كيني فايلوير

Kidney failure means the kidneys can no longer clear waste, balance salts and remove fluid well enough to keep you healthy. It comes in two forms. Acute kidney injury develops over hours to days, usually during another illness, and often recovers. End-stage kidney disease is the final stage of chronic kidney disease, with filtering capacity (eGFR) below about 15, and is permanent.

At end stage, life depends on kidney replacement: haemodialysis, peritoneal dialysis or a transplant. A transplant generally gives the longest life and the most freedom, but not everyone is fit for one and it requires lifelong anti-rejection medication. Some frail people choose conservative care without dialysis, focused on comfort.

Symptoms

• Tiredness and poor concentration
• Swollen ankles, legs or face
• Breathlessness from fluid overload
• Nausea, poor appetite and a metallic taste
• Itching and restless legs
• Passing much less urine, or foamy urine
• Muscle cramps
• High blood pressure that is hard to control

Causes and risk factors

Diabetes and high blood pressure account for most end-stage kidney disease. Other causes include glomerulonephritis, polycystic kidney disease, long-standing obstruction from stones or an enlarged prostate, repeated kidney infections, lupus and inherited conditions. Acute kidney injury is usually triggered by dehydration, severe infection, major surgery, heart failure, blocked urine flow or medicines such as anti-inflammatory painkillers, some antibiotics and X-ray contrast, especially in people whose kidneys were already weak.

How it is diagnosed

• Creatinine and eGFR: Blood tests that estimate filtering capacity; the trend over time separates acute from chronic failure.
• Urine tests: Albumin to creatinine ratio and microscopy detect protein and blood, which point towards the cause.
• Electrolytes and blood count: Potassium, bicarbonate, calcium, phosphate, parathyroid hormone and haemoglobin show the complications that need treatment.
• Kidney ultrasound: Small scarred kidneys suggest chronic disease; swollen collecting systems suggest a blockage.
• Kidney biopsy: Used when the cause is uncertain and the result would change treatment.
• Transplant work-up: Tissue typing, crossmatch, heart assessment and infection and cancer screening for recipient and donor.

Treatment options

• Treating reversible factors: Rehydration, stopping harmful drugs, relieving obstruction and treating infection can restore function in acute kidney injury.
• Slowing chronic disease: Blood pressure control, ACE inhibitors or ARBs, SGLT2 inhibitors, good diabetes control and avoiding anti-inflammatory painkillers.
• Managing complications: Treatment of anaemia, bone mineral disorder, acidosis and high potassium, with dietary advice from a renal dietitian.
• Haemodialysis: Blood is cleaned by a machine, usually three sessions a week of about four hours, through a fistula created in the arm months ahead.
• Peritoneal dialysis: Fluid exchanges through a soft tube in the abdomen, done at home daily or overnight.
• Kidney transplant: From a living or deceased donor. Best done before or soon after dialysis starts when possible.
• Conservative kidney management: Symptom-focused care without dialysis for people who are unlikely to benefit from it.

When it is urgent

Severe breathlessness, chest pain, palpitations or marked muscle weakness (possible high potassium), confusion or fits, passing almost no urine, or fever with a painful dialysis access site need emergency care locally at once. Missing dialysis sessions in order to travel is dangerous.

Travelling to Türkiye for treatment

Dialysis and chronic kidney care belong near home. Holiday dialysis can be booked in advance if you wish to visit for another reason. People mainly travel for living donor kidney transplantation. Under Turkish law the donor must be a relative (up to the fourth degree) or spouse, documented officially, and cases are reviewed by an ethics committee; no donor is found or provided for you. Expect the recipient to stay around 3 to 4 weeks and the donor about 1 to 2 weeks, and arrange lifelong transplant follow-up at home before you leave.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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