Auckland DHB Renal Medicine
Public Service, Nephrology
This is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood. Kidney failure is divided into two general categories, acute and chronic.
Acute kidney failure (acute kidney injury) occurs suddenly and may be the result of injury, loss of large amounts of blood, drugs or poisons. Kidneys may return to normal function if they are not too badly damaged.
Chronic renal failure means kidney function has slowly worsened over a number of years and the kidneys do not get better but stay the same or slowly get worse. When chronic renal failure has progressed to end stage renal disease (ESRD), it is considered irreversible and unable to be cured.
End Stage Renal Disease (ESRD)
End stage renal disease (ESRD) has many causes but no cure. When almost all kidney function is lost, one of the existing treatment types must be used to maintain life. Specialist input from a skilled physician (renal physician, also called nephrologist) is necessary.
Regular blood tests and urine tests are necessary to see how fast your kidney problem is progressing. The renal physician will look at many issues, like your fluid balance, the concentration of waste products in your body and the influence of renal disease on many of your body's functions such as blood pressure, bones and red blood cell production.
Together with the renal physician you will discuss when the moment has come to seriously think about one of the dialysis options, as mentioned below. He/she will then refer you to a predialysis nurse specialist. This is a nurse with special skills who will discuss with you the options that there are in dialysis, looking at your specific situation. Discuss any problems connected with a type of treatment with your healthcare team and choose the best type for you and your medical condition. Later, when you have been on dialysis for some time, you may decide to use another type of treatment e.g. you may start on peritoneal dialysis (PD) and then switch to haemodialysis (HD) in the unit or at home.