Kidney failure, or end-stage kidney disease (ESKD), occurs when kidneys function at less than 15% capacity, leading to waste buildup and health complications. In the US, it’s often linked to chronic conditions like diabetes and hypertension, with 131,000 new cases projected for 2025. Treatment focuses on replacing kidney function, slowing progression, and addressing symptoms, as outlined by organizations like the American Kidney Foundation and Mayo Clinic. While there’s no cure, options can extend life and enhance well-being—decisions depend on age, overall health, and preferences. Below are key treatment approaches available in the US, drawn from established guidelines and 2025 updates.
- Dialysis: This filters blood artificially when kidneys can’t. Hemodialysis (HD) uses a machine, typically 3-4 sessions/week at centers or home (home HD), lasting 3-5 hours each. Peritoneal dialysis (PD) uses the abdomen’s lining, done daily at home for flexibility. In 2025, in-center nocturnal HD (overnight sessions) is increasingly available for better work-life balance. About 555,000 Americans are on dialysis.
- Kidney Transplantation: Considered the best long-term option, it involves replacing a failed kidney with a donor organ. In 2023 (latest data), 27,332 transplants occurred, with living donor transplants offering faster recovery. Wait times average 3-5 years via UNOS lists; policy priorities in 2025 aim to increase access through better matching and incentives.
- Medications and Supportive Care: For early stages or alongside dialysis/transplant, drugs manage symptoms: ACE inhibitors/ARBs for blood pressure (preferred for diabetic CKD), diuretics for fluid control, and erythropoietin for anemia. In 2025, GLP-1 agonists like Ozempic (semaglutide) are FDA-approved to reduce CKD progression risk in type 2 diabetes patients.
- Lifestyle and Dietary Management: A kidney-friendly diet low in sodium, potassium, and phosphorus helps; regular exercise and smoking cessation slow decline. Programs like CMS’s Kidney Care Choices (KCC) Model incentivize coordinated care for Medicare patients, delaying dialysis onset.
- Emerging Therapies: Research in 2025 includes stem cell treatments to repair kidney tissue (Mayo Clinic trials) and cell therapies for diabetic CKD (UC Davis). These are experimental and not widely available yet, but show potential for reducing dialysis needs.
Access varies by insurance; Medicare covers 80% of dialysis/transplant for ESKD patients. Resources: Contact NKF at 1-855-NKF-CARES or visit kidney.org for support. During potential 2025 government shutdowns, dialysis and transplant services continue uninterrupted. This information is general—treatment plans require professional evaluation. Early intervention through screenings can make a difference.