Dialysis is a medical treatment that filters waste products and excess fluid from the blood when kidneys fail. This life-sustaining procedure becomes necessary when kidneys can no longer perform their natural role. Many people who begin dialysis wonder if it is possible to stop the treatment.
Why Dialysis Becomes Necessary
Dialysis becomes necessary when kidney function declines, leading to a buildup of harmful waste and fluid. This impairment stems from two main conditions: Acute Kidney Injury (AKI) or Chronic Kidney Disease (CKD), including End-Stage Renal Disease (ESRD).
AKI is a sudden, temporary loss of kidney function, often due to illness or injury. Dialysis may be used short-term to support kidneys during recovery.
In contrast, CKD involves a gradual, often irreversible decline. When CKD progresses to ESRD, kidney function drops below 15% of normal, requiring long-term dialysis or a kidney transplant for survival. Common causes of CKD include high blood pressure and diabetes.
Pathways to Stopping Dialysis
Stopping dialysis is possible under specific circumstances, primarily through two pathways. One pathway involves recovery from Acute Kidney Injury (AKI). If the underlying cause of AKI is treated and kidney function improves, patients may no longer need dialysis. This means kidneys regain enough filtering capacity to manage waste and fluid independently.
The second, more common, pathway is a successful kidney transplant. A transplant replaces failing kidneys with a healthy donor kidney, allowing patients to live without dialysis. This procedure involves complex surgery, and patients must take lifelong immunosuppressant medications to prevent organ rejection.
Key Factors Determining Discontinuation
Several factors influence whether a patient can discontinue dialysis. The type of kidney failure is a primary determinant; recovery is more likely with Acute Kidney Injury (AKI), while End-Stage Renal Disease (ESRD) typically requires a transplant. The underlying cause of kidney disease also plays a role, as some conditions are more amenable to recovery.
A patient’s overall health and other medical conditions (comorbidities) significantly impact their ability to recover or be eligible for a transplant. Severe heart or lung conditions, recent cancer, or certain infections can prevent transplant candidacy. Candidacy also depends on age, adherence to medical regimens, and donor organ availability.
Life After Dialysis
For individuals who successfully discontinue dialysis, life shifts to a new phase of medical management. Patients recovering from Acute Kidney Injury require ongoing follow-up to monitor kidney function and prevent future problems. This monitoring ensures declining kidney health is addressed promptly.
For those who receive a kidney transplant, life after dialysis involves different responsibilities. Lifelong adherence to anti-rejection medications is important to prevent the immune system from attacking the transplanted kidney. These medications, such as tacrolimus, cyclosporine, and mycophenolate mofetil, suppress the immune response. Regular medical follow-ups, including blood tests, are also important to monitor the new kidney’s function and adjust dosages. Patients often experience improved energy and a return to more normal activities, but must maintain a healthy lifestyle, including a balanced diet and regular exercise, to support the transplanted organ’s long-term health.
Managing Long-Term Dialysis
For many individuals, dialysis becomes a permanent part of life, requiring ongoing management. Two common types of dialysis are hemodialysis and peritoneal dialysis. Hemodialysis typically involves filtering blood through an external machine several times a week, often at a clinic, while peritoneal dialysis uses the lining of the abdomen to filter waste, and can often be performed at home.
Living with long-term dialysis involves careful management of diet and fluid intake. Patients typically follow specific dietary restrictions, limiting foods high in potassium, phosphorus, and sodium, and adhering to strict fluid allowances. This helps prevent the buildup of waste products and excess fluid between dialysis sessions.
Maintaining a degree of normalcy often includes adjusting daily routines around treatment schedules, and many patients continue to work, travel, and engage in social activities. Support from medical teams, including nephrologists and dietitians, along with family and support groups, plays an important role in managing the physical and emotional aspects of living with long-term dialysis.