A kidney failure diagnosis can feel overwhelming. Whether it’s your own or someone close to you, it brings up a lot of questions. One of the most common concerns is how long a person can live with kidney failure without dialysis. While there’s no one-size-fits-all answer, understanding what happens without treatment can help you make informed choices.
What Happens in Kidney Failure?
Kidney failure means your kidneys can no longer do their main job: clearing out waste and extra fluid from your blood. When they stop working, harmful substances begin to pile up, slowly affecting everything from your energy levels to your ability to think clearly. This breakdown can happen in a matter of days or develop over months or years, depending on the cause.
There are two main types:
- Acute kidney failure is sudden. It may happen in just a few hours or days due to illness, injury, or medication. Some people recover kidney function with treatment.
- Chronic kidney disease (CKD) is long-term and develops slowly. It worsens over time and eventually reaches end-stage renal disease, when the kidneys have lost nearly all function.
Doctors track kidney function using a test called eGFR. A normal eGFR is above 90. When it drops below 15, the kidneys are in stage 5 failure.
How Long Can You Live in Kidney Failure Without Dialysis?
When someone reaches end-stage kidney failure, dialysis or a kidney transplant becomes the usual treatment. But not everyone chooses or qualifies for dialysis. So the big question is this: how long does it take to die from kidney failure without dialysis?
How long someone can live without dialysis varies from person to person. It often depends on their age, how much kidney function is left, and whether they have other health issues like diabetes, heart problems, or high blood pressure. Each of these factors plays a role in how quickly the body declines once the kidneys stop working.
A study involving 239 people who stopped dialysis showed that survival ranged from zero to 40 days. The average survival time was 4 days for those on peritoneal dialysis and 6 days for those on hemodialysis. These are only averages, so some people live longer depending on their health and the reason for stopping treatment.
Another large study from 2017 found that stopping dialysis shortened survival time from over two years to just over one month in people over age 65.
So while there’s no exact answer, most people only survive for a few days to a few weeks after stopping or avoiding dialysis. This makes the life expectancy of those with kidney failure quite limited if they don’t get treated or undergo dialysis.
What Affects How Long You Can Live Without Dialysis?
Kidney failure without dialysis can progress quickly or slowly depending on several factors:
- Age plays a major role. Older adults with other health problems usually have a shorter life expectancy.
- Kidney function matters too. If some function remains, a person may survive longer.
- Other conditions, such as diabetes, cancer, or heart disease, can speed up decline.
- The reason for stopping dialysis can also affect survival. People who stop for quality-of-life reasons may live longer than those who stop because of severe illness.
The body starts to shut down as toxins build up. Symptoms include nausea, swelling, confusion, extreme fatigue, and difficulty breathing.
Choosing Not to Start Dialysis: What to Expect
Some people decide not to begin dialysis at all. This is often called conservative care or non-dialysis management. It focuses on comfort rather than extending life.
Many older adults or people with multiple health problems prefer this route. It allows them to avoid hospital visits and focus on quality of life. Even though kidney failure without dialysis may be shorter, the person may feel more in control.
Conservative care involves:
- Managing symptoms like swelling, itching, and tiredness
- Reviewing medications to avoid side effects
- Eating a diet that limits salt and potassium
- Staying comfortable with help from caregivers or hospice teams
Supportive care doesn’t stop just because dialysis is not chosen. Doctors, nurses, and social workers continue to help with emotional support and pain management.
Can You Change Your Mind After Stopping Dialysis?
Yes. If someone stops dialysis but changes their mind, they may be able to resume treatment. This depends on how long dialysis has been stopped and whether their condition allows for it. It’s important to talk to a doctor quickly in that case.
Healthcare teams often encourage patients and families to create a care plan ahead of time. That way, wishes are respected, and loved ones know how to support the person’s decisions.
Living on Your Terms, Even in the Final Chapter
Kidney failure may change the course of life, but it doesn’t erase your ability to choose how you face it. Whether you continue treatment or decide to step back, your voice still matters. Your decisions shape the kind of care you receive and how your final days unfold.
This is a time to lean into honesty with yourself, with your doctors, and with your loved ones. Speak clearly about what you want. Find space for peace, presence, and comfort. Ask for support, not just to survive but to live meaningfully in the time you have.