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Getting Prepared: What's Next?

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

When you have chronic kidney disease (CKD), your kidney function gets worse over time. There is no cure for CKD. Once you reach end-stage kidney disease (ESKD, or kidney failure), you will need dialysis or a kidney transplant to help keep you alive.1,2

There are 5 stages of CKD. Getting prepared for the later stages – stages 4 and 5 – involves making some important decisions when it comes to:1,2

  • Preserving kidney function
  • Treatment options
  • Future health management
  • Financial help
  • Preparing for kidney failure

Preserving your kidney function

With CKD, it is vital to preserve your existing kidney function as early as possible and as best you can. There are certain steps you can take and lifestyle habits that can help maintain your kidney function, such as:1,2

  • If you have diabetes, keep blood sugar levels under control
  • Keep blood pressure under control
  • Take your medicines as prescribed by your doctor
  • Eat a kidney-friendly diet, which is low in phosphorus and potassium
  • Balance your body’s fluids
  • Do not smoke
  • Stay active

Understanding your treatment options

As CKD progresses, you might consider going on some form of dialysis. Dialysis is a treatment method that does the work of your kidneys once they no longer can. If you are in kidney failure, you have the following treatment options:1,3

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How long you may live (your life expectancy) depends on many things, such as:2

  • How old you were when you were first diagnosed with CKD
  • How closely you follow your treatment plan
  • Any other health issues you may have

Making a health management plan

Advance care planning is a reality when you have ESKD. Your health management plan will depend on:3,4

  • Your age
  • Your overall health
  • Which treatments you pursue
  • Future health priorities

Some people may choose not to be on dialysis or receive a kidney transplant. Instead, they may choose conservative management. This treatment focuses on maintaining quality of life and controlling symptoms.5

You have the right to decide whether to receive treatment for your kidney disease. This is an important and unique decision that only you can make. Work with your doctor, healthcare team, and family to weigh all your options and decide what is right for you.3,5

Seeking financial help

There are many costs associated with CKD. With all the medical appointments, treatments, medicines, dialysis equipment, and supplies, CKD is a very expensive disease.6

For many people, Medicare covers most of the costs associated with ESKD, even for those under the age of 65. Here are some other resources that can help you financially if you need them:6

  • Joint federal-state programs, such as Medicaid and the Children’s Health Insurance Program (CHIP)
  • Federal programs like Social Security Disability Insurance (SSDI)
  • Private health insurance
  • Charities and foundations like the National Kidney Foundation

If you need financial assistance or help paying for your medicine, speak with your healthcare team. They can give you resources that may be able to assist you financially.6

Many people live for many years with CKD, even after a kidney failure diagnosis. So, it is important to know what financial resources exist and how you can get help paying for your treatment.6

Considering palliative care

Palliative care is a special type of medical care that helps manage symptoms and improve quality of life for both you and your family. You can receive palliative care whether you are currently in treatment (dialysis or seeking a kidney transplant) or doing conservative management.4,7

Talk with your family, caregiver, and healthcare team about palliative care options. You also may want to decide who your spokesperson and advocate will be if you become unable to make healthcare decisions for yourself.4,7

These conversations can be difficult. But making important decisions about your future healthcare can help with any confusion as well as reduce emotional stress.4,7