceased person donates their healthy kidney to someone with kidney failure. In most cases, people who receive a kidney transplant have already been on dialysis. Transplants performed before dialysis (called preemptive transplants) make up about 2.5 percent of all kidney transplants in the United States. People who have had kidney transplants tend to live longer and can thrive with a transplanted kidney for 15 years or more.¹

While people with kidney failure can successfully manage their health and enjoy a better quality of life, some people choose not to treat kidney disease. Supportive or palliative care can help a person with kidney failure stay comfortable as their life comes to a natural end. This is a major decision, so it’s important to discuss all your treatment options with your family and care team. Speaking openly with your doctor will help you understand your choices and make adjustments as your health changes.

You can choose the kidney disease treatment that’s best for you. Consider your health, lifestyle, goals, and wishes. If you decide that neither dialysis nor transplant is right for you, you can still work with your doctor to take medicine to control your symptoms.

You and your kidney doctor should address the root cause of your kidney disease. The two main causes of CKD and ESRD are high blood pressure and diabetes, so it’s very important to keep these conditions under control. Other causes of kidney disease, like injury or certain conditions, should be treated to help improve kidney function, if possible. Visit your nephrologist regularly to track your kidney function, manage your other health conditions, and help you stay as healthy as possible for as long as possible. Take your medications as prescribed and keep track of any supplements or vitamins you’re taking. Always be aware of the symptoms of CKD and speak to your doctor right away if you’re feeling unwell. 

Ultimately, the best way to avoid dialysis is to treat your body right. One of the most effective ways you can do this is to eat a kidney-friendly diet. One of your kidneys’ biggest functions is to balance nutrients, so by eating well, you are putting less stress on your body.

Staying physically active is important for everybody, and exercise is a great way to support your heart and kidney health. Talk to your doctor about how much exercise is right for you.

One often-overlooked way to support your health is to build a strong support network. Relying on trusted friends, family, or an in-person or online support group can help you manage stress and keep your health on track.

Remember, everyone’s situation is different. Many people are able to slow the progression of kidney disease by managing their health, but not everyone will be able to avoid kidney failure and dialysis.

The way you choose to manage your kidney disease is up to you. Your doctor can help you decide which treatment options are best for your needs and lifestyle.

It’s important to remember that while you can delay or even avoid dialysis by managing your health, you may still need dialysis at some point in the future. The key is to focus on slowing the progression of CKD by eating well, staying active, managing your other health conditions, and seeing your kidney doctor regularly. Know your options and be confident in the next steps on your journey.