“What should we expect after end stage renal failure?”

Unfortunately, renal dialysis is the answer after end-stage renal failure to eliminate the toxins and extra fluid. Kidneys are the major organ to eliminate these toxins and fluids, and if someone's kidneys are not able to eliminate them, then dialysis is done. Nephrology follow-up and recommendations are a must after end-stage renal disease is diagnosed.

More dialysis

The American Association of Kidney Patients should be a good place to start. Encourage your friend to sign up for the transplant list if s/he is eligible.

End stage renal disease can lead to several problems, all of which are related to the fact that the kidneys can no longer carry out their job. Dialysis helps to manage some of these problems, but not all of them. For example, patients can have problems with fluid retention, which leads to fluid overload in different areas of the body like the legs and lungs, leading to leg swelling and shortness of breath, respectively. Patients with end stage renal disease can have high blood pressure that is much harder to control with medications. Patients may have anemia (condition of low red blood), which leads to symptoms like fatigue, shortness of breath or chest pain; patients with anemia may require injections to help stimulate production of red blood. Patients may also suffer from bone mineral defects, leading to weak bones and higher risk of fractures.

Longer and/or more frequent dialysis would be an option to control fluid overload and having quality of life. In my opinion, peritoneal dialysis would be a better solution. She will get dialyzed at home through a catheter put in her abdominal cavity and doing fluid exchange through machine named cycler while she is sleeping at night. There no blood involved and she will do it herself. The other options would be home hemodialysis probably 3 hour 5 days a week. Another option would be nocturnal hemodialysis which she goes to the center at night and gets dialyzed 6-8 hours 3 days a week.