Is Kidney Replacement Therapy Required for Everyone with Kidney Disease?

Asian Institute of Nephrology and Urology | Feb 22, 2025

Kidney disease is a common health condition, affecting thousands of individuals every year. While it is extremely serious and demands extensive medical care and intervention, not all kinds of kidney disease require kidney replacement therapy. Understanding kidney disease is an essential first step to knowing when you might need kidney replacement therapy. In this article we will explore the issues in detail, explaining what this therapy is, when it is needed, and its varied types to help you be more conscious of your symptoms and make better decisions regarding the treatment.

What is Kidney Disease?

Kidney disease largely encapsulates diseases that lead to a progressive loss of kidney function. By impacting kidney function, these diseases hamper the body’s ability to filter out and get rid of any waste. To combat this, regular management of the condition is required, and often, kidney replacement therapy is needed as well.

Some of the most common types of kidney diseases include chronic kidney disease, acute kidney injury, and end-stage renal disease. Chronic kidney disease is typically a result of diabetes, high blood pressure, and other genetic challenges. Acute kidney injury results from a significant injury, medicinal side effect, or illness. End-stage renal disease is an advanced stage of chronic kidney disease in which the kidneys completely fail.

When this happens, the patient would require medical intervention in the form of regular dialysis or kidney replacement therapy, based on the requirements of every individual patient.

What is Kidney Replacement Therapy?

Kidney replacement therapy (KRT) or renal replacement therapy (RRT) refers to medical procedures, or interventions, which are used for performing the functions of the kidney, when the organ is unable to perform the functions itself. The therapy is used for enabling the body to maintain the fluid balance, electrolyte level, and help the body get rid of wastes effectively. It is a life-saving process, allowing individuals whose kidneys have failed to survive. However, it may not be required for every kind of kidney disease.

The key function that the kidney replacement therapy performs is eliminating waste such as urea as well as creatinine from the blood. Along with it, it focuses on maintaining the electrolyte levels in the body, which promotes optimal functionality and prevents weakness. By controlling the balance of bodily fluids, it also helps in managing the blood pressure levels of the body.

When is Kidney Replacement Therapy Needed?

Although it is not required for everyone, kidney replacement therapy may be required for individuals who are experiencing the following kidney challenges:

• Individuals with end-stage renal disease face complete kidney failure. At this advanced stage, when the glomerular filtration rate drops below 15 ml/min, kidney replacement therapy is often recommended.
• Kidney replacement therapy is typically advised for those experiencing severe and persistent symptoms such as excessive swelling, extreme electrolyte imbalances, and unmanageable hypertension.
• Accumulation of Uremic Toxins: Uremia occurs due to an excessive buildup of toxins, resulting from significant waste accumulation in the blood. This can lead to severe complications like seizures, confusion, or nausea, necessitating kidney replacement therapy.

Renal Replacement Therapy Types

Renal replacement therapy is of two key types, including dialysis and kidney transplant. Dialysis is of two types, and the treatment course is recommended on a case-by-case basis.

• Dialysis: A dialysis treatment can be of two types, including hemodialysis and peritoneal dialysis. Hemodialysis is a process in which a machine is used to filter the blood with the aim of eliminating toxins and waste. Blood extracted from the body is filtered in the machine and then returned into the body, with the process performed at least three times per week.

Peritoneal dialysis, on the other hand, involves using the peritoneum or the abdominal lining as a filter. The process involves inserting a specialized fluid in the abdominal cavity, which can effectively absorb waste in the body and then drain it out. The advantage of this process is that it can be performed at home, giving the patient greater convenience.

• Kidney Transplant: A kidney transplant is a big procedure that involves extracting one of the failed kidneys from the patient’s body and replacing it with a healthy kidney that has been taken from a donor. This treatment is the most effective in the long term; however, it may not be suitable for everyone, as it requires the patient to take medications all through their life and undergo regular follow-ups.

Dialysis or Kidney Transplant?

Choosing whether you should choose dialysis or kidney transplant is a big decision, and several factors must be considered before making a decision. For instance, dialysis is more suitable as an immediate treatment for failed kidneys. It is a non-surgical procedure and does not depend on donor availability. Moreover, it is the only resolution for individuals who do not fall in the safe category for getting a transplant.

Alternatively, kidney transplant is ideal for people suffering from end-stage renal disease, individuals who are looking for more effective and long-term solutions, and patients who do not have the bandwidth to regularly visit for dialysis treatments.

If you have been suffering from kidney disease or suspect it, visit us at AINU, Hyderabad. Our experienced team of doctors provides comprehensive examinations to get an in-depth diagnosis, along with ongoing care. Our facilities feature best-in-class equipment and sanitary standards, ensuring your kidney replacement therapy is conducted safely and with precision.

Conclusion

Kidney disease affects thousands of Indians every year, in varying grades. This progressive issue causes a big challenge for individuals, preventing them from living their regular lives hassle-free. However, to manage the conditions, medical intervention is critical, and this is where kidney replacement therapy may be recommended. If you are suffering from these challenges, consult with an experienced expert at the earliest and prevent your kidneys from failing early.