Kidney Function Down to 15%: Treatment Options You May Need

When kidney function drops below 15% of normal, this condition is referred to as end-stage kidney disease. At this stage, the kidneys are no longer able to filter waste, toxins, and excess fluid from the body effectively. As a result, these substances build up in the body and can cause a range of symptoms and serious complications. To replace lost kidney function, doctors will recommend treatment options tailored to the patient’s condition — ranging from dialysis (hemodialysis) to kidney transplantation.

Mandaya Royal Hospital Puri provides comprehensive kidney failure care, from hemodialysis to kidney transplantation. All services are supported by a complete team of experienced specialists, including internal medicine specialists with a subspecialty in nephrology and hypertension, urologists, and other multidisciplinary teams, to provide optimal care for every patient.

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Kidney Function at 15%: What Are the Treatment Options?

Here are some of the treatment options doctors may recommend if your kidney function is at 15%:

1. Hemodialysis

Hemodialysis, or dialysis, is a life-saving procedure for kidney failure patients. This treatment removes metabolic waste products and excess fluid from the blood when the kidneys are no longer able to perform this function properly. Hemodialysis also helps keep blood pressure stable.

How does hemodialysis work?

The hemodialysis machine acts as an artificial kidney by:

Removing metabolic waste and excess fluid from the body to prevent buildup.
Keeping mineral levels in the blood — such as potassium, sodium, calcium, and bicarbonate — within a safe range.
Helping to control blood pressure.

To clean the blood, the hemodialysis machine uses a special filter called a dialyzer. To allow blood to flow to the dialyzer, a surgeon will create a special access point in one of the patient’s blood vessels through a minor surgical procedure. This is called vascular access and is usually created in the arm.

Inside the dialyzer are two chambers separated by a thin membrane. One chamber carries the patient’s blood, while the other contains a special fluid called dialysate.

Blood cells, proteins, and other important components remain in the blood because they are too large to pass through the membrane. Meanwhile, waste products such as urea and creatinine, along with excess fluid, can pass through the membrane into the dialysate and are ultimately removed from the body. This process leaves the blood cleaner before it is returned to the patient’s body.

2. Kidney Transplant

A kidney transplant is a surgical procedure to replace a kidney that is no longer functioning properly with a healthy kidney from a donor.

In a kidney transplant, the donor kidney is placed inside the patient’s body to take over all the functions of the damaged kidney — such as filtering waste and toxins from the blood, maintaining fluid and mineral balance in the body, and producing urine.

During the operation, the donor kidney is usually placed in the lower right or left side of the patient’s abdomen. This position is chosen because it makes it easier for the surgeon to connect the new kidney to the blood vessels and bladder. The blood vessels of the donor kidney are connected to the patient’s blood vessels so blood can flow to the new kidney. Meanwhile, the donor kidney’s ureter is connected to the bladder so that urine produced by the new kidney can be excreted from the body normally.

With a well-functioning new kidney, many patients are able to return to their daily activities with a better quality of life compared to undergoing routine dialysis.

Dialysis or Kidney Transplant: Which Is Right for Me?

A kidney transplant is the recommended treatment option for most patients who are eligible for the procedure. However, for patients who do not yet meet the eligibility criteria or are still waiting for a donor kidney, treatment is generally carried out through hemodialysis or peritoneal dialysis (dialysis performed through the abdominal cavity).

Choosing between peritoneal dialysis and hemodialysis is a fairly complex decision. For this reason, the decision should be made in consultation with a doctor, and if needed, with input from family members or caregivers. To date, there is no clear evidence that one dialysis method is significantly superior to the other in terms of survival rates.

The choice of dialysis type is usually based on several factors, such as patient preference, support available at home, and other health conditions the patient may have. If the patient’s needs or condition change over time, the type of dialysis can also be adjusted by switching from one method to another.

Dialysis and Kidney Transplant Services at Mandaya Royal Hospital Puri

Mandaya Royal Hospital Puri offers dialysis services designed with patient comfort as a priority. The Mandaya Hemodialysis Unit is equipped with a Hi-Flux hemofiltration system that filters blood more effectively, providing patients with noticeable positive effects after completing hemodialysis treatment. For a more private experience, a VIP hemodialysis room is also available, complete with a comfortable waiting area for patients’ families.

In addition to dialysis, Mandaya Royal Hospital Puri has also obtained the license to perform kidney transplants. In early 2026, Mandaya Royal Hospital Puri successfully completed its first kidney transplant, made possible through the collaboration of a multidisciplinary medical team along with advanced facilities and technology.

The hospital has dedicated operating rooms designed specifically for kidney transplant procedures, for both donors and recipients, with the two operating rooms positioned adjacent to one another so that organ transfer can be carried out quickly and safely, keeping the kidney’s quality and function optimal. The donor kidney is retrieved using a laparoscopic technique through a small incision via a retroperitoneal approach, making the procedure more minimally invasive and supporting faster patient recovery.

Kidney transplants at Mandaya Royal Hospital Puri are handled by an experienced multidisciplinary medical team, consisting of Dr. dr. Maruhum Bonar H. Marbun, Sp.PD-KGH, FINASIM; Prof. dr. Chaidir Arif Mochtar, Sp.U(K), PhD; Prof. dr. Ponco Birowo, Sp.U(K), PhD; dr. Sigit Sholichin, Sp.U, FICRS; and dr. Vidhia Umami, Sp.PD-KGH. This collaboration between nephrologists (internal medicine specialists with a subspecialty in kidney and hypertension) and urologists allows patients to receive comprehensive kidney transplant care — from pre-operative evaluation and the transplant procedure itself, to post-transplant monitoring and care.

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