IntroductionSome people with kidney failure will decide not to have dialysis treatment. There may be many reasons for this. Some may feel that the treatment will be hard to manage and impact too much on the remainder of their life, or they may feel that the journey to the hospital three times a week is too much for them. Having heart disease or other chronic conditions may also make the renal treatments such as dialysis particularly difficult. For those who are easily confused, for example, people who have dementia, dialysis may seem frightening or upsetting. Show
Whilst old age itself is not a barrier to commencing dialysis, older people are more likely to have other diseases such as heart or respiratory diseases which may impact on their ability to do well on dialysis. Also, because of these additional health problems they may not be suitable for a transplant. Some patients having reached the stage where they decide not to embark on dialysis to treat their renal disease may live for one to two years without dialysis, but this varies and is often difficult to predict. Patients making the decision not to have dialysis will ultimately die, but often of other causes and many die with some kidney function remaining. The medical and nursing team will counsel and support people and their carers through these difficult decisions. Treatment once someone decides not to have dialysisIf a patient decides not to have dialysis they will still receive support and medical treatment from the hospital team. Their GP will also be aware of the decision. Everyone involved in the patient’s care will support the decision, as long as they are happy that it is a fully informed choice. Patients are still seen at the hospital in the kidney clinic or if unable to make the trip, they may be seen locally and sometimes in their own home. Some hospitals have nurses who will make home visits to check bloods for any change in a patient’s condition. This also helps the team decide what medication a patient will need to manage the symptoms that come about with chronic kidney disease. The kidney care team works closely with other health professionals to manage other illnesses too. Sometimes patients may refuse dialysis treatment, but later change their mind. This is very understandable and acceptable. Everyone has the right to change their mind at any time and can discuss this with the kidney team. At some point patients may be referred to community-based agencies to help manage care at home. Everyone will work hard to ensure patients are symptom and pain free until death. Support during this time will also be offered to those who care for the person with renal disease. Refusing dialysis treatment if your transplant failsSome people who have a kidney transplant that then fails decide that they don’t want to restart dialysis. Again, this is an acceptable decision and patients will be supported by the healthcare team. End of life careGenerally, dying from kidney failure is a gentle process and the majority of symptoms can be identified and well managed. Most people who make the decision not to have dialysis have other diseases and because of this it is common to die from another illness other than renal disease. Patients with their carers can make choices about where they would like to die. Once a decision has been made the healthcare team will do their best to comply with these wishes. BookletsWe have a couple of leaflets about choosing to not have or stop dialysis that you can download:-
Deciding not to have dialysis: download or order Kidney Care UK's information leafletsYou can download our deciding not to have dialysis leaflets for free:
You can also order a printed copy of Kidney Care UK’s deciding not to have dialysis leaflets to be sent to you in the post.
 Life expectancy for stage V kidney failure without dialysis varies from person to person. However, death is inevitable within a few weeks Life expectancy for stage V kidney failure without dialysis is not definitive. However, as toxins accumulate in the body and cause uremia, death is inevitable within a few weeks. Even if death does not occur immediately, quality of life dramatically decreases. How long a person can live depends on their medical history and other factors, such as:
According to the National Kidney Foundation (NKF), with dialysis stage V kidney disease has a life expectancy of 5-10 years, though many patients have lived well for 20-30 years. What changes occur after stopping dialysis?During the final days of life, physical and emotional changes may occur:
What is stage V kidney disease?Chronic kidney disease (CKD) is divided into five stages based on the estimated glomerular filtration rate (eGFR) scale. A normal GFR range is around 125 mg/dL. Stage V kidney disease occurs when eGFR falls to 15 or less, indicating kidney failure. Typically, kidneys are responsible for:
SLIDESHOWKidney Stones: Symptoms, Causes, and Treatment See SlideshowHow is stage V chronic kidney disease treated?While there is no cure available for end-stage renal disease, treatment may extend lifespan and provide better quality of life: Dialysis: Dialysis involves using a machine that helps filter blood by removing toxic waste products and maintains a healthy level of potassium, sodium, bicarbonate, and other chemicals that control blood pressure. If their kidneys have failed, a person will need to be on dialysis for the rest of their life unless they undergo a kidney transplant. Dialysis extends life expectancy and prevents further damage. The types of dialysis are: Hemodialysis (HD): Can be performed at home or in a dialysis center. Peritoneal dialysis (PD): Blood is filtered by using blood vessels in the lining of the abdomen along with a solution called dialysate. Kidney transplant: Kidney transplant involves receiving a healthy kidney from a living or a deceased donor. Anti-rejection medicines are prescribed to avoid organ rejection. Diet and lifestyle changes and regular follow-ups can also help increase lifespan:
Health NewsMedically Reviewed on 1/19/2022 References Image Source: iStock Images American Kidney Fund. Stages of Chronic Kidney Disease. https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/stages-of-chronic-kidney-disease/ National Kidney Foundation. Dialysis. https://www.kidney.org/atoz/content/dialysisinfo Johns Hopkins Medicine. End Stage Renal Disease (ESRD). https://www.hopkinsmedicine.org/health/conditions-and-diseases/end-stage-renal-failure How long can a kidney patient live without dialysis?People who stop dialysis may live anywhere from one week to several weeks, depending on the amount of kidney function they have left and their overall medical condition.
How long can a person live with Stage 5 kidney failure without dialysis?Without life-sustaining dialysis or a kidney transplant, once a person with kidney disease reaches stage 5 (end stage renal disease or ESRD), toxins build up in the body and death usually comes within a few weeks.
How long can you live with Stage 4 without dialysis?Stage 4 Kidney Disease: The kidneys are significantly damaged. Kidney failure becomes likely, which will require dialysis or a kidney transplant. A 40-year-old man with stage 4 kidney disease has a life expectancy of 14 years after diagnosis, while a 40-year-old woman can expect to live 16 more years.
How long before death when kidneys shut down?Once the patient reaches end stage renal disease (ESRD), death usually occurs within a few weeks. This can be longer or shorter depending on the patient's overall health, and how much kidney function they have left.
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How long can you survive kidney failure without dialysis
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