When will I need it?

[kidneyqueen]

How will I know when or if I need dialysis treatment? Yesterday I was just informed by my kidney doctor that my kidney function is at 20 percent. Is there any way to predict if or when that time will come...for dialysis?

[Bassetmommer NKF Ambassador]

Great question. I too just found out that I am going to need dialysis in the near future. My Gfr is 23. I am wondering what is the best ways to slow the decline if any.

[KelliC_NKF in reply to Bassetmommer]

Best ways to slow the decline are to treat the underlying cause (for example if the cause is diabetes make sure your blood sugars are under control, if the cause is high blood pressure, make sure your blood pressure is within normal range). Diet can also help (low salt, low protein, avoid processed/frozen foods): kidney.org/nutrition/Kidney.... Also many doctors recommend the DASH diet: kidney.org/atoz/content/Das...

[Bassetmommer NKF Ambassador in reply to KelliC_NKF]

thank you

[KelliC_NKF]

Great question. Although it's hard to answer because everyone's different and there isn't an exact timeline that everyone follows. Your doctor may be able to give you a sense of a timeline based on how your kidney function (GFR) has declined so far, the cause of your kidney disease and your overall health.

Generally, your doctor will regularly check your GFR (typically more frequently as GFR declines) and also monitor your symptoms (if any): kidney.org/atoz/content/abo....

While you can't start dialysis until your GFR is below 15, many doctors will work with you to make a plan to start. Some people will start dialysis when their GFR is 12 and others when it's 8; this largely depends on how you feel overall and your doctors assessment.

With a GFR of 20 it's a great time to be evaluated for a transplant if you have not started the process already.

[kidneyqueen in reply to KelliC_NKF]

Thanks very much for this info. I sure had no idea of what to "do" next, if anything. I just met this nice doctor yesterday, and we clicked right away, so I look forward to visiting her, and have until August to wait...she's not changing my medications for blood pressure and that's a positive sign for me, I think. I also have thyroid cancer, so am just in the beginning stages of treatment for that, so she thinks I should handle all of that first before I get very concerned about what's going on with the kidney issue. Once again, thanks for the advice!

[TaffyTwoshoes27 in reply to kidneyqueen]

Doctor? Or Nephrologist? There are many drugs and procedures that will put undue stress on your kidneys and a lot of doctors are not very knowledgeable about those issues like a nephrologist is.

It is not true that you CANNOT start dialysis until your GFR is 15 (we all know the GFR is subjective and goes up and down anyway). NHowever, Medicare will not pay for dialysis treatment until the GFR is at least 15. Consult with someone (nephrologist, health insurance agent, whatever) to find out when your health insurance will start paying for dialysis. Your Nephrologist should know by your blood analysis and symptoms when you are ready for dialysis.

Have you decided what dialysis modality you will use? Keep in mind that whether you choose Hemodyalysis or PD (only if your Nephrologist approves you for PD), there will be a couple months or more of preparation (surgery for a fistula or PD catheter) before dialysis can start because of healing time.

Good luck with your journey. I agree with one responder: start researching transplant centers, evaluations, and get on the Transplant List. Start talking to friends/family/etc. about your need for a kidney transplant. You do not have to be on dialysis to start the process with your chosen Transplant Hospital to get evaluated and accepted for transplant.

[kidneyqueen in reply to TaffyTwoshoes27]

Thanks for this info..it's really helpful!