Kidn

CHOOSIN

T R E ATMENT TH

R I G H T F O R 
National Institutes of Health

National Institute of Diabetes and Digestive and Kidney Diseases

Kidney 

CHOOSING 

T R E ATMENT THA

R I G H T F O R YO 
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

When Your Kidneys Fail . . . . . . . . . . . . . . . . . . . . . 

Treatment Choice: Hemodialysis . . . . . . . . . . . . . . 

Treatment Choice: Peritoneal Dialysis . . . . . . . . . . 

Treatment Choice: Kidney Transplantation . . . . . . . 

Treatment Choice: Refusing or Withdrawing 

From Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Paying for Treatment . . . . . . . . . . . . . . . . . . . . . . . 

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . 
Your kidneys filter wastes from your blood and regulat

functions of your body. When your kidneys fail, you n

treatment to replace the work of healthy kidneys to su

Developing kidney failure means that you have some d

to make about your treatment. If you choose to receiv

ment, your choices are hemodialysis, peritoneal dialysi

kidney transplantation. Each of them has advantages a

advantages. You may also choose to forgo treatment. 

learning about your choices, you can work with your d

to decide what’s best for you. No matter which treatm

you choose, you’ll need to make some changes in your 

including how you eat and plan your activities. But w

help of your health care team, family, and friends, you 

lead a full, active life.

When Your Kidneys Fa i l

Healthy kidneys clean your blood by removing excess 

minerals, and wastes. They also make hormones that k

your bones strong and your blood healthy. When you

neys fail, harmful wastes build up in your body, your b

pressure may rise, and your body may retain excess flu

not make enough red blood cells. When this happens, 

need treatment to replace the work of your failed kidn
2

P u r p o s e

Hemodialysis cleans and filters your blood using a mac

temporarily rid your body of harmful wastes, extra sal

extra water. Hemodialysis helps control blood pressur

helps your body keep the proper balance of important 

cals such as potassium, sodium, calcium, and bicarbona

How It Wo r k s

Hemodialysis uses a special filter called a dialyzer that 

tions as an artificial kidney to clean your blood. Durin

ment, your blood travels through tubes into the dialyze

which filters out wastes and extra water. Then the cle

blood flows through another set of tubes back into you

The dialyzer is connected to a machine that monitors b

flow and removes wastes from the blood.

H e m o d i a l y s i s .

Heparin pump

(to prevent

c l o t t i n g )

Dialyzer inflow

pressure monitor

D i a l y z e r

A r t e r i a l

pressure monitor

Blood pump

Blood removed

for cleansing

Air detector

c l a m p

Ai

air 

Ve

pressu
treatment lasts from 3 to 5 or more hours. During tre

you can read, write, sleep, talk, or watch TV. 

Getting Ready

If you choose hemodialysis, several months before you

treatment, an access to your bloodstream will need to 

created. You may need to stay overnight in the hospita

many patients have their access placed on an outpatien

This access provides an efficient way for blood to be c

from your body to the dialysis machine and back witho

causing discomfort. The two main types of access are 

and a graft. 

• A surgeon makes a fistula

by using your own blood

vessels; an artery is connected directly to a vein,

usually in your forearm.

The increased blood flow

makes the vein grow larger and stronger so that it

can be used for repeated

needle insertions. This

i s the preferred type of

access. It may take several

weeks to be ready for use.

• A graft connects an artery to a vein by using a sy

tube. It doesn’t need to develop as a fistula does

can be used sooner after placement. But a graft i

likely to have problems with infection and clottin

Needles are placed into the access to draw out the bloo

You’ll be given a local anesthetic to minimize any pain 

d i a l y s i s .

Arteriovenous fistula.
4

If your kidney disease has progressed quickly, you may 

have time to get a permanent vascular access before yo

hemodialysis treatments. You may need to use a cathe

tube inserted into a vein in your neck, chest, or leg nea

groin, as a temporary access. Some people use a cathe

long-term access as well. Catheters that will be needed 

Catheter for temporary access.

G r a f t .

Looped graft

A r t e r
skin to increase comfort and reduce complications. 

