Kidneys filter blood, removing toxins, excess fluid, and other harmful substances. When kidneys fail, or stop working completely, a person typically only has a few days to weeks to live without dialysis or a kidney transplant.

Renal failure is the fifth and final stage of kidney disease. When it occurs, a person may experience a reduced quality of life and an early death.

This article discusses what happens when the kidneys completely fail. It also provides information about symptoms of end stage kidney failure, what treatments may help, and more.

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Stage 5 chronic kidney disease, or kidney failure, occurs when the kidneys have a glomerular filtration rate of less than 15 milliliters per minute (mL/min). The kidneys can no longer filter enough blood to meet the demand.

This leads to a buildup of fluids and toxins in the body. As more toxins remain in the body, a person may experience worsening symptoms, such as fatigue or general weakness.

Learn more about end stage renal disease.

During the early stages of chronic kidney disease, a person may not experience symptoms or find that treatment options help manage them.

Once end stage kidney failure starts, a person may develop symptoms or notice worsening symptoms as the toxins and waste build up in the body. Common symptoms can include:

  • itchiness
  • fatigue
  • difficulty sleeping
  • swelling, often in the lower extremities, such as the legs, feet, or ankles
  • little to no urine production
  • headaches
  • confusion, memory difficulties, or challenges focusing
  • lose of sense of taste
  • weight loss
  • pain, stiffness, or fluid in the joints
  • appetite loss
  • an ill feeling in the stomach
  • muscle weakness, numbness, or cramps

Dialysis is a treatment option available for many people with end stage kidney failure.

There are two options: hemodialysis and peritoneal dialysis.

In hemodialysis, a doctor attaches a machine that acts as a kidney to a person. Their blood filters through the machine and returns to the body through intravenous lines. Vascular access is also necessary to reach the blood. This may be through a temporary catheter or permanently through a graft or fistula that a surgeon creates.

In peritoneal dialysis, doctors use the abdomen cavity lining, or peritoneum, as an internal filter. A person needs a surgical procedure to place the peritoneal catheter in the abdomen.

During each treatment, a doctor uses a catheter to inject a mixture of water, salt, and other additives, known as a dialysate, into the opening. The person’s blood flows around the cavity naturally, and the dialysate pulls the toxins or waste through the membrane.

In both cases, a part of a person’s blood experiences filtration. It is not a cure for kidney failure, but it can help extend a person’s life.

On average, a person receiving dialysis can live an additional 5–10 years.

Learn more about dialysis.

Another option for kidney failure treatment involves a transplant. A doctor may use a donor kidney from a recently deceased person or a living donor.

A person who receives a kidney can increase their lifespan on average by 10–15 years from a deceased donor or 15–20 years from a living person.

According to a 2021 report, the waiting list for either type of kidney donation contains about 90,000 people in the United States. A person is typically eligible for waitlisting once the estimated glomerular filtration rate reaches less than or equal to 20 mL/min per 1.73 m2.

The wait time for a kidney transplant from a deceased donor is around 5 years. However, this can vary greatly, depending on factors such as where a person lives and what their blood type is.

Learn about kidney transplant surgery.

A doctor can recommend different dietary changes whether a person undergoes a kidney transplant or dialysis treatment.

Although it is a good idea for a person to discuss diet changes with a doctor or dietitian, some general recommendations include limiting intakes of:

  • salt
  • protein
  • fluid

A person may also need to make other changes to their lifestyle. These may include:

  • getting physical activity for at least 30 minutes most days
  • limiting or eliminating alcohol and smoking
  • stopping certain medications
  • maintaining a stable blood pressure
  • keeping a low blood sugar level, particularly if they have diabetes

A person’s doctor can provide more information on steps they can take to manage symptoms and generally feel better with end stage kidney failure.

Learn more about kidney failure and diet.

The outlook for a person with end stage kidney failure is generally unfavorable. Without proper treatment, a person with kidney failure may live about a week to several weeks. The length of time a person can live may depend on how much the kidneys still function.

With treatment, a person can increase their life expectancy by several years, depending on the exact treatment. Average life expectancy with treatment for end stage kidney failure includes:

  • 5–10 years with dialysis treatment
  • 10–15 years with a kidney transplant from a deceased donor
  • 15–20 years with a kidney transplant from a living donor

A person’s doctor can provide more information about their outlook based on their circumstances.

The following sections provide answers to frequently asked questions about end stage kidney failure.

Can a person recover from kidney failure?

There is currently no cure for kidney failure. Even with treatment, a person can often have a reduced life expectancy.

What is the main reason for kidney failure?

Several underlying conditions can cause chronic kidney disease, which can lead to complete kidney failure. They include:

  • diabetes, which is the most common cause
  • high blood pressure, the second most common cause
  • recurrent kidney stone disease
  • use of certain medications, such as nonsteroidal anti-inflammatory drugs
  • vascular diseases
  • genetic disorders

End stage kidney failure occurs when kidney function severely reduces or stops entirely. Toxins and other wastes build up in the body, causing increasing symptoms and eventually death.

Treatments for end stage kidney failure include dialysis or kidney transplant. These treatments can increase life expectancy by several years or even decades.

A person may need to make additional lifestyle changes to help improve their quality of life and life expectancy. A person’s doctor can provide more information about steps to manage symptoms and advise on suitable treatments.