Category Archives: End of Life Issues

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

My brother is a kidney patient and doesn’t want to have dialysis. Three days after discharge from the hospital, we observed that he keeps on smiling and talking alone. We don’t know what to do for him. He really doesn’t want dialysis when he is in normal condition.

If your brother is competent and able to make his own decisions, then it is his right to refuse care such as refusing dialysis.  I think you will have to talk with your brother and his physician.  If they both … Continue reading

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

How long can a person who is not a dialysis candidate survive with an eGFR of 7?

I am unable to provide a prognosis without performing a complete history and physical examination.  An estimated glomerular filtration rate (eGFR) of 7 milliliters per minute per 1.73 meters squared is a very low level of kidney function.  I suggest … Continue reading

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

How long can a person with end stage renal failure, survive without dialysis? I’ve been on dialysis twice for a year each time.

I am unable to provide a prognosis without performing a complete history and physical examination.  I would need to know more about your kidney disease and why you are on dialysis.  If you actually have end stage kidney disease (ESRD) … Continue reading

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

My Mother has ESRD and she does not want to have a kidney transplant or dialysis because it’s too expensive. Is there any medications that can help or is dialysis her only hope?

Dialysis, either peritoneal dialysis or hemodialysis, is the only way to treat people with kidney failure.  There are no medications that will treat and reverse kidney failure.  In some cases, your mother may be requesting to live as long as … Continue reading

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

I have 100% antibodies and apparently it’s very hard for them to find a kidney that matches me exactly. I am on dialysis and I no longer want to go but if I don’t I will likely die. So can you tell me what other options I have?

I suggest that you discuss your options with your nephrologist and see what might work for you.  In general, your options are to wait on the transplant list and hope for a kidney.  It is true that if you have … Continue reading

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

My brother-in-law has kidney disease with renal function of 7 percent. He is hesitant about starting dialysis. Can a patient do a trial dialysis in the United States to see if it will help him and stop if it doesn’t work for him. I am very concerned that he seems to be deteriorating quickly. He lives in Texas and is 67 years old with insulin-dependent diabetes. Please let me know what you would recommend. Thank you.

Yes, a person can try dialysis and if it does not suit him, he may elect to stop.  The decision to start dialysis is one that is made between a nephrologist and the patient.  He can choose to do dialysis … Continue reading

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

My mom will be 78 in December if she makes it to her birthday. I spent that last two weeks at home with her in NY after a one week hospitalization after serious stomach pain-she was unable to get out of her chair. She has ESRD on 3x/week hemodialysis, congestive heart failure (with pacemaker for a-fib), diabetes and now indications of cirrhosis and ascites. At the hospital they took of 7L (16#) of fluid. The second paracentesis on 14 October, 3.5L was drained. She tends to have very low blood pressure. Both her hospital care team and now her PCP have said she likely has 6 months to a year to live. They have not said why this is (honestly, I didn’t ask, I assumed her system is simply wearing out ?) What is her death likely to be like? We have DNR, DNI and health proxies now documented for her but she asked me the question and I didn’t know how to answer. I know if she gets too tired she can just stop dialysis, but how long would she live if she did that? Will her heart, her kidneys or liver be what kills her? I hate to see her suffering. Her life has been so difficult. She is a devout Catholic, I doubt she would choose suicide, but she already sees herself as a burden to others. I am a social worker (mental health, I treat vets with PTSD) and have worked mental health/chemical dependency for many years with the Air Force, but I’m out of my element with this. And she’s my mom. The best I’ve been able to do for her is be with her and help her make decisions about funeral, burial, etc. What else should my siblings and I be sure to consider?

You and your family are going through a very difficult time and you may need professional help.  The best advice I can give you is to sit and listen to your mother’s wishes.  She will cherish your interest and this … Continue reading

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

I am now in stage 5 with a GFR of 10. Have dropped 3 for the last 2 months. I have made the decision not to do dialysis. As I also have a heart condition. Would like to know what to expect next and how long till things shut down. Nobody seems to be able or wish to tell me what happens next. Just want to know what to plan for.

I don’t believe there is any way to know the answer to your question.  Your nephrologist will likely tell you that you should live as long as you can and as well as you can.  When someone decides not to … Continue reading

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

When a nurse says the gfr is trending down, does it usually continue to go in this direction? I’m wondering how much approximate time my brother has left before he is on dialysis which he says he will not do. His GFR is 22, creatinine 2.2, and bun 45. He is a type 2 diabetic and very overweight. He’s only 55 years old but will not do dialysis so I’m wondering what the rate of decline may be? He does not always follow the kidney diet as much as I beg him too. Just need to know what is ahead? His GFR has dropped 12 points in the last 10 months or so. I am also taking care of my sick and elderly mom. I’m looking for approximations. I know everybody is different. Just trying to manage their lives as best as I can for the time they have left?

Natural aging results in a loss of kidney function of about 1% per year.  In patients with chronic kidney disease (CKD) from diabetes, this loss can range from 1% to 10% or more per year.  There is really no way … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, End of Life Issues, GFR, Hypertension/High Blood Pressure, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments