Hello! My dad's kidney function is around 12% and has been for a couple months. He recently had fistula surgery so he'll be ready for dialysis after it fully heals. He'll be 86 next month and I'm concerned about the emotional and physical toll HD will have on him. I've been reading some articles that suggest waiting until kidney function is 10, 8 or even 6 might be okay as long as there are no major symptoms. It seems other countries adhere to this, but it goes against most US convention.
Do any of you out there have a GFR below 15 and are NOT on dialysis? How are you managing? We're tying to balance longevity with quality of life. He's still relatively healthy (bikes, walks, goes to his local fitness center) and would like to be alive and active as long as possible. Thank you!
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JDsDaughter
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I am in the same boat as your dad. I am not as old. I feel the same way. I am very active, and I will wait until the last possible chance to start dialysis. I am going for a fistula conference at the end of the month of February to prepare. I am currently at 13 , creatinine below 4. I have been pretty steady for the last years. My nephrologist knows that this decision is mine to make based on how I feel and even she agrees I am not there yet. I won't be surprised if I go as low as 8 before I start. I was against getting the fistual but it takes a while to heal and so.... I said OK.
It