Chronic kidney failure is the last stage of chronic (slowly worsening) kidney disease. Also called end-stage renal disease, it occurs when your kidneys can no longer filter blood or remove waste and excess fluids from your body during urination. As toxins and fluids build up in your body, it causes severe, life-threatening damage that can harm your kidneys, heart, brain, lungs, and bones.

In children, chronic kidney disease can cause growth problems. In both children and adults, chronic kidney disease can lead to high blood pressure, anemia (low blood iron), proteinuria (protein in the blood), and other serious conditions caused by imbalances in hormones or other substances in your blood.

The most common sign of chronic kidney failure is uremia, a collection of symptoms that includes:

• Nausea and vomiting
• Fluid buildup around the heart
• Nerve problems
• Shortness of breath
• Confusion
• Seizures
• Coma

Many conditions can lead to or complicate chronic kidney failure, such as:

• Glomerular diseases: damage to the tiny blood vessels that filter waste out of the blood
• Nephrotic syndrome: a group of serious symptoms like proteinuria, or high protein in the urine
• Congenital urogenital anomalies: birth defects or hereditary conditions that affect the urinary and genital tract
• Congenital uropathies: birth defects or hereditary conditions that affect urine flow
• Renal vasculitis or ANCA glomerulonephritis: swelling of the blood vessels

University of Miami Health System kidney specialists (nephrologists) provide advanced treatments for chronic kidney failure in children and adults, including the latest dialysis and kidney transplant approaches. We offer a variety of preventive therapies to improve treatment options and outcomes. We work with you to develop a treatment plan that fits your lifestyle.

Tests

Biopsy
A kidney biopsy is a tissue sample taken from the kidney through a needle and analyzed at a lab. Results help your doctor diagnose the type of kidney disease, assess kidney damage, and determine the best treatment.

Kidney Function Test
The glomerular filtration rate (GFR) is a blood test that assesses kidney function by measuring the protein (albumin and creatinine) levels in your bloodstream. The GFR number shows how well your kidneys function.

Urinalysis
Doctors use urine samples to look for red blood cells, white blood cells, infections, or excessive protein in your urine. Your doctor may take a sample during your appointment, arrange urine collection over 24 hours, or take a sample directly from your bladder using a catheter (thin, flexible tube).

Treatments

Dialysis
Dialysis mechanically performs the function of your kidneys. It’s not a cure for kidney disease, but it can make you feel better and live longer. There are different types of dialysis, which can take place at one of our facilities or at home. Types of dialysis include:

• Hemodialysis: This form of dialysis uses a machine, called a dialyzer, to clean your blood outside of your body. Your doctor will do a minor surgery (called dialysis access) to prepare a vein in your arm for removing and returning blood. During dialysis, blood is taken out of the access point with a needle, passed through the dialyzer, and returned to your body through a different needle. Hemodialysis treatments take a few hours and are performed a few times a week.

  Peritoneal Dialysis: This form of dialysis uses your own body to filter blood using a catheter (a thin, flexible tube) placed in your navel. In a process called an exchange, a solution is passed through the catheter into your abdomen either by hand or a machine. The solution soaks up waste and excess body fluids and returns it to a collection bag. The procedure is usually performed four or more times a day, and each exchange takes a few hours.

Continuous Renal Replacement Therapy (CRRT)
This therapy includes hemodialysis and other mechanical waste filtration techniques performed slowly over long periods of time (12 to 24 hours). CRRT is used for critically ill people with sudden (acute) kidney failure.

Kidney Transplant
If dialysis or other therapies no longer work, your doctor may recommend a kidney transplant.

Why Choose UHealth?

Nationally recognized kidney care. Our kidney care program has been ranked among the nation’s best programs by U.S. News & World Report for the past nine years. We use preventive approaches to help avoid kidney injury and disease, along with advanced therapies to improve kidney health and function. We offer some of the most advanced kidney therapies, including continuous renal replacement therapy (CRRT) and therapeutic plasma exchange (TPE).

Advanced treatment options at the Comprehensive Children’s Kidney Failure Center (CCKFC). As the only comprehensive center in southeast Florida, the CCKFC is uniquely suited to care for children and young adults under 21. Our highly skilled team provides early diagnosis and treatment to stop the progression of kidney disease and protect your child’s health and development.

World-class care in an academic health system. We’re recognized by the National Institutes of Diabetes and Digestive and Kidney Diseases as a Center of Excellence and a leader in treating kidney conditions. Backed by one of the nation’s top universities, our team uses the latest technologies and research-driven expertise to provide you with superior, personalized care and the latest treatment options.

Highest patient survival rate after transplant. The Kidney Transplant Program at the University of Miami Miller School of Medicine/Jackson Memorial Medical Center have performed more than 250 kidney and combined kidney-pancreas transplants. This expertise earned us recognition by the U.S. Department of Health and Human Services for the largest volume in the nation and the highest transplant success and patient survival after kidney transplant. In addition, our Kidney Paired Donor Exchange Program gives those who need a kidney transplant a better chance of finding a match. With this program, donors that aren’t a medical match for the patient can take part in an exchange program that matches them with another recipient/donor.

Convenient dialysis options. We make it easier for you to make dialysis part of your routine. Our multiple locations, easy scheduling, and comfortable rooms help you take control of your treatment.