Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit, the AAFP patient education website.

Information from Your Family Doctor

Advanced Kidney Disease


Am Fam Physician. 2012 Apr 1;85(7):715.

  See related article on end-stage renal disease.

What is kidney failure?

Kidney failure is when your kidneys don't work right, and waste products build up in your blood. Your blood pressure might increase, and you might retain water. When kidney failure is found early, treatment can slow the disease.

What are the symptoms?

Most people with kidney failure will not have any symptoms until late in the disease. Some of the most common symptoms are nausea, poor appetite, feeling tired, itching, swelling (especially in the legs), and trouble sleeping. Kidney failure usually does not cause pain, but patients may have pain from other medical problems.

How is it treated?

Dialysis (die-AL-uh-sis) is one treatment option for kidney disease, but it is not recommended until late in the disease when the kidneys are no longer able to function. Dialysis is not right for everyone. Your doctor can help you decide whether it is a good choice for you. A kidney transplant is another option for some patients.

What can I expect?

Your kidney failure may get worse over time. Your doctor may need to adjust the dosages of your medicines. Make sure you tell your doctor every medicine you take, including over-the-counter and herbal medicines, and medicines prescribed by other doctors.

People with kidney failure can live for years on dialysis, but complications are common. If you have serious kidney failure, you should have a living will and durable power of attorney for health care. A living will tells doctors what kind of medical care you would want if you were not able to speak for yourself. A durable power of attorney for health care lets you choose someone to make medical decisions for you if you cannot make them yourself. Talk to your family and friends so that they know your preferences before you get very sick.

Some people decide that they want to stop dialysis. These people can get hospice care, either at home or in a hospital. Hospice focuses on making people comfortable at the end of life, and on supporting the patient and the patient's family.

Where can I get more information?

Your doctor

American Academy of Hospice and Palliative Medicine

Web site:

National Kidney Foundation

Web site:

Telephone: (800) 622-9010

This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.


Copyright © 2012 by the American Academy of Family Physicians.
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