For more information about vascular access, see the N 

Institute of Diabetes and Digestive and Kidney Disease

( N I D D K ) fact sheet Vascular Access for Hemodialysis.

Who Performs It

Hemodialysis is usually done in a dialysis center by nu

trained technicians. In some parts of the country, it ca

done at home with the help of a partner, usually a fam

member or friend. If you decide to do home dialysis, 

a n d your partner will receive special training.

Possible Complications

Vascular access problems are the most common reason 

hospitalization among people on hemodialysis. Comm

problems include infection, blockage from clotting, an

blood flow. These problems can keep your treatments 

working. You may need to undergo repeated surgeries 

order to get a properly functioning access. 

Other problems can be caused by rapid changes in you

b o d y’s water and chemical balance during treatment. 

cramps and hypotension, or a sudden drop in blood pr

are two common side effects. Low blood pressure or

hypotension can make you feel weak, dizzy, or sick to 

s t o m a c h .

You’ll probably need a few months to adjust to hemod

Side effects can often be treated quickly and easily, so 

should always report them to your doctor and dialysis 

You can avoid many side effects if you follow a proper 

limit your liquid intake, and take your medicines as dir
6

Hemodialysis and a proper diet help reduce the wastes 

build up in your blood. A dietitian is available at all d

centers to help you plan meals according to your docto

orders. When choosing foods, you should remember t

• Eat balanced amounts of high-protein foods such 

meat, chicken, and fish. 

• Control the amount of potassium you eat. Potas

a mineral found in salt substitutes, some fruits (b

oranges), vegetables, chocolate, and nuts. Too m

potassium can be dangerous.

• Limit how much you drink. When your kidneys 

working, water builds up quickly in your body. T

much liquid makes your tissues swell and can lea

high blood pressure, heart trouble, and cramps an

blood pressure during dialysis.

• Avoid salt. Salty foods make you thirsty and mak

body hold water.

• Limit foods such as milk, cheese, nuts, dried bean

dark colas. These foods contain large amounts o

mineral phosphorus. Too much phosphorus in y

blood causes calcium to be pulled from your bon

which makes them weak and brittle and can caus

arthritis. To prevent bone problems, your doctor 

give you special medicines, which you must take 

meals every day as directed.

For more information about choosing the right foods, 

NIDDK booklet Eat Right To Feel Right on Hemodialy

P ros and Cons

Each person responds differently to similar situations. 

may be a negative factor for one person may be positiv
I n Center Hemodialysis

P ros 

+ Facilities are widely available. 

+ You have trained professionals with you at all t

+ You can get to know other patients. 

Cons 

– Treatments are scheduled by the center and are 

tively fixed. 

– You must travel to the center for treatment. 

Home Hemodialysis

P ros 

+ You can do it at the times you choose (but you 

must do it as often as your doctor orders). 

+ You don’t have to travel to a center. 

+ You gain a sense of independence and control o

your treatment. 

Cons 

– You must have a helper. 

– Helping with treatments may be stressful to yo

f a m i l y. 

– You and your helper need training. 

– You need space for storing the machine and su

at home. 
8

tages and disadvantages of in-center and home hemodi

Working With Your Health Care Te a m

Questions You May Want To Ask:

• Is hemodialysis the best treatment choice for me? 

• If I’m treated at a center, can I go to the center o

choice? 

• What should I look for in a dialysis center?

• Will my kidney doctor see me at dialysis?

• What does hemodialysis feel like? 

• What is self-care dialysis? 

• Is home hemodialysis available in my area? How 

does it take to learn? Who will train my partner 

me? 

• What kind of blood access is best for me? 

• As a hemodialysis patient, will I be able to keep w

ing? Can I have treatments at night? 

• How much should I exercise? 

• Who will be on my health care team? How can 

people help me? 

• Whom can I talk with about finances, sexuality, o

family concerns? 

• How/where can I talk to other people who have 

this decision? 

