Your kidneys remove waste and extra water from the blood in your body. This waste and water then leave your body as urine. Without the kidneys, the waste would keep building up and, over time, you would die. When the kidneys are not healthy, they have a hard time removing waste from the blood. Chronic kidney disease moves slowly from early stages (stages 1 and 2), which usually have no symptoms, to advanced stages (stages 3, 4, and 5). Stage 5 is called “end-stage kidney disease.” This is because the kidneys can no longer be saved. This brochure explains two treatments that are offered for chronic kidney disease.

Anemia Drugs

One important decision you may have to make is whether to treat anemia. Anemia is common in people with kidney disease.

Erythropoiesis-stimulating agents (ESAs) are sometimes used to raise the number of red blood cells, even when a patient does not have severe anemia or symptoms. But research shows that the drugs do not help people with chronic kidney disease live longer. And when they are used aggressively, they can actually raise the risk of death by causing heart failure, heart attack, or stroke.

Bottom line: You should consider an ESA only if you have symptoms of anemia, such as feeling tired or short of breath, and you also have a very low hemoglobin level. Very low is under 100g/l.

Deciding whether Dialysis is right for you

Dialysis takes over some of the things your kidneys normally do, like removing waste and keeping a safe balance of water and salts in your blood. But dialysis is not a good idea for everyone with advanced kidney disease. Dialysis is hard on a person, and many people have to go a hemodialysis center at least three days a week. Each treatment session lasts three to five hours, and common side effects of hemodialysis include headaches, nausea, and feeling tired. In surveys of older adults on long-term hemodialysis, over half of them say they wish they had not started the treatment. Many say they only chose hemodialysis because their doctors wanted them to.

More information for patients about the options when your kidney fail (transplant, dialysis or conservative care) can be found at http://www.cann-net.ca/patient-information/educational-tools.

Bottom line: You should talk with your doctor, your family, and any other caregivers you have before you decide if long-term dialysis is the right choice for you. Ask your doctor to tell you all the benefits and risks of dialysis. Ask how well dialysis will manage your symptoms and how it will affect your lifestyle. And ask how your symptoms would be managed if you do not start dialysis.

Conditions: Chronic Kidney Disease (CKD), Kidney Failure, Renal Failure.

Procedures: Chronic Dialysis, Hemodialysis, Peritoneal Dialysis.

Treatments: Crythropoiesis Stimulating Agent (ESA), Erythropoietin (EPO), Epoetin Alfa. Procrit, Epogen, Epoetin Beta, NeoRecormon, Darbepoetin Alfa, Aranesp, Methoxy Polyethylene Glycol-Epoetin Beta, Mircera.