How Long Does It Take to Die From Kidney Failure Without Dialysis?
If you or a loved one is living with kidney failure and choosing not to start dialysis, you likely have a lot of questions. What will the final weeks be like? How long do people usually live without treatment? And most importantly, how can this time be made as peaceful and dignified as possible?
In this article, you’ll learn what happens when the kidneys shut down, what symptoms typically appear, how long survival may last, and how hospice or palliative care can help support a compassionate end-of-life experience.
What happens when your kidneys fail?
Your kidneys filter out toxins and excess fluid from the bloodstream. They also help regulate blood pressure, balance electrolytes like potassium and sodium, and produce hormones that support bone and red blood cell health.
When they stop working—called end-stage kidney disease (ESKD)—waste products like urea and creatinine build up. The body slowly becomes overwhelmed with toxins, leading to symptoms such as:
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Fatigue
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Nausea
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Confusion
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Shortness of breath
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Swelling (edema)
Without dialysis or a transplant to perform these critical functions, kidney failure becomes life-limiting.
How long can someone live with kidney failure without dialysis?
Survival after kidney failure without dialysis depends on several factors. For most people, life expectancy ranges between 7 days to 3 months, though some may live longer or shorter.
Average survival estimates:
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7–14 days: Common in people who are already critically ill or stop eating and drinking.
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1–3 weeks: Typical for older adults or people with multiple health conditions.
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1–3 months: Seen in people with some residual kidney function and strong overall health.
According to the National Institute of Health, uremia (a buildup of waste in the blood) is the main cause of death in people with kidney failure not receiving treatment.
For a deeper understanding of how this buildup is tracked, review creatinine levels and what they indicate.
What factors affect how long you live?
Everyone’s body is different, and several things can influence how long you or a loved one might live without dialysis:
1. Residual kidney function
If your kidneys still make some urine, toxins may build up more slowly—giving you more time.
2. Fluid and electrolyte balance
People who avoid fluid overload and dangerous electrolyte spikes (like high potassium) often live longer. Urine specific gravity testing can help assess hydration status and kidney concentration ability.
3. Other medical conditions
Conditions like heart failure, diabetes, infections, or cancer can shorten survival significantly. If diabetes is involved, be aware of the link between kidney stones and diabetes.
4. Age and physical condition
Younger, stronger people with good nutrition may live longer than older or frail individuals.
5. Emotional and spiritual readiness
People who feel at peace with their decision and are supported by loved ones often experience less stress—and that can have a meaningful impact on quality of life.
What symptoms should you expect?
When the kidneys fail completely, the body goes through several stages of decline. Symptoms can develop over days or weeks, depending on individual factors.
Early symptoms:
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Loss of appetite
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Nausea or vomiting
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Metallic taste in the mouth
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Itching
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Difficulty sleeping
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Mild confusion or forgetfulness
Mid-stage symptoms:
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Fatigue and weakness
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Swelling in legs or feet
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Shortness of breath from fluid buildup
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Difficulty concentrating
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Restlessness or agitation at night
Late-stage symptoms:
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No desire for food or fluids
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Irregular breathing
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Cold hands or feet
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Drowsiness leading to unresponsiveness
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Coma, followed by death
Itching and sleep disturbance can be difficult to manage—find practical tips in how to stop itching from kidney disease.
Most people pass away peacefully in their sleep during the final stages of uremia.
Is death from kidney failure painful?
No—when managed properly, death from kidney failure is typically not painful. Uremia acts as a natural sedative. Most people feel increasingly sleepy, then enter a coma before dying.
However, some symptoms like nausea, breathlessness, or itching can be uncomfortable. That’s where palliative care or hospice can help.
Urine pH levels can reveal signs of acidosis, a contributor to discomfort in later stages.
What is conservative kidney management?
If you decide not to pursue dialysis, you can still receive treatment. Conservative kidney management (CKM) focuses on relieving symptoms and improving quality of life—without trying to prolong it through dialysis.
CKM may include:
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Diuretics to reduce swelling
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Potassium binders to manage electrolytes
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Anti-nausea medication
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Opioids for shortness of breath
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Gentle hydration and nutritional support
This approach helps people feel better, even when dialysis isn’t part of the plan. Learn about at-home urine protein testing for better monitoring.
Why do some people choose not to start dialysis?