For more information about hemodialysis, see the NID

booklet Treatment Methods for Kidney Fa i l u re: Hemod
P u r p o s e

Peritoneal dialysis is another procedure that removes e

w a t e r, wastes, and chemicals from your body. This typ

dialysis uses the lining of your abdomen to filter your 

This lining is called the peritoneal membrane and acts 

artificial kidney.

How It Wo r k s

A mixture of minerals and sugar dissolved in water, ca

dialysis solution, travels through a soft tube into your

abdomen. The sugar, called dextrose, draws wastes, ch

cals, and extra water from the tiny blood vessels in you

Peritoneal dialysis.

C a t h e t e r

A b d o m i n a l

c a v i t y

Pe r i t o n e u m

D i a l y s i s

s o l u t i o n
1 0

hours, the used solution is drained from your abdomen

through the tube, taking the wastes from your blood w

Then you fill your abdomen with fresh dialysis solutio

the cycle is repeated. Each cycle is called an exc h a n g e 

Getting Ready

Before your first treatment, a surgeon places a small, s

called a catheter into your abdomen. The catheter ten

work better if there is adequate time—usually from 10 

2 or 3 weeks—for the insertion site to heal. This is an

way in which planning your dialysis access can improv

ment success. This catheter stays there permanently to 

transport the dialysis solution to and from your abdom

Types of Peritoneal Dialysis

There are three types of peritoneal dialysis.

1. Continuous Ambulatory Peritoneal Dialysis (CA P D 

CAPD is the most common type of peritoneal dialy

requires no machine and can be done in any clean, 

place. With CAPD, your blood is always being clea

The dialysis solution passes from a plastic bag throu

catheter and into your abdomen, where it stays for 

hours with the catheter sealed. The period that dia

solution is in your abdomen is called the dwell time

Next, you drain the dialysis solution back into the b

disposal. You then use the same catheter to refill yo

abdomen with fresh dialysis solution so the cleanin

process can begin again. With CAPD, the dialysis s

stays in your abdomen for a dwell time of 4 to 6 ho

more). The process of draining the used dialysis so

and replacing it with fresh solution takes about 30 

minutes. Most people change the dialysis solution 
at night. With CAPD, its not necessary to wake up 

perform dialysis tasks during the night.

2. Continuous Cycler-Assisted Peritoneal Dialysis (CC

CCPD uses a machine called a cycler to fill and em

your abdomen three to five times during the night w

you sleep. In the morning, you begin one exchange 

dwell time that lasts the entire day. You may do an 

tional exchange in the middle of the afternoon with

cycler to increase the amount of waste removed an

reduce the amount of fluid left behind in your body

3. Combination of CAPD and CCPD

If you weigh more than 175 pounds or if your peri

filters wastes slowly, you may need a combination o

CAPD and CCPD to get the right dialysis dose. Fo

ple, some people use a cycler at night but also perfo

e xchange during the day. Others do four exchange

ing the day and use a minicycler to perform one or 

e xchanges during the night. You’ll work with your 

care team to determine the best schedule for you.

Who Performs It

Both types of peritoneal dialysis are usually performed 

patient without help from a partner. CAPD is a form 

treatment that needs no machine. However, with CCP

need a machine to drain and refill your abdomen.

Possible Complications

The most common problem with peritoneal dialysis is 

tonitis, a serious abdominal infection. This infection c

occur if the opening where the catheter enters your bo

becomes infected or if contamination occurs as the cat
1 2

requires antibiotic treatment by your doctor.

To avoid peritonitis, you must be careful to follow pro

exactly and learn to recognize the early signs of perito

which include fever, unusual color or cloudiness of the 

fluid, and redness or pain around the catheter. Report 

signs to your doctor immediately so that peritonitis can 

treated quickly to avoid serious problems.

Diet for Peritoneal Dialysis

A peritoneal dialysis diet is slightly different from a he

ysis diet. 

• You’ll still need to limit salt and liquids, but you 

able to have more of each, compared with hemod

• You must eat more protein. 

• You may have different restrictions on potassium

• You may need to cut back on the number of calo

eat because there are calories in the dialysis fluid 

may cause you to gain weight.

