Kidney Failure Symptoms & Dialysis —
A Complete Patient Guide

India has over 220 million people with chronic kidney disease (CKD). Most of them don't know it yet — because CKD is almost entirely symptom-free until the kidneys have lost more than 60% of their function. By the time swelling, fatigue, and breathlessness appear, patients are often already in Stage 4 or 5, where dialysis or a transplant is the only option. This guide explains what to watch for, what CKD stages mean, and how dialysis works.

1. The 5 Stages of Chronic Kidney Disease

CKD is classified by GFR (Glomerular Filtration Rate) — a measure of how much blood the kidneys filter per minute. A normal GFR is above 90 mL/min:

The progression through stages can take years or decades — which is why regular monitoring matters. Stopping progression at Stage 2 or 3 is infinitely better than managing Stage 5.

2. Kidney Failure Symptoms

Most people feel nothing until Stage 3b–4. When symptoms do appear, they include:

3. Tests That Diagnose Kidney Disease

• Serum creatinine & BUN — blood tests measuring waste product buildup; used to calculate GFR
• Urine albumin-creatinine ratio (UACR) — detects early protein leakage; abnormal from Stage 1
• Complete blood count — anaemia is common in CKD due to reduced erythropoietin production
• Serum electrolytes — potassium, sodium, bicarbonate, and calcium are all affected by failing kidneys
• Kidney ultrasound — assesses kidney size and structure; small, echogenic kidneys suggest chronic damage
• Kidney biopsy — in selected cases, to determine the exact cause of kidney disease

4. When Is Dialysis Needed?

Dialysis is generally started when:

• GFR falls below 10–15 mL/min (Stage 5), OR
• Symptoms of uraemia appear — extreme fatigue, confusion, nausea, pericarditis, or pulmonary oedema — even at a higher GFR
• Dangerous potassium levels or uncontrolled fluid overload that cannot be managed with medication

The decision to start dialysis is made individually by the nephrologist based on GFR, symptoms, lab values, and overall condition — not on a single number alone.

5. Haemodialysis vs Peritoneal Dialysis

Charak Hospital operates a state-of-the-art dialysis centre in Lucknow with multiple Fresenius dialysis machines, RO-purified water systems, and experienced nephrologists supervising each session.

6. Kidney Transplant — When Is It an Option?

A kidney transplant is the best long-term treatment for end-stage kidney disease. It offers better quality of life, fewer dietary restrictions, and longer survival than dialysis. Key facts:

• Transplant can come from a living donor (relative) or a deceased donor
• The donor kidney must have compatible blood group and crossmatch
• Most patients can resume normal life within 3–6 months of transplant
• Lifelong immunosuppressive medication is required to prevent rejection
• Charak Hospital performs kidney transplants under the kidney transplant programme — contact us for evaluation

7. Diet in CKD — What to Eat and Avoid

Diet management is one of the most important tools in slowing CKD progression:

Nutrient	Recommendation	Why
Protein	Reduce (0.6–0.8 g/kg/day in non-dialysis CKD)	Excess protein generates urea waste that damages kidneys
Protein (on dialysis)	Increase (1.0–1.2 g/kg/day)	Dialysis removes protein — must be replaced
Potassium	Restrict in Stage 4–5 (avoid banana, potato, tomato, orange)	High potassium causes dangerous heart rhythm problems
Phosphorus	Restrict (avoid dairy, nuts, cola drinks, processed food)	High phosphorus damages bones and blood vessels
Sodium / Salt	Restrict to <2 g/day	Controls blood pressure and fluid retention
Fluid	Restrict if on dialysis (as advised by nephrologist)	Kidneys cannot remove excess fluid — causes dangerous overload

8. How to Slow Down CKD Progression

CKD is not always reversible — but its progression can often be dramatically slowed:

• Control blood pressure strictly — target below 130/80 mmHg. ACE inhibitors or ARBs are the preferred drugs in CKD.
• Control blood sugar rigorously — target HbA1c below 7% in diabetic CKD patients
• SGLT2 inhibitors (like empagliflozin, dapagliflozin) — newer diabetes drugs with proven benefit in slowing CKD even in non-diabetic patients
• Avoid NSAIDs — common painkillers like ibuprofen and diclofenac are toxic to kidneys; use paracetamol instead
• Avoid contrast dyes unless absolutely essential — CT contrast can precipitate acute kidney injury
• Treat anaemia — with erythropoietin injections and iron supplementation
• Regular nephrologist follow-up — every 3–6 months in stable CKD; monthly in advanced CKD