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When to Start Dialysis with Renal Failure

2013-01-14 14:22

Dialysis is one important renal replacement therapy for renal failure patients. Usually when the illness condition enters into stage 4 patients will begin to prepare for hemodialysis or peritoneal dialysis. And a catheter or fistula will be placed in the patients’ body.

That is to say, when GFR falls below 30, dialysis will be ordered or recommended. Dialysis will be started when CKD progresses into the end stage and when GFR is below 15.

However for renal failure that are caused by diabetes or diabetic nephropathy, dialysis should be started earlier. Usually when Ccr (creatinine clearance rate) is 10-15ml/min dialysis should be started. If patients have obvious uremic symptoms or other life-threatening illness conditions such as severe hyperkalaemia, dialysis should be started even earlier.

Many kidney patients pay more attention to their serum creatinine level and consult the doctor what should be the creatinine to begin dialysis. Though creatinine level is one important index for reflecting kidney functions, it should not be the only factor to determine when to begin dialysis. Many other factors and elements need to be taken into account. In case of the following conditions dialysis should be offered.

Having oliguria or anuria for 24-48 hours or more;

Obvious nausea, vomiting, agitation, pulmonary edema or consciousness disturbance;

Blood urea nitrogen is higher than 21.4mmol/l or daily increase higher than 9mmol/l;

Serum creatinine is higher than 442;

Serum potassium is higher than 6.5mmol/l;

HCO3 is lower than 15mmol/l

Besides when to begin dialysis, another commonly asked question by renal failure patients is can dialysis be stopped and when to stop dialysis.

We know that dialysis can be called artificial kidney which is used to replace part of the kidneys’ functions. So long as kidney functions are improved higher than 30 and remain stable can dialysis be stopped, that is to say weather dialysis can be stopped depends on what kind of treatments the patients receive and the curative effects.

Immunotherapy is a new remedy for renal failure. It can be combined with dialysis. Dialysis can remove creatinine and metabolic wastes from the blood so as to create a favorable internal environment for immunotherapy to repair damaged renal tissues and improve kidney functions.

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