Your doctor and a dietitian who specializes in helping p

with kidney failure will be able to help you plan your m

P ros and Cons

Each type of peritoneal dialysis has advantages and

disadvantages. (See the boxed text.)

Working With Your Health Care Te a m

Questions You May Want To Ask: 

• Is peritoneal dialysis the best treatment choice fo

Why? If yes, which type is best? 
• How long will it take me to learn how to do peri

dialysis? 

• What does peritoneal dialysis feel like? 

• How will peritoneal dialysis affect my blood pres

• How will I know if I have peritonitis? How is it

treated? 

Peritoneal Dialysis

CA P D

P ro s

+ You can do it alone.

+ You can do it at times you choose as long as yo

perform the required number of exchanges eac

+ You can do it in many locations.

+ You don’t need a machine.

C o n s

– It can disrupt your daily schedule.

– This is a continuous treatment, and all exc h a n g 

must be performed 7 days a week.

C C P D

P ro s

+ You can do it at night, mainly while you sleep.

C o n s

– You need a machine.
1 4

working? 

• How much should I exercise? 

• Where do I store supplies?

• How often do I see my doctor?

• Who will be on my health care team? How can 

people help me? 

• Whom do I contact with problems?

• Whom can I talk with about finances, sexuality, o

ly concerns? 

• How/where can I talk to other people who have 

this decision? 

For more information about peritoneal dialysis, see the

NIDDK booklet Treatment Methods for Kidney Fa i l u re 

Peritoneal Dialysis.

Dialysis Is Not a Cure

Hemodialysis and peritoneal dialysis are treatments tha

replace the work your kidneys did. These treatments h

you feel better and live longer, but they don’t cure kid

failure. Although patients with kidney failure are now 

longer than ever, over the years kidney disease can cau

problems such as heart disease, bone disease, arthritis, 

damage, infertility, and malnutrition. These problems 

go away with dialysis, but doctors now have new and b

ways to prevent or treat them. You should discuss the

complications and treatments with your doctor.
P u r p o s e

Kidney transplantation surgically places a healthy kidn

another person into your body. The donated kidney d

work that your two failed kidneys used to do.

How It Wo r k s

A surgeon places the new kidney inside your lower abd

and connects the artery and vein of the new kidney to 

artery and vein. Your blood flows through the donated 

n e y, which makes urine, just like your own kidneys did 

they were healthy. The new kidney may start working 

away or may take up to a few weeks to make urine. U

your own kidneys are causing infection or high blood 

sure, they are left in place.

Kidney transplantation.

D i s e a s e d

k i d n e y s

A r t e ry

Tr a n s p l a n t e 

k i d n e y

Tr a n s p l a n t 

u r e t e r

B l a d d e r
1 6

The transplantation process has many steps. First, talk 

your doctor, because transplantation isn’t for everyone

doctor may tell you that you have a condition that wo

make transplantation dangerous or unlikely to succeed

You may receive a kidney from a member of your fami

(living, related donor), from a person who has recently 

(cadaveric donor), or sometimes from a spouse or a ve

friend (living, unrelated donor). If you don’t have a liv

d o n o r, you’re placed on a waiting list for a cadaveric k

The wait for a cadaveric donor kidney can be several y

The transplant team considers three factors in matchin

neys with potential recipients. These factors help pred

whether your body’s immune system will accept the ne

kidney or reject it.

• Blood type. Your blood type (A, B, AB, or O) m

match the donor’s. This is the most important m

f a c t o r.

• Human leukocyte antigens (HLAs). Your cells ca

s i x important HLAs, three inherited from each p

Family members are most likely to have a comple

match. You may still receive a kidney if the HLA

a complete match as long as your blood type mat

the organ donor’s and other tests are negative.

• C ross-matching antigens. The last test before im

ing an organ is the cross-match. A small sample 

blood will be mixed with a sample of the organ d

blood in a tube to see if there’s a reaction. If no 

tion occurs, the result is called a negative cross-m

and the transplant operation can proceed.
How long you’ll have to wait for a kidney varies. Bec

there aren’t enough cadaveric donors for every person 

needs a transplant, you must be placed on a waiting lis

H o w e v e r, if a voluntary donor gives you a kidney, the 

plant can be scheduled as soon as you’re both ready. A

the long wait is a major advantage of living donation.