Dialysis is a life-extending treatment, but it’s not always the best choice for every person. Reasons for skipping or stopping dialysis include:
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Advanced age and frailty
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Multiple chronic illnesses
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Feeling overwhelmed by the time and travel commitment
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Prioritizing time at home with family
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Wanting a natural end-of-life process
According to the National Kidney Foundation, conservative care is a valid and respectful option, especially for those who value comfort and dignity.
What is palliative care, and when should it start?
Palliative care is a specialized form of medical care that focuses on relieving symptoms and emotional stress. It’s appropriate at any stage of serious illness—even before death is near.
Your palliative care team may include:
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A physician and nurse
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Social worker
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Spiritual advisor
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Counselor or therapist
You don’t need to wait until the final days. Many people start palliative care weeks or months before death, especially when opting out of dialysis.
What about hospice care?
Hospice is a form of palliative care offered to people with a life expectancy of six months or less. If you’re no longer pursuing dialysis, you likely qualify for hospice right away.
Hospice services often include:
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Regular nurse visits
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Pain and symptom relief
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Support for caregivers
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Access to spiritual or emotional counseling
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Help with end-of-life planning
Hospice can be delivered at home, in a facility, or in the hospital. It’s covered by Medicare and most insurance plans.
Learn about at-home urine protein testing for better monitoring.
What should families expect?
As kidney failure progresses, caregivers may notice changes in behavior and appearance. Families often report:
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Loved ones sleeping more and talking less
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Periods of confusion or vivid dreams
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Less interest in food and water
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Labored or noisy breathing in final hours
These changes are normal and expected. Support from hospice or a palliative care team can make this time more manageable and peaceful.
Can you reverse the decision to avoid dialysis?
Sometimes, yes. If a person still has stable vital signs and mental clarity, dialysis can be started—even if they initially chose not to. But once the body has entered the final stages of dying, restarting dialysis is usually not effective or recommended.
In the meantime, consider exploring how to check kidney function at home to stay informed.
What’s the takeaway?
Choosing not to start dialysis—or deciding to stop it—is never easy. But many people live their final weeks with peace, comfort, and dignity thanks to conservative care and hospice support.
Without dialysis, survival typically ranges from a few days to a few months, depending on health, age, and personal circumstances. Symptoms can be managed, and pain is not common when the right support is in place.
Talking openly with your care team, family, and spiritual advisors can help guide your decisions. Remember, you have choices—and support is available every step of the way.
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Can you live longer with just diet and medication?
In early CKD stages, yes. But once you reach kidney failure, diet and meds can manage symptoms but not replace dialysis.
Related resources
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Understanding Stage 4 and 5 Kidney Disease
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Signs It’s Time to Consider Hospice
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How to Talk to Family About End-of-Life Care
References
Dialysis: Deciding to Stop. (2025, June 19). Retrieved July 7, 2025, from National Kidney Foundation website: https://www.kidney.org/kidney-topics/dialysis-deciding-to-stop
Fletcher, J. (2023a, October 9). What to expect from end stage kidney failure. Retrieved July 7, 2025, from Medicalnewstoday.com website: https://www.medicalnewstoday.com/articles/what-happens-if-kidneys-fail
Fletcher, J. (2023b, October 27). What to know about stopping dialysis treatment. Retrieved July 7, 2025, from Medicalnewstoday.com website: https://www.medicalnewstoday.com/articles/longest-someone-has-lived-after-stopping-dialysis
Jewell, T. (2023, January 9). Life Expectancy After Stopping Kidney Dialysis. Retrieved July 7, 2025, from Healthline website: https://www.healthline.com/health/kidney-disease/what-is-the-longest-someone-has-lived-after-stopping-dialysis
Kidney Failure: Stages, ESRD, Causes, Symptoms & Treatment. (2023, September 5). Retrieved July 7, 2025, from Cleveland Clinic website: https://my.clevelandclinic.org/health/diseases/17689-kidney-failure
Russon, L., & Mooney, A. (2010). Palliative and end-of-life care in advanced renal failure. Clinical Medicine, 10(3), 279–281. https://doi.org/10.7861/clinmedicine.10-3-279
Murtagh, F. E., Addington-Hall, J., Edmonds, P., Donohoe, P., Carey, I., Jenkins, K., & Higginson, I. J. (2010). Symptoms in the Month Before Death for Stage 5 Chronic Kidney Disease Patients Managed Without Dialysis. Journal of Pain and Symptom Management, 40(3), 342–352. https://doi.org/10.1016/j.jpainsymman.2010.01.021
