Kidney Disease Treatment at Southwest Virginia Nephrology Medicine, PC  

Unfortunately, kidney disease is usually a progressive disease, which means that the damage in the kidneys tends to be permanent and can’t be undone. The good news is that kidney disease can be treated very effectively if it is caught in the early stages. Therefore, it is important to identify if you have kidney disease or disorder at an early stage before the damage is done.

Southwest Virginia Nephrology Medicine in Roanoke will develop a comprehensive and personalized renal disease treatment plan based on your specific health needs and the state of your kidneys. It could include one or more of the following kidney disease or disorder treatment options:

  • Conservative Kidney Disease Treatment,
  • Dialysis,
  • Kidney Transplant, and
  • End-of-life Care for End Stage Renal Disease.

Conservative Kidney Disease Treatment

When or our kidney doctors treats your kidney disease conservatively we do not use dialysis or a kidney transplant. The aim of conservative kidney treatment management is for you to maintain a good quality of life by prolonging your kidney function and controlling symptoms. Treatment usually consists of measures to help control signs and symptoms, reduce complications, and slow progression of your disease. Our Roanoke kidney specialist may also have to help you to control if you have high blood pressure, high cholesterol levels, swelling, bone health, weight, and more. (See also Prevention of Chronic Kidney Disease (CKD) – click here). As with most full body diseases diet and exercise is essential for healthy living. Depending on the underlying cause(s) we can treat some types of renal diseases by conservative kidney treatment.  If your kidneys become severely damaged, you most likely will need treatment for end-stage kidney disease.


When your kidneys are no longer able to sustain the demands of your body, end-stage kidney failure (End Stage Renal Disease (ESRD)) has occurred and without dialysis or renal replacement therapy, you will eventually die from kidney failure. Dialysis performs the functions of your kidneys and filters and purifies the blood using a medical device. Our kidney doctor may use dialysis for acute kidney injury, or acute renal failure, or progressive but chronically worsening kidney function (chronic kidney disease stage 5 when you lose about 85 to 90 percent of your kidney function and have a GFR of <15). Dialysis doesn’t cure kidney failure, but it will extend your life if you go to regularly scheduled treatments.

There are three primary types of dialysis:

  • Hemodialysis (primary) where your blood is pumped through the blood compartment of a dialyzer (kidney machine), exposing it to a partially permeable membrane for cleaning. Before your first treatment, a surgeon may create a fistula (or shunt), which connects an artery and vein, in your arm. Or you may require a dialysis catheter that goes into the jugular vein in your neck. Another tube is connected to the shunt so that your cleaned blood can be pumped back into your body. You most probably have to go three time per week for several hours.
  • Peritoneal dialysis (primary), is a form of dialysis that makes use of the lining of the abdomen, or peritoneal membrane (which has many of the kidneys’ filtering characteristics) to help clean the blood. In this treatment, a tube is surgically implanted into your abdominal cavity around the intestine and a sterile solution containing glucose (called dialysate) is run through the tube into the peritoneal cavity. The dialysis fluid picks up waste products and is then drained out after several hours. Several cycles of treatment (fluid instillation, time in the abdomen, and drainage) are needed every 24 hours. Automated medical peritoneal dialysis devices can now do this for you overnight, allowing you more freedom of movement and time during the day for regular activities.
  • Continuous Veno-Venous Hemofiltration (CVVH), is a temporary treatment which is usually used when you are in intensive care and requires dialysis to treat acute kidney injury (AKI). Hemofiltration (similar to hemodialysis) is the removal of waste products from your blood by passing the blood through extracorporeal filters. It is a slow continuous therapy in which sessions usually last between 12 to 24 hours and are usually carried out every day. If you have low blood pressure or other contraindicators to hemodialysis, CVVH may be a necessary alternative.

Kidney Transplant

Another treatment option for you when you have end-stage renal disease is kidney transplantation or renal transplantation. Your kidney function is then taken over by the new healthier kidney of a compatible organ donor and inducing immunologic tolerance of that organ with immunosuppression. The advantages to a transplant are that your new kidney can work perfectly, and dialysis is no longer required. The disadvantages are that there is usually a long wait to receive a donor kidney that’s compatible with your body and that immunosuppressive drugs must be taken after the surgery. Kidney transplantation is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ.

End-of-life Care (EoLC) for End Stage Renal Disease (ESRD)

End-of-Life Care (or EoLC) refers to health care of those that are terminally ill or has terminal disease condition that has become advanced, progressive and incurable. For many people with kidney failure, dialysis or a kidney transplant enables them to live longer and enjoy their quality of life. However, this may not be the case for everyone and each person has the right to choose how — or even if — they want to receive treatment for chronic kidney disease. Without life-sustaining dialysis or a kidney transplant, once a person with kidney disease reaches Stage 5 (end stage renal disease (ESRD)), toxins build up in the body and death usually comes within a few weeks.

We will make sure that your will make an informed and voluntary decision to stop treatment after consultation with your family practice physicians, social workers, therapist and family. We also make sure that you fully understand your choices, know what to expect and that you have planned for end-of-life care.

Our kidney specialist can help you to choose the appropriate kidney disease treatment option that is right for you, please call Southwest Virginia Nephrology Medicine in Roanoke, Virginia at (540) 904- 5366 or complete the contact us form (click here). We provide specialized Nephrology services in Virginia and West Virginia, including Roanoke, Salem, Franklin County and Botetourt County.