The surgery takes 3 to 4 hours. The usual hospital sta

about a week. After you leave the hospital, you’ll have

regular followup visits.

If someone has given you a kidney, the donor will prob

stay in the hospital about the same amount of time.

H o w e v e r, a new technique for removing a kidney for

donation uses a smaller incision and may make it possi

f o r the donor to leave the hospital in 2 to 3 days.

Between 85 and 90 percent of transplants from cadave

donors are working 1 year after surgery. Transplants f

ing relatives often work better than transplants from c

donors because they’re usually a closer match.

Possible Complications

Transplantation is the closest thing to a cure. But no m

how good the match, your body may reject your new k

A common cause of rejection is not taking medication 

p r e s c r i b e d .

Your doctor will give you drugs called immunosuppres

help prevent your body’s immune system from attackin

k i d n e y, a process called rejection. You’ll need to take

immunosuppressants every day for as long as the trans

kidney is functioning. Sometimes, however, even these 

can’t stop your body from rejecting the new kidney. If 
1 8

wait for another transplant.

Immunosuppressants can weaken your immune system

can lead to infections. Some drugs may also change yo

appearance. Your face may get fuller; you may gain w

o r develop acne or facial hair. Not all patients have th

problems, though, and diet and makeup can help.

Immunosuppressants work by diminishing the ability o

immune cells to function. In some patients, over long 

of time, this diminished immunity can increase the risk 

developing cancer. Some immunosuppressants can cau

cataracts, diabetes, extra stomach acid, high blood pres

and bone disease. When used over time, these drugs m

cause liver or kidney damage in a few patients. 

Diet for Tr a n s p l a n t a t i o n

Diet for transplant patients is less limited than it is for 

patients, although you may still have to cut back on so

foods. Your diet will probably change as your medicin

blood values, weight, and blood pressure change.

• You may need to count calories. Your medicine m

give you a bigger appetite and cause you to gain 

• You may have to eat less salt. Your medications 

cause your body to retain sodium, leading to high 

pressure. 

P ros and Cons

Kidney transplantation has advantages and disadvantag

(See the boxed text.)
Working With Your Health Care Te a m

Questions You May Want To Ask:

• Is transplantation the best treatment choice for m

W h y ?

• What are my chances of having a successful trans

• How do I find out whether a family member or f

can donate? 

• What are the risks to a family member or friend 

donates? 

Kidney Tr a n s p l a n t a t i o n

P ros 

+ A transplanted kidney works like a normal kid

+ You may feel healthier or “more normal.” 

+ You have fewer diet restrictions. 

+ You won’t need dialysis. 

+ Patients who successfully go through the select

process have a higher chance of living a longer 

C o n s

– It requires major surgery.

– You may need to wait for a donor.

– Your body may reject the new kidney, so one tr

plant may not last a lifetime.

– You’ll need to take immunosuppressants, which 

cause complications.
2 0

get placed on a waiting list for a kidney? How lo

I have to wait? 

• What symptoms does rejection cause? 

• How long does a transplant work?

• What side effects do immunosuppressants cause?

S c h e d u l e

L o c a t i o n

Av a i l a b i l i t y

Equipment and

S u p p l i e s

Training Required

D i e t

Level of Fr e e d o m

Level of Responsibility

Three treatments a week

for 3 to 5 hours or more.

Dialysis center.

Available in most

communities; may require

travel in some rural areas.

No equipment or supplies

in the home.

Little training required;

clinic staff perform most

t a s k s .

Little freedom during

treatments. Greater

freedom on nontreatment

d a y s .

Some patients prefer to

let clinic staff perform

a l l t a s k s .

More flexibility in de

your schedule of tre

H o m e .

Generally available, 

widely used because 

equipment requirem

Hemodialysis machi

connected to plumb

You and a helper mu

several training sess

More freedom to se

schedule. You’re stil

a machine for severa

w e e k .

You and your helper 

responsible for clean

setting up equipmen

monitoring vital sign

stressful on family h

H e m o d i a l y s i s

In Center H o m e

Must limit fluids, sodium, potassium, and phosph
people help me? 

• Whom can I talk to about finances, sexuality, or 

concerns? 

• How or where can I talk to other people who ha

faced this decision? 

Four to six exchanges a

d a y, every day.

Widely available.

Bags of dialysis

solution take up

storage space.

You can move aro u n d ,

exe rcise, work, drive,

etc., with solution in

your abdomen.

You must perform

exchanges four to six

times a day, every day.

Three to five exchanges a

night, every night, with an

additional exchange begun

first thing in the morning.

Widely available.

Cycling machine; bags of

dialysis solution.

You’re linked to a machine

during the night. Yo u ’ r e

free from exc h a n g e s

during the day.

You must set up your

cycler every night.

You may wait

several years

before a 

suitable kidney 

is available.

If a friend 

member is 

you can sc

operation w

both ready

Peritoneal Dialysis

CA P D C C P D

Kidney Tr a n s p l a n t 

C a d a v e r i c L i v 

After the operation, you’ll have 

checkups with your doctor.

The transplant operation takes p

h o s p i t a l .

Transplant centers are located t

the country. However, the dema

kidneys is far greater than the su

No equipment or supplies need

You’ll need to learn about your 

and when to take them.

Fewer dietary restrictions.

Offers the greatest amount of fr

You must take immunosuppress

day for as long as the transplant

f u n c t i o n s .

Any clean environment that allows solution

exc h a n g e s .

You’ll need to attend several training sessions.

Must limit sodium and calories.
2 2

booklet Treatment Methods for Kidney Fa i l u re: Kidney

Tr a n s p l a n t a t i o n.

Treatment Choice: Refusing or Wi t h d r a w i n g

Fro m Tr e a t m e n t

For many people, dialysis and transplantation not only 

life but also improve quality of life. For others who ha

ous ailments in addition to kidney failure, dialysis may 

burden that only prolongs suffering. You have the righ

refuse or withdraw from dialysis if you feel you have n

of leading a life with dignity and meaning. You may w

speak with your spouse, family, religious counselor, or 

worker as you make this decision. 

If you withdraw from dialysis treatments or refuse to b

them, you may live for a few days or for several weeks

depending on your health and your remaining kidney 

tion. Your doctor can give you medicines to make you 

comfortable during this period. Should you change yo

mind about refusing dialysis, you may start or resume 

treatments at any time.

Even if you’re satisfied with your quality of life on dia

you should think about circumstances that might make 

want to stop dialysis treatments. At some point in a m

crisis, you might lose the ability to express your wishes 

your doctor. An advance directive is a statement or do

in which you give instructions either to withhold treatm

or to provide it, depending on your wishes and the spe

circumstances. 
details the conditions under which you would want to 

treatment. You may state that you want your health ca

to use all available means to sustain your life. Or you 

direct that you be withdrawn from dialysis if you beco

manently unresponsive or fall into a coma from which 

won’t awake. In addition to dialysis, other life-sustain

treatments that you may choose or refuse include

• Cardiopulmonary resuscitation (CPR)

• Tube feedings

• Mechanical or artificial respiration

• A n t i b i o t i c s

• S u r g e r y

• Blood transfusions

Another form of advance directive is called a durable p

of attorney for health care decisions or a health care p

In this type of advance directive, you assign a person t

health care decisions for you if you become unable to 

them for yourself. Make sure the person you name un

stands your values and is willing to follow through on 

i n s t r u c t i o n s .

Each State has its own laws governing advance directiv

can obtain a form for an advance medical directive tha

in your State from Partnership for Caring (see the “Re s 

section at the back of this booklet). 
2 4

Treatment for kidney failure is expensive, but Federal h

insurance plans pay much of the cost, usually up to 80 

cent. Often, private insurance or State programs pay t

For more information, see the NIDDK fact sheet Fi n a n 

Help for Treatment of Kidney Fa i l u re.

