Category Archives: Dialysis

A nephrologist says a person with a high risk of bleeding can’t have dialysis because they will bleed to death. Bleeding complications that leads to death. No treatment can stop it. In this case what does the CKD patient do?

I am unable to offer a specific diagnosis based on the information that you present.  I suggest that you ask the nephrologist for clarification as to why the bleeding is occurring and why dialysis is not an option.  

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Treatments

Does dialysis warrant daily narcotic use? I am concerned for a dialysis patient that takes a minimum of 6 10mg hydrocodone and 400MG neurontin daily. ESRD, no other current medical issues.

Daily use of potent narcotics in patients who are on dialysis is not usually warranted.  I am unable to make any other specific diagnosis based on the information that you present.  I suggest that the dialysis patient make sure that … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Medication and Kidney Function, Nephrologist, Treatments

An 83 male diabetic on hemodialysis for 7 yrs wants to discontinue treatment for reasons other than medical. No family, no income, cannot do without support. He cannot stand up on his own due to balance problems. Wants to discontinue HD. Can expect to stay alive for how long after stopping HD? Do not want suffering. Can you advise?

If someone stops dialysis after being on dialysis for seven years, it is unlikely that he will live for very long.  In most studies, patients who stop dialysis after being dependent on dialysis for 7 years will die within two … Continue reading

Posted in Ask the Doctor, Dialysis, End of Life Issues, Kidney Failure, Kidney-Related Health Questions

What happens to CKD patients who can’t have dialysis or a kidney transplant because of a high risk of bleeding during surgery? What do they do?

I do not understand the bleeding problem.  In most cases, bleeding can be controlled with treatment.  In some cases, major surgery, such as transplant surgery may not be possible, but dialysis should still be possible.  I suggest you ask for … Continue reading

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

My daddy is 74 yrs. old and almost almost 300 pounds. He has diabetes Type 2, COPD, congestive heart failure and has recently had pneumonia which caused a ton of fluid on his lungs. The Lasix used to help with the fluid is causing kidney failure. Is dialysis reasonable for a quality life?

The decision to start dialysis must be made by your father and a nephrologist based on the his ability to tolerate the treatment and the goals for treatment.  Your father should discuss his desires and wishes with his nephrologist and … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Nephrologist, Treatments

There are 2 nephrologists in this area. They have a tendency to not take selected patients that need dialysis. Patients that go without dialysis would not survive. IS THAT LEGAL? These doctors are the only nephrologists in town.

A physician can chose to treat or not treat a patient depending on the services they have available.  You may have to consult with a nephrologist outside of the immediate area to get care that is not provided in your … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Treatments

Hello Dr. I am writing to you for my father who is 86 years old. He is diabetic and has a pacemaker implant. Last year, his hemoglobin fell to 8 which was due to bleeding ulcers in the stomach caused due to the blood thinning medicine. However that was brought under control. Over the last 3 months his creatinine has gone up from 2.1 to 4.3, The doctor has suggested that we should now think of a dialysis. I would be greatly thankful if you could advise if a dialysis is required at these creatinine levels with his condition? Thank you and best regards.

I am unable to recommend medical treatment without performing a complete history and physical examination.  Your father has very low kidney function and you should consult with his nephrologist as to the best course of action.  Dialysis in someone who … Continue reading

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

I am in Stage 4 CKD – most recent GFR was 20. I am interested in peritoneal dialysis when it gets to that stage. I understand the peritoneal surgical implant needs to heal for 3-4 weeks before use. Is there a medical necessity criterion for the surgery in anticipation of dialysis? I would like to get the surgery done so that I will be ready when/if the GFR drops to 15. My GFR has dropped from the high 30’s to 20 since January.

This is a discussion you should have with your nephrologist.  Catheters can be placed well before starting dialysis and can be left in place until needed.  In some cases, the catheter can even be buried below the skin and then … Continue reading

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

My husband is on Dialysis three times a week , his platelets , for the last month have been dropping and are now at 32000. Can the dialysis cause his platelets to drop?

A decrease in the blood platelet count can be a finding in some patients on chronic maintenance hemodialysis.  Normal counts are between 150,000 and 400,000 (generally).  A platelet count of 32,000 would be very unusual in my experience.  Further testing … Continue reading

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

My daughter has been on dialysis for nearly 17 years with several different complications. She is 35. We never thought she could get pregnant. That seems the possibility now. I can’t find any data on that for her time in ESRD. I’m in shock. What are her chances of survival? The baby’s?

The chances of successful pregnancy for a patient on chronic hemodialysis treatments is very poor.  Successful pregnancy has been reported but dialysis treatments must be increased.  Dialysis treatment times may have to be increased to more the 30 hours per … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist, Pregnancy / Kids, Symptoms and Side Effects, Treatments