End-Stage Kidney Disease & Cancer

Conditions & Treatments

End-Stage Kidney Disease & Cancer

End-Stage Renal Failure

When the kidney can no longer effectively filter waste and excess fluid, the buildup of toxins affects every system of the body. While there are virtually no symptoms of early stage kidney disease, later symptoms may include:

Nausea or vomiting
Fatigue
Changes in appetite
Changes in urination
Swelling of feet and ankles
Chest pain and shortness of breath
Insomnia
Abdominal pain
Back pain

At this advanced stage of kidney disease, patients will require either dialysis to filter toxins from the body or a kidney transplant.

Kidney (Renal) Cancer

When cells in one or both kidneys grow at abnormally fast rates, a lump, or tumor, forms. Typically, renal cell carcinoma begins in the lining (renal tubules) of the kidney, preventing the kidney from performing its functions. Cancers may develop in the kidney due to long-term dialysis, immunosuppressant anti-rejection medication or from other causes. Although symptoms may not appear in early stages, they may develop later in the form of:

Blood in the urine
A painful lump forming on the side
Loss of appetite and weight loss
Persistent fever
Prolonged fatigue

Diagnostic Testing & Treatment

Einstein's team of nephrologists and trusted kidney specialists is here to help you and your family formulate the right treatment plan for kidney and pancreatic disease. Current state-of-the-art treatment includes:

This treatment for pancreatic cancer is also known as pancreaticoduodenectomy. During the procedure, a surgeon removes the wide head of the pancreas, part of the adjacent small intestine (the duodenum), part of the common bile duct, the gallbladder and, when necessary, a portion of the stomach. Once the cancerous region is removed, the surgeon creates a new digestive passageway through the remaining intestine, bile duct and pancreas.

When ready to start dialysis as treatment for advanced kidney failure, you will likely need vascular surgery to create dialysis access. The most common type of dialysis access is called an arteriovenous (AV) fistula. In this procedure, the surgeon will take a vein, usually in your forearm, and connect it directly to the parallel artery. This increases blood flow in the vein, which causes it to enlarge, and creates a reliable access point to filter your blood during dialysis.

If you are not a good candidate for an AV fistula, your vascular surgeon may recommend AV grafting. This procedure also involves connecting your vein and artery but uses a synthetic tube instead of a piece of your vein to make the connection.

Treatment for kidney cancer depends on factors like tumor size, tumor location and health of the patient. You and your nephrologist will discuss the best option to treat renal cancer. Options include:

Chemotherapy: Chemotherapy drugs attack cancer cells as they divide, weakening the growth and slowing or stopping the cancer from spreading.
Immunotherapy: Immunotherapy is a type of biological therapy that boosts the body’s immune system to fight cancer cells.
Radiofrequency ablation: In RFA, high-energy radio waves heat up and destroy the tumor.
Arterial embolization: This pre-surgery treatment blocks blood flow to the tumor, shrinking it before surgery.

Pancreas transplantation involves replacing a diseased organ with a healthy organ or partial organ from one of two sources:

A deceased donor with healthy organs: The donor’s kidneys may go to a single recipient or to two different recipients depending on the severity of illness and other factors.
A living donor with matching organs: Receiving a kidney or partial pancreas from a living donor is an excellent way to eliminate long waiting times for a suitable organ. Living donors are incredible people who have decided to make a remarkable sacrifice for transplant patients.

Learn more about the Transplant process.

When it comes time for your patient to get a new kidney, the surgeons of Einstein’s Kidney and Pancreas Transplant division will be with your patient through the entire spectrum of care, starting with dialysis access. We specialize in fibula access and difficult access patients. Expedited appointments for your patients. Speak directly with an Einstein Transplant team member. Call 215-606-7167 to refer your patient or for more information.