C o n c l u s i o n

Deciding which type of treatment is best for you isn’t e

Your decision depends on your medical condition, lifes

and personal likes and dislikes. Discuss the pros and c

each treatment with your health care team and family. 

can switch between treatment methods during the cou

your therapy. If you start one form of treatment and d

you’d like to try another, talk to your doctor. The key 

learn as much as you can about your choices first. Wit

knowledge, you and your doctor will choose the treatm

that suits you best.
O rganizations That Can Help

American Association of Kidney Pa t i e n t s

100 South Ashley Drive

Suite 280

Tampa, FL 33602

Phone: 1–800–749–2257 or (813) 223–7099

Email: AAKPnat@aol.com

Internet: www. a a k p . o r g

American Kidney Fund

6110 Executive Boulevard

Suite 1010

Rockville, MD 20852

Phone: 1–800–638–8299 or (301) 881–3052

Email: helpline@akfinc.org

Internet: www. a k f i n c . o r g

Life Options Rehabilitation Pro g r a m

603 Science Drive

Madison, WI 53711–1074

Phone: 1–800–468–7777 or (608) 232–2333

Email: lifeoptions@medmed.com

Internet: www. l i f e o p t i o n s . o r g

National Kidney Foundation, Inc.

30 East 33rd Street

New York, NY 10016

Phone: 1–800–622–9010 or (212) 889–2210

Email: info@kidney. o r g

Internet: www. k i d n e y. o r g
2 6

1035 30th Street, NW.

Washington, DC 20007–3823

Phone: 1–800–989–9455 

Internet: www. p a r t n e r s h i p f o r c a r i n g . o r g

Additional Reading

If you would like to learn more about kidney failure an

treatment, you may be interested in reading

AAKP Patient Plan

This is a series of booklets and newsletters that cover t

different phases of learning about kidney failure, choo

treatment, and adjusting to changes.

American Association of Kidney Pa t i e n t s

100 South Ashley Drive

Suite 280

Tampa, FL 33602

Phone: 1–800–749–2257 or (813) 223–7099

Email: AAKPnat@aol.com

Internet: www. a a k p . o r g

Financing Transplantation: What Every Patient Need

To K n o w, 2nd edition, 1996

United Network for Organ Sharing

1100 Boulders Pa r k w a y

Suite 500

P. O. Box 13770

Richmond, VA 23225–8770

Phone: 1–888–894–6361 to order single copies

(804) 330–8541 to order bulk copies

Internet: www. u n o s . o r g

Kidney Disease: A Guide for Patients and Their Fa m i 

American Kidney Fu n d

6110 Executive Boulevard
Rockville, MD 20852

Phone: 1–800–638–8299 or (301) 881–3052

Email: helpline@akfinc.org

Internet: www. a k f i n c . o r g

M e d i c a re Coverage of Kidney Dialysis and Kidney

Transplant Services: A Supplement to Your Medicare

H a n d b o o k

Publication Number HCFA – 1 0 1 2 8

U.S. Department of Health and Human Services

Health Care Financing Ad m i n i s t r a t i o n

7500 Security Boulevard

Baltimore, MD 21244–1850

Phone: 1–800–MEDICARE (1–800–633–4227)

TDD: 1–877–486–2048

Internet: www. m e d i c a r e . g o v / P u b l i c a t i o n s / E n g l i s h . a s p

National Kidney Foundation (NKF) Patient Education

B ro c h u re s (includes materials based on NKF’s Dialysis

Outcomes Quality Initiative)

National Kidney Foundation, Inc.

30 East 33rd Street

New York, NY 10016

Phone: 1–800–622–9010 or (212) 889–2210

Internet: www. k i d n e y. o r g

What Every Patient Needs To Know, 1 9 9 7

United Network for Organ Sharing

1100 Boulders Pa r k w a y

Suite 500

P. O. Box 13770

Richmond, VA 23225–8770

Phone: 1–888–894–6361 to order single copies

(804) 330–8541 to order bulk copies

Internet: www. u n o s . o r g
2 8

Family Focus Newsletter (published quarterly)

National Kidney Foundation, Inc.

