What are my treatment options if I have end-stage kidney disease?

End-stage kidney disease is treated in a number of ways. 

Not all options are suitable for all people with end-stage kidney disease. 

You should discuss which options are suitable for you with your kidney team. 

Your kidney team includes all the health professionals who are involved with your kidney treatment. 

Option 1: Transplant

There are 2 types of kidney transplant.

1. Live kidney donor transplant

You can get a new kidney from a healthy relative or friend. This is called a live kidney donation. It is sometimes also called directed donation because the donor (your family member or friend) ‘directs’ that their kidney goes to a particular person – you. 

A live kidney transplant is the best treatment option for end-stage kidney disease because it gives you the best possible quality and length of life. After a successful live kidney transplant, you won’t need dialysis and you will be able to live a more independent life. 

If you have a live kidney donor this means you do not have to wait for a kidney from a deceased donor.

2. Deceased donor kidney transplant

You can go on the waiting list for a kidney from a deceased donor.

A deceased donor is a person who has died and their family has agreed to donate the deceased person’s kidneys.

Most people will need to be on dialysis while they wait for a kidney to become available from a deceased donor.

It is difficult to say how long you will have to wait, but most New Zealanders who eventually receive a kidney from a deceased donor have been waiting about 3 years from the time they started dialysis.

You need to know that more than 80–90% of people with end-stage kidney disease in New Zealand are not able to get a deceased donor transplant because they are either too sick to have a kidney transplant or they die while they are waiting.

This is one of the reasons a live kidney transplant is better if you have someone who wants to donate one of their kidneys to you.

Option 2: Dialysis

There are two types of dialysis – haemodialysis and peritoneal dialysis.

The average time a person lives on dialysis is 4–5 years, although some people live much longer than that.

Option 3: Medical care without dialysis or transplantation

This is also called conservative management or supportive care.

If you choose this option, you are choosing not to have dialysis or a kidney transplant.

If you chose this option you will only live as long as your kidneys can support you, which is different for different patients.

However, for some patients, this option allows them to have a better quality of life or even a longer life, compared to what they would have had on dialysis or with a kidney transplant. For example, they can avoid operations and medical procedures, and spend more time with their family and friends.