Category Archives: Dialysis

I have polycystic kidney disease and have recently begun dialysis. Once I completed the first treatment I went home and soon after began feeling tremors and vibrations all over my body. It lasted until one in the morning. After the following treatment, and after every subsequent treatment, it has lasted from 4-6 hours. No one has been able to tell me why this is occurring and whether or not it will eventually stop. Will this have any effect on my muscles or tissues if prolonged, and can you tell me why this is occurring? I’m a white female, age 77.

I am unable to make a specific diagnosis based on the information that you provide. During your dialysis treatment, the machine may be cooling you to some extent and this could be causing you to shiver. I find it unusual … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Symptoms and Side Effects

I am having severe problems after having dialysis treatment. Is there any suggestion to help how bad I feel after treatment?

I am not able to make a specific diagnosis based on the information that you present. Fatigue is very common after dialysis. This is especially true after in-center hemodialysis where recovery times as long as 6-8 hours have been reported. … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Nephrologist

Unfortunately, I had a poor nephrologist who was not on top of things. After seeking a second opinion because of feeling so awful, I am now in full blown kidney failure, with a GFR of 13. We are to see the dialysis nurse next week to discuss options for treatment. I am leaning toward hemodialysis, with a fistula, rather than a graft. However, after researching, it appears the fistula takes up to four months to heal before dialysis can begin. Can both a graft and fistula be done at the same time, so that the graft can be used initially and the fistula used, once healed? Thanks.

A fistula should be your first choice. It would be hazardous to place both a fistula and a graft. I suggest you try for the fistula, if possible, and place a graft if the fistula is unsuccessful. Your nephrologist and … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Nephrologist

My cousin is mid 30’s and does not have either kidney. She is cleared to have a live donor. I would like to write something up to provide statistics on her scenario for people to understand medically what a rare situation this is. Can you advise on statistics of: 1) About how many people are living now with out either kidney? 2) What is the average age of a person in this situation? 3) What other statistics and information would be helpful for others to understand what it means to donate a kidney. I think I found about how many live transplants are done a year. Also the risk to someone that donates. It did not hit me how rare this scenario is until I went into the ICU with her a few years ago to visit and I heard the nurses say in shock that she had neither and they did not know it was possible to live with out them. My point is asking for information to motivate others to become a living donor. Thank you!

I am not familiar with any statistics about how many people are living on dialysis without any kidneys being present. This data is not compiled by any entity that I am aware of. We have a section on our web … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, organ donation

I am one of the caregivers for my 79 year old father. He is Type 2 diabetic and started dialysis in Dec 2016 via AV fistula graft in upper right arm. In February, my father fell, broke his clavicle. He was in a rehab facility during his recovery. He started struggling with confusion, nausea (during and after dialysis), extreme cramping even hours to next day after dialysis and overall weakness. We discovered at that time that the dialysis center was continuously decreasing his dry weight to remove edema in his feet. They were trying to get him to 98 kilos (which is where he was in the fall) and after a Z-scan they discovered he was actually at 100k. They decided he was actually dehydrated and the problems got better and pretty much went away after they adjusted for the higher dry weight. My dad is generally what you would call the ideal dialysis patient. His facility sends home monthly reports of protein and calcium levels and such. Other than being low in protein, his numbers that are monitored are right in the middle the target zone. He says the nurses set him up and leave him alone because he doesn’t present any problems during treatment. We don’t know if this is normal or bad nursing. In the last 5-6 weeks the edema in his legs/feet has increased and the nausea has returned. The nausea is in the form of dry heaves, generally no stomach fluid and happen within 8 hours of dialysis. He has told me that he’s felt nauseated during dialysis and told the nurses he was cramping so they would adjust the machine. He said telling them about cramping got more attention than feeling sick. My family spoke to this doctor yesterday. His dialysis doctor keeps trying to decrease his dry weight to get the fluid out of his feet but it brings on the nausea. Her only response was we have to get the water out of his feet and that being on dialysis only offers poor quality of life and this was as good as he was going to get. We tried talking to his general doctor, she refers us back to the dialysis doctor. We tried talking to the nephrologist he used to see prior to dialysis and they refer us back to the dialysis doctor. We are considering taking him to a different facility, but are we just jumping from one hot pan to another? We have no idea who else to speak to or who to ask for help. No one will talk to us and the current dialysis doctor is not helping at all. Thus this email. Today he had an EKG, chest x-ray and carotid artery ultrasound done so see if there are other problems. My dad really struggled with dialysis in the beginning as it was an emergency start. But he finally settled into a routine and generally did well. He would be tired and sleep for about 1 hour afterwards and then perk up and be fine in between treatments. Since this trouble with dehydration, edema and nausea started since February, he can’t even walk out of treatment (needs a wheelchair) and can barely function between treatments. We know dialysis is an extremely hard way of living. We know that our dad is 79 years old and that adds its own set of complications. But is it really a disease that you just barely exist until your next treatment? Are we in a bad facility and need to move or is this just the way it is? Or is dialysis really just a disease that is like putting a band-aide on a severed leg? I know you can’t really answer some of these questions but how can we get help?

