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Kidney Disease
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CKD 3A

Is dialysis inevitable?

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HI Brody,

Good question and I am sure you will get a lot of response to this question. The answer is yes and no. It all depends on the situation. For example, if your CKD is caused by diabetes, and you get that under control by losing weight and eating better....there is a chance you can stay at a 3 level for a very long time and remain in remission so to speak ... and die of something else. But isn't that life in general?

This is what one journal article said: "In contrast to the traditional paradigm of steady GFR progression over time, many CKD patients have a non-linear GFR trajectory or a prolonged period of nonprogression. These findings highlight the possibility that stable kidney disease progression can accelerate, and, conversely provide hope that CKD need not be relentlessly progressive. These results should encourage researchers to identify time-dependent factors associated with periods of nonprogression and other desirable trajectories." ncbi.nlm.nih.gov/pmc/articl...

On other words, there are findings saying that with improved lifestyle and health care, patients are going longer without dialysis.

There is a lot of work being done now in kidney regeneration. A lot of the health of the kidney depends on the type of damage. There are new studies working with stem cells repairing the damage. hsci.harvard.edu/kidney-rep...

But the short answer is, yes, dialysis is inevitable for most CKD patients. But I think that they are finding more and more ways to improve patient's care with targeted treatment to slow the decline. Personally, I hope so.

ncbi.nlm.nih.gov/pmc/articl...

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I have stage 3, I got 2nd opinion and she said I’m good for 20 yrs, my GFR goes up And down between 46 and 53.

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Hi, Jenkea. I would do a lot more than rely on one doctor's opinion and two decade estimate. Also, your GFR is sometimes very close to Stage 3B (less than 45) which is where you can really start to slide downhill to Stage 4. The most important thing is to educate yourself. Read my reply to Brody below.

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My personal belief is that dialysis is not inevitable. Through diet and hydration (doing all the things they tell you to do when you reach stages 4 & 5), I was able to raise my egfr and lower my creatinine. Many others have also done this.

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I know with Polycystic kidney disease, not everyone will progress to dialysis. Some do, some don’t. I would assume it’s the same for other types of this disease. I also know, you can slow it down. I’ve done it. Hope this helps you. Prayers for you. With God all things are possible 😀

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Hi, Brody. It all depends on you and your age. If you are 60 and really put in the work, I would say no. If you are 20 and don't watch what you eat, then I would say yes.

A brand new book came out in January of 2019 which is called Stopping Kidney Disease by Lee Hull available on Amazon. The whole book is about your question. It is the most detailed, up to date, comprehensive book on CKD right now. Everything is backed up by medical studies which are included in the book - you can skim or skip those. I would strongly urge you to buy the book; I did. Good luck.

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I’m 73 Beckett..does that make a difference?

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Hi, Brody. I think it does make a difference. Without sounding morbid, a 30 or even 40 year old with Stage 3 or 4 CKD is in a lot worse trouble than a 73 year old. With those youngsters, it's very hard to stop CKD progression for another 50 or 40 years (assuming a minimum 80 year life-span). At age 73, there might not be enough time for you to reach Dialysis with your remaining lifespan - again not trying to sound morbid. My point is that, in my opinion, it's a lot better to get CKD in the latter stages of life, because Old Age will probably get you first. If you don't mind me asking, what is your CKD stage? I am 60 at stage 3B with last GFR of 44.

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Hi Beckett my GFR is 55 and my Creatinine is within acceptable limits.Im Canadian it’s neasured at 114

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Hi, Brody. You are almost at stage 2 CKD (60-89) with a GFR of 55. You should easily be able to get it above 60 with a super-healthy CKD diet (plant based is the best), exercise, drinking half of your body weight per day of water (in fluid ounces, not pounds LOL), proper weight management, reducing sodium to well under 1,500 mg per day, and getting plenty of sleep. Although your GFR will go down slightly as you age more, I personally feel that if you (you personally, Brody) put in the work, you will never be on Dialysis because there simply isn't enough time left in your lifespan for your CKD to progress that far if you take care of yourself.

Now, in my case I am nowhere near 100% sure as I am 60 years old. My wife and I started eating super-healthy on 2/1/19. She had her labs done on 3/20/19, about seven weeks later. Her last labs of about two years ago showed a creatinine of 0.91 and a GFR of 66. Her labs of 3/20/19 showed a creatinine of 0.79 and a GFR of 78. This is quite an improvement for only seven weeks of healthy eating. And similar to what Fezzik said in the Princess Bride, she doesn't even exercise. She is 67 years old.

As I previously wrote, my labs of 12/18 showed a creatinine of 1.66 and a GFR of 44. I am getting my labs done on 4/22/19 and hope to see an improvement. My ultimate goal is to be back above a GFR of 60 and to stay there.

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Hi Beckett..Very encouraging news you gave me..Thank you so much and so glad your wife has done so well after six weeks of conscientious dieting. I’m confident you will have Great results too.

As for the article my most optimistic take was that kidney FAILURE should be a misnomer.

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BTW.Are you able to convert.79!Creatinine level to Canadian standards..AS I said mine was 114

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Hi, Brody. Please see reply below.

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Hi, Brody. I'm not sure what my takeaway was from the article. I suppose it was that older people should be diagnosed differently than young people. But I think that would give older people a false sense of security. In my opinion, no matter your age if you have CKD you should do everything you can to fight it and educate yourself - don't be lax because you're older. The extra effort might net you another bunch of years being alive and away from dialysis.

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Btw .79 Creatinine level is what number by Canadian standards..Do you know?

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Hi, Brody. I just looked at my wife's lab results. The creatinine level units are mg/dL or milligrams per deciliter. From Google: "In Canada, Australia, and a few European countries, μmol/L is the usual unit. One mg/dL of creatinine is 88.4 μmol/L."

So... your creatinine was 114 micromol/L... 114/88.4 = 1.29 mg/dL. At DaVita's online GFR calculator (https://www.davita.com/tools/gfr-calculator), a USA creatinine level of 1.29 mg/dL, gender male, age 73, non-Black comes out to... 55 GFR ml/min/1.73m! This exactly matches what you were told.

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Thank you so much!

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You're welcome.

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Google the article called “For Older Adults:A Diagnosis Of CKD” by Paula Span in the New York Times dated Sept 14,2015.Very envouraging..Pass it on.

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HI, Brody. I just read the article. Two BIG things in my opinion are missing. 1. People with CKD are four times as likely to die from heart disease than people without CKD. (I read this recently, I don't remember exactly where - probably either from How Not to Die or Stopping Kidney Disease.) 2. There was really no mention of how a proper diet, controlling blood pressure and diabetes, proper weight management, and exercise can drastically improve your CKD status.

I suppose the big take away is: "The lifetime risk of kidney failure in the United States is 3.6 percent for whites and 8 percent for African-Americans, one widely cited study found." I had previously read that it was about five percent, generally speaking.

Good article, though. Thank you for the reference.

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