End-Stage Kidney Disease (ESKD)/Dialysis

End-stage kidney disease (ESKD), or stage 5 of chronic kidney disease (CKD), occurs when your kidneys have less than 15 percent function left. At this stage, it is important to work with a nephorologist.

At Commonwealth Nephrology Associates, our kidney specialists take a proactive approach to reduce the mortality rate of CKD and ESKD, including aggressive evaluation and early treatment options including different dialysis modalities and/or renal transplant.

Kidney Transplant

Many patients choose this option because they believe it offers more freedom and a better quality of life than dialysis. In fact, studies show that people with kidney transplants live longer than those who are on dialysis.

However, if you receive a donor kidney, you will have to take anti-rejection (immunosuppressant) drugs daily. These drugs can suppress your immune system, which increases your risk for infections and certain types of cancer. Also, although a successful kidney transplant may last for many years, you may need more than one during your lifetime.

Dialysis

Dialysis is a treatment that cleans and purifies your blood when your kidneys are unable to do an adequate job and your health is at stake. You can receive dialysis therapy at home or in a dialysis center, but planning well in advance of kidney failure is vitally important. That’s because it allows for the best treatment options with the highest quality of life and the best chance for long-term survival.

There are two types of dialysis: peritoneal dialysis and hemodialysis. With peritoneal dialysis, the lining of your abdomen acts as a natural filter for disposing of wastes from your body. You will have a catheter surgically implanted near your belly button, and a sterile cleansing fluid is infused into the abdomen through this catheter. When the filtering process is complete, the fluid and waste products are drained from your abdomen through the catheter.

Peritoneal dialysis is administered at home and is the most desirable option, as it mimics your own kidneys’ function. The filtering process is repeated for several cycles per day at 60 to 90 minutes per cycle.

With hemodialysis, your blood is cleaned by an external dialysis machine and a dialyzer, a type of filter that acts like an artificial kidney. The machine is hooked up to an access point called an AV (arteriovenous) fistula that is surgically implanted in your arm. Blood and waste is pumped out of your body through the fistula. It cycles through the machine, which removes waste products and then returns the clean blood to your body.

Hemodialysis can be done in a dialysis center or at home. If performed in a center, hemodialysis is usually done 3 times per week for about 4 hours per visit. If performed at home, you can do more treatments, usually 4-7 times per week, for a shorter amount of time.

At Commonwealth Nephrology Associates, our physicians will explain your kidney disease treatment options and help you decide which is best for your condition and circumstances. Our nephrologists are committed to eliminating or delaying the need for dialysis as long as possible, whether through effective treatments or early transplant referral.

When dialysis is necessary, we strive to match the type of dialysis with your lifestyle and preferences to help you maintain a high quality of life while receiving excellent medical care.

The fellowship-trained kidney specialists at Commonwealth Nephrology Associates will evaluate your condition and do everything possible to slow the progression of chronic kidney disease and improve your outcomes. To schedule a visit to one of our conveniently located offices in the Boston area, call (617) 739-2100 or Request an Appointment online.