Category Archives: End of Life Issues

I am puzzled. I have exhibited symptoms of CKD and those symptoms have remained consistent at 2.0 for about a year now. I am frightened that my CKD may decline in the near future and I am fearful of having, in that event, to drive from my home at Lake Chapala in Mexico to nearby Guadalajara (about one hour each way) for treatment and At 76 years of age, am unwilling to go through that although I am told that death would be the alternative. No one ever elaborates on the potential suffering and declines experienced by those electing to die rather than go through the torture (as I define it) of onerous treatment on a machine several times a week. Tell me, please, keeping in mind that I am in my mid-70s and come from a family where men rarely live to that age, if I refuse treatment, what may I anticipate in terms of declining health and ultimate demise if I refuse treatment. I do not fear your response.

I am not able to provide a prognosis without performing a complete history and physical examination.  You have the right to make decisions about participating in dialysis treatments or merely leading your life as long as you can and as … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, End of Life Issues, GFR, Kidney Failure, Kidney-Related Health Questions, Medication and Kidney Function, Symptoms and Side Effects, Treatments

Hi. So there was a 70 male patient who was having dialysis. The patient was well before dialysis with bp 120/70. After 2 hours of dialysis he went into hypoglycemia but soon glucose level stabilized with IV ddextrose. However, he went into a deep sleep with loud snores. We tried to wake him up but unsuccessful. Even the doctors did not know what to do. The patient died in his sleep latter in the evening. But why did he go into such deep sleep? Was it due to hypoglycemia? Past medical history: diabetes mellitus.

I am unable to make a specific diagnosis based on the information that you present.  I can only suggest that you discuss your concerns with the physician who has cared for this person prior to his death.  Hypoglycemia is usually … Continue reading

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

I was diagnosed with end stage renal failure. After doing dialysis for only 3 months, I quit because my quality of life (money, lifestyle). It made me feel I would rather have 2 weeks of making memories for my friends. 2 months later I am more active then before the dialysis. Am I near the end of the road still?

I am not able to offer a prognosis without performing a complete history and physical examination.  Since you were on dialysis for only a short time, it is important for you to consult with a nephrologist who knows your history … Continue reading

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

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