30 East 33rd Street

New York, NY 10016

Phone: 1–800–622–9010 or (212) 889–2210

Email: info@kidney. o r g

Internet: www. k i d n e y. o r g

For Patients Only (published six times a year)

ATTN: Subscription Department

18 East 41st Street

20th Floor

New York, NY 10017–6222

Re n a l i f e (published quarterly)

American Association of Kidney Pa t i e n t s

100 South Ashley Drive

Suite 280

Tampa, FL 33602

Phone: 1–800–749–2257 or (813) 223–7099

Email: AAKPnat@aol.com

Internet: www. a a k p . o r g

The U.S. Government does not endorse or favor an

specific commercial product or company. Tr a d e ,

p r o p r i e t a r y, or company names appearing in this

publication are used only because they are conside

necessary in the context of the information provid

If a product is not mentioned, this does not mean 

imply that the product is unsatisfactory.
The National Institute of Diabetes and Digestive and K

Diseases thanks these dedicated health professionals fo

careful review of this publication.

William Owen Jr., M.D.

Duke University Medical Center

Richard D. Swartz, M.D.

University of Michigan Health System

The individuals listed here facilitated field testing for t

publication. NIDDK thanks them for their contributio

Kim Bayer, M.A., R.D., L.D.

BMA Dialysis

Bethesda, MD

Cora Benedicto, R. N .

Clinic Director

Gambro Health Care

N Street Clinic

Washington, DC
I n f o r m a t i o n C l e a r i n g h o u s e

3 Information Wa y

Bethesda, MD 20892–3580

Phone: 1–800–891–5390 or (301) 654–4415

Fax: (301) 907–8906

Email: nkudic@info.niddk.nih.gov 

The National Kidney and Urologic Diseases Informatio

Clearinghouse (NKUDIC) is a service of the National I

of Diabetes and Digestive and Kidney Diseases (NIDD

NIDDK is part of the National Institutes of Health un

U.S. Department of Health and Human Services. Esta

in 1987, the clearinghouse provides information about 

eases of the kidneys and urologic system to people wit

ney and urologic disorders and to their families, health 

professionals, and the public. NKUDIC answers inqui

develops and distributes publications; and works closel

with professional and patient organizations and Gover

agencies to coordinate resources about kidney and uro

diseases. 

Publications produced by the clearinghouse are careful

reviewed by both NIDDK scientists and outside expert

This publication is not copyrighted. The clearinghouse encourages users of this booklet to duplicate

and distribute as many copies as desired. 

This booklet is also available under “Health

Information” at w w w. n i d d k . n i h . g o v on the Interne
You and your doctor will work together to choose a tr

ment that’s best for you. The booklets and fact sheets 

NIDDK Kidney Failure Series can help inform you ab

specific issues you will face.

Booklets

• Kidney Failure: Choosing a Treatment That’s Rig

for You

• Treatment Methods for Kidney Failure: Hemodia

• Treatment Methods for Kidney Failure: Peritonea

Dialysis

• Treatment Methods for Kidney Failure: Transplan

• Eat Right To Feel Right on Hemodialysis

• Kidney Failure Glossary

Fact Sheets

• Vascular Access for Hemodialysis

• Hemodialysis Dose and Adequacy

• Peritoneal Dialysis Dose and Adequacy

• Amyloidosis and Kidney Disease

• Anemia in Kidney Disease and Dialysis

• Renal Osteodystrophy

• Financial Help for Treatment of Kidney Failure

Learning as much as you can about your treatment wi

make you an important member of your health care te

NIDDK will develop additional materials for this serie

needed. Please address any comments about this serie

requests for copies to the National Kidney and Urolog

Diseases Information Clearinghouse. This series is als

on the NIDDK web site at www.niddk.nih.gov; click o

“Kidney” under Health Information.
National Institute of Diabetes and Digestive and Kidney Diseas

N I H Publication No. 01–2412

April 2001

U.S. Department of Health and Human Serv i c e s

National Institutes of Health