CKD stage 5 or ESRD with a coronary artery stent 20 years ago , creatinine at 5 and egfr at 9 and 67 years old is dialysis good or bad forme

[CKD5]

creatinine:5

Egfr : 9

Sodium : 125/meq/l

Potassium : 3.7 /mmol/L

[Sapphire187]

I am 66 years old and have ESRD with a GFR of 13. I don’t know anything about coronary artery stents, but you are at a point where it will require either dialysis or a transplant. Dialysis is hard on the body no matter who you are. I’m not on dialysis yet so don’t have experience with it. From what I’ve read Peritoneal Dialysis is easier on the body than hemodialysis. If you can do that, it may be a better option for you until you can get a transplant. I would speak to your nephrologist about which modality would be best for your circumstances. Good luck to you.

[Darlenia]

My heart goes out to you, CKD5. My husband, a diabetic, and close to 70 years old at the time, also faced that cross roads. He reviewed his options and chose dialysis. While on dialysis, he received a heart stent, got on the transplant list, and received his gift at age 71. (Yes, you can receive a transplant if your heart is stable.) He's leading a wonderful life right now - at nearly 75. The process wasn't easy but exceptionally worth it.

The route you wish to take is truly yours to make. You are captain of your own boat. Some chose to do nothing at all - particularly if they have a number of other heath issues. Others go on dialysis and use dialysis as a short-term measure to a transplant. Others proactively manage to get on the transplant before their kidneys collapse and receive a "preemptive transplant" and skip dialysis all together. (We were too late for that.) And then there are others that stay on dialysis for life. The thing I'd really like to emphasize is that seniors in most western countries can indeed seek a transplant - a transplant is widely regarded as the best option for improving quality and length of life. So the choice to investigate this likely also lays in your hands.

If your choice involves dialysis, you'll want to review the advantages and disadvantages of both forms - hemodialysis and peritoneal. Hemodialysis requires direct access to blood vessels (almost always involving needles) and can be done at a clinic or at home. Peritoneal is always done at home with a catheter and solution in lower abdomen to cleanse the body of toxins. My husband crashed into hemodialysis (eGFR 6, Creatinine 8, BUN 114), the only way to lower his extremely high blood pressure. He then quickly switched to peritoneal dialysis. His transplant center wanted to keep his blood vessels from calcifying (a problem for diabetics) for transplantation. Please note that it's good to get your access (usually a fistula or catheter) in place sooner than later to "mature" to avoid emergency dialysis like my husband endured. If you do it right, one can do everything without overnight stays.

This helpful link explains the different forms of options available to you as well as dialysis choices. They all have plusses and minuses. If you choose to go with dialysis, it also provides a nice questionnaire and a recommendation for the type best suited to your particular interests. See mykidneylifeplan.org/#erye-... Naturally, this also would be a good time to start a discussion regarding availability and expectations with your loved ones and doctors.

I'd like to note that we're so glad you're here. This community is filled with wonderful people who will surround you with compassion and support. Some will be where you are right now, others have already moved ahead of you. We're here to lift you up and inform you about our personal experiences and thereby help you over the ruts in the road, lighten your load, and brighten your day. Check back with us anytime.

[ShyeLoverDoctor]

Dialysis is life support plain and simple. You are near a point where your choices are dialysis, a transplant, or death. Stage 5 is known as End Stage and is considered a fatal condition. Transplant is also a treatment. It is not a cure.

Many doctors put their patients on dialysis at GFR 10.

If you get a peritoneal catheter, it takes 1 month to heal. A fistula takes 3 months to mature. If neither of these are ready to be used when death draws near, they insert a central line catheter and perform hemodialysis. This catheter goes right to your heart. You get an infection, it can kill you. It makes it hard to shower with. If you get it went that can lead to infection. Doctors and dialysis centers will push you hard to either get a fistuala or a PD catheter. That is because they don’t want you to get that infection and die. You also don’t get as good filtering that way, as I understand it. Feel free to “do your own research” as they say.

“He’ll really like you. Nephrologists love a patient with a fistula!” Quote from my nephrologist of 13 years as he was transferring me to another doctor when it was time to start dialysis.

Up until the consult with the surgeon, the night before, I was set on a PD catheter.I didn’t want an ugly fistula getting lumpy on my arm. They can get to looking pretty ugly. However i realized I did not want to have worry about infection from not keeping a PD catheter sterile. Those are painful. I got my fistula and never looked back. Absolutely no regrets.

A PD catheter lets you keep some of your native kidney function a bit longer. That may be one reason to go that way. Most people on PD feel better and have more energy. But you need a lot of space for the supplies at home, you have to keep one room sterile, no pets in the room and don’t sit under an AC blowing vent when the PD has its cap off.

Every single person who does PD will eventually have to go to hemodialysis, Your peritoneal membrane wears out. That can take years and years to happen.

[Darlenia in reply to ShyeLoverDoctor]

Not all PD patients go on HD. Careful infection control, optimal catheter placement internally, your weight, and more are things that matter. (PD should always be painless, If not, it's a signal to seek prompt modifications.) I know of some who have been on PD for well over fifteen years - one recently received a transplant and the other is in her seventies, living alone, and doing very well.

[ShyeLoverDoctor in reply to Darlenia]

1. I was told this by a dialysis nurse.

2. You are not a doctor (are you?). I am not a doctor. I am seeing my nephrologist on Friday and will report back what he said.

[Darlenia in reply to ShyeLoverDoctor]

Trust me...not all PD patients "will eventually 'have to' go to hemodialysis". Yes, some will, but not all. I hope you'll use that same language when asking your neph. I wonder if your nephrologist has privileges at a dialysis clinic that does PD? Ask him if he does. Not all nephrologist do...hence the encouragement for HD. Simply curious here...

[ShyeLoverDoctor in reply to Darlenia]

It also depends on how long you live. I was assured by a dialysis nurse that the peritoneal membrane does wear out, eventually. Faster of course for people who get repeated infections.

I was on dialysis before my transplant so I know my nephrologist rounds at a clinic that does PD. They had a PD machine in the lobby in an effort to recruit patients and a door that said “PD Treatment Room.”

As far as my using the language you hope for with my nephrologist, I can assure you that my father was a physician and I am well-versed in medical terms. I have been mistaken for a nurse twice, and I am often asked “Are you in the field?” by healthcare workers because of how I talk and how much I know.

No, I am not a doctor.

I do not believe I give any medical “advice” to anyone on these forums, I just provide information I believe to be true, some gained from personal experience, some learned from legitimate webites, and suggest they look for information as well or ask their doctors.

I do not advocate doing something their doctor did or did not advise, but I encourage people to ask for an explanation. Again, I am not a doctor. But, doctors also make mistakes. Doctors are also misinformed.