When Should Dialysis be Taken into Consideration

Dialysis is a replacement therapy for patients with Kidney Failure, especially the End Stage Kidney Failure. It is take over the functions of kidneys when the two kidneys both fail, which often make patients mistake that the later dialysis is taken, the better patients feel. Actually, the late dialysis will increase the chances of complications as well as the total expenses for the severe complications will prolong and increase the hospitalization. What’s worse; the quality of life after late dialysis is usually not better than that of the early dialysis and the patients live a shorter life than those who take early dialysis.
When to take dialysis depends on some values
Chronic Kidney Disease can be divided in to five stages. At the last two stages, namely the stages of Kidney Failure and the previous Kidney Failure, dialysis is usually adopted. The reference values may be different in different places. In China, when serum creatinine is up to 8mg/dl or 707.2umol/L, doctors will advise patients to receive dialysis, while in other countries, the reference creatinine is more than 443 umol/L and Ccr (Creatinine Clearance Rate) is less than 10 ml/min.
The suitable time for dialysis depends on the general medical condition
Besides those reference values, doctors will take the general medical condition into account and then determine the suitable time for dialysis. For instance, as Diabetic Kidney Failure often deteriorate quickly at its late stages and the patients tend to be accompanied by many complications, doctors will suggest those patients take dialysis much earlier to effectively slow down the deterioration and prevent the severe complications. At that time, Ccr is still at the level of 15 ml/min. As for old people or people of malnutrition, with less amount of muscle, they normally have less creatinine in their blood, so the common values are not enough to determine the time for dialysis. Apart from those clinical values, doctors will take their symptoms into consideration, such as swellings, electrolyte disturbance, high blood pressure and heart failure.
The general standard to determine dialysis
In general, it is suitable time to receive dialysis, when patients’ hemoglobin is over or close to 8.0g/dl and have no symptoms of uremia like malnutrition, bleeding and anuria. The following is the general standard for determining dialysis:
1. Occurrence of severe symptoms: skin itching, fatigue, nausea, vomiting, poor appetite.
2. Severe electrolyte disturbance: edema, high blood pressure, heart failure, acidosis (PH < 7.1) and high blood potassium (> 6.5mmol/L).
3. Anemia, bleeding, malnutrition, stroke, somnolence and other peripheral neuropathy.
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