Early dialysis to prevent further renal deterioration

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Early dialysis to prevent further renal deterioration

Postby gilders » Fri Apr 22, 2016 8:27 pm

First post so I hope my question/topic is not breaking any rules as I'm asking for opinions, not a diagnosis :)
If someone started dialysis early, lets say when renal function is around high teens to 20%, would starting dialysis help to prevent/slow down further deterioration (in general) in the kidneys?
I understand that this hypothetical person would be feeling relatively well at 20% function and dialysis would make overall life worse due to the commitment it takes. But if his/her sole purpose was to extend his kidney function and life, would early dialysis help?
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Re: Early dialysis to prevent further renal deterioration

Postby SKM23435 » Sat Apr 23, 2016 9:31 am

I was told that kidney deteriation continues despite dialysis but not as fast on PD as HD. The insinuation was that deteriation was quite fast once you were on dialysis - but that could be due to the underlying problem rather than dialysis it's self. I don't know.

I'm sure others on here would agree if I said dialysis comes all too soon. It's life changing and restricting. Enjoy your last few months/years with out it. Don't wish it on yourself any earlier than you have to.

Good Luck
Started APD July 2014
On transplant and paired exchange lists.
Transplant 9/5/15
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Re: Early dialysis to prevent further renal deterioration

Postby wagolynn » Sat Apr 23, 2016 2:56 pm

Hi gilders,

Dialysis replaces some of the failing kidneys functions, I do not know of any way that dialysis can directly affect the kidneys. Dialysis doe's help with many of the secondary symptoms of kidney failure, and that may be where the confusion originates.
In short, early dialysis is unlikely to make any difference to your kidneys decline.

The most useful thing that can be done at your stage is to get blood pressure down to 120/80, eliminate added salt to foods etc (look out for some soft drinks, and energy drinks, they can have lots of salt [Sodium] in them).
Though it may be difficult, stay as active as you can, and eat in a healthy way - plenty of fibre (fruit and veg but not at the expense of sufficient protein).

You will read of dietary limitations for patients in kidney failure, these are again to counteract the accumulation of nutrients working kidneys would have controlled, and because dialysis cannot remove them. It is, I would say, dangerous to diet in this way without medical supervision, most patients in the UK are assigned a dietician at about the time of starting dialysis.

Don't take Aspirin or other anti-inflammatory drugs, unless advised to do so by a doctor, even then I would question it, Paracetamol is OK.

There is a tendency to feel depressed, do what you can to ward this off or at least be aware that it is there, it will colour your thinking (black/purple/grey).

In the above comments, dialysis means - Haemodialysis or Peritoneal dialysis.

Best wishes.
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Re: Early dialysis to prevent further renal deterioration

Postby gilders » Sun Apr 24, 2016 3:27 pm

Thanks for the replies.
Many kidneys completely failed a little over 20 years ago and I was put on Haemodialysis 3/week and Plasma exchange 2/week. My kidneys recovered very well, initially, once the cause of the damage had been put in remission (Wegener's Granulomatosis).
Over the last 20 years I've had various relapses, each one damaging kidney function further.
Therefore, I knew early dialysis wouldn't help me to regain kidney function, like 20 years ago, but hoped it might prolong my current 18% function. But I'm beginning to think that's not the case :(

Really struggling to decide on which dialysis to choose. I've got the pre-dialysis team coming to my home soon. I just hope all options are available to me, or they don't try to convince me on to one type of dialysis because it's better for their budget.

I'm fortunate to have a caring wife that will offer her kidney to me (or through the pooling/exchange system), but I have to be in remission for at least 12 months.
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