Kidney Failure: When Dialysis is Too Burdensome

Our kidneys are different from many other major organs. First, we have two of them; if one is diseased or has a cancer, it can be removed and the remaining one will take up the slack. If our kidneys are healthy, we can even donate one to a person with kidney failure.

What exactly do the kidneys do? Their main function is to filter the blood to remove excess water, balance electrolytes (such as sodium and potassium), and remove byproducts and waste.

Many diseases can attack the kidneys, leading to decreased function. The two most common causes of chronic kidney disease are diabetes and high blood pressure.

According to the National Institutes of Health, about 660,000 Americans have end-stage kidney disease. Around 190,000 of them have received kidney transplants, and about 470,000 benefit from regular dialysis treatments.

When the kidneys fail, dialysis can be a great option to keep a person alive. Dialysis can be accomplished through a filtering machine, usually at a dialysis center, or at home with an implanted tube in the abdomen that allows a patient to take advantage of the ability of the lining of the abdominal cavity to work as a filtering membrane.

While dialysis does replace the kidneys’ main function of filtering impurities out of the blood, even a sick kidney works better than the best dialysis machine. As a person is on dialysis longer, he or she becomes sicker and more frail; even the dialysis itself may become a burden.

When symptoms like swelling, fatigue, trouble breathing, low mood and insomnia cannot be controlled with medications and dialysis, palliative care may be considered. Elizabeth Palliative Care is an integral part of the service offering at The Elizabeth Hospice. This medical approach focuses on providing patients relief from the symptoms, pain and stress of chronic conditions like kidney failure. Working with your primary care physician and other physicians, the palliative care team provides an added layer of support.

The palliative team will facilitate discussions about care goals with patients, family members, doctors, nurses and others. This is an opportunity for everyone to assess what is working, what is not working, what is helping and what is causing more harm than good. Sometimes, people realize that they do not want to go to the hospital anymore but do want to continue aggressive treatments at home and in the doctor’s office.

Some end-stage kidney patients reach a point where the burden of dialysis is too great too bear, and they choose to stop dialysis. Hospice care from The Elizabeth Hospice, focusing on the relief of symptoms, is an option. As the largest nonprofit hospice provider in San Diego County and Southwest Riverside County, we offer a comprehensive program that goes beyond managing symptoms and relieving pain. We become our patients’ trusted companions and customize the comfort care experience to meet their unique needs and wants. Our focus is not on the illness but on embracing experiences that bring meaning and joy to a person’s life.