In some cases, it is necessary to be persistent. You and your family have the right to attend a multidisciplinary conference that is held about your father once per month at the dialysis facility. I suggest that you contact the … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

I am currently receiving dialysis treatment at a clinic but want to begin home peritoneal dialysis for all the obvious reasons. Five years ago, I had a kidney removed with laparoscopic surgery and I have no scar tissue complications. Could I pursue peritoneal dialysis?

Peritoneal dialysis is always a good option if your abdomen contains no scar tissue. In most cases, the only way to know if you are a candidate is to agree to have a peritoneal dialysis catheter placed for dialysis and … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Nephrologist

My dad is a stage 5 CKD patient. He is 60 years old and has been on dialysis since Feb’18. We got his monthly tests done and found that his creatinine is 7.44 and his BUN is 28. Though he is on hemodyliasis, is this something to worry about? His hemoglobin has increased from previous months to 9.6. He is been prescribed Renemia 10000 injection once a week along with Orofer 100mg and Polybian at the same frequency. He is lately complaining of fever and lose of motion often. He was hospitalized due to pleural effusion. Is this something with regards to the medicines he has been taking or is it because of the increase in BUN and creatinine or something else? Please advise. Thanks.

I am unable to make a specific diagnosis based on the information that you present. The laboratory findings that you describe are relatively normal for someone on dialysis. If he has fluid in his lungs (pleural effusion), then he may … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Nephrologist

Dear Dr. Spry: I understand that the DASH diet is recommended for those with kidney disease. However, I’m perplexed by the recommendation in the DASH diet that people consume up to 6 servings of meats, poultry, and fish per day (see https://www.nhlbi.nih.gov/health-topics/dash-eating-plan), as my understanding from the scientific literature is that daily protein consumption (particularly from animal sources) should be limited to no more than 0.5 g/kg of body weight, for people with kidney disease. Under the DASH diet, 6 daily servings (even small servings) of animal-source protein would greatly exceed the quota, would it not? (See, for example, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406621/). Thank you.

I do not recommend very low protein diets for patients with chronic kidney disease (CKD). In the largest prospective controlled trial of low protein diets in patients with moderate to severe CKD, the study did not show a benefit and … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Diet/Nutrition, GFR, Hypertension/High Blood Pressure, Kidney Stones, Kidney-Related Health Questions

Hi, my aunt has stage 5 kidney failure and she is also mentally disabled. Is their a way that she can be helped? She is denying dialysis because of her mental state. Is their anything me and the family can do to help her? I am so lost right now doctor, I don’t want to loose my aunt.

Despite your aunt’s mental illness, she is still able to refuse anything that is done to her that may hurt her. In order to do dialysis, we need what we call “active consent”. That means that she must let us … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions

Dear Sir, My father has a kidney problem as shown on his test last month 3/20/2018. On the day food, swelling happen that day. His results on all test read, creatinine 4.50 and after two weeks it read 6.50 and after another two weeks ( I mean today taken) it read 7.60. He is maintaining a diet but his creatinine level does not reduce. So please advise me and my family as we are worried about my father. One doctor said he should go on dialysis. Any other alternative option to reduce or cure disease?

It sounds like your father has rapidly advancing kidney disease. I am unable to make any other specific diagnosis based on the information that you present. I recommend that you consult with the nephrologists in your country and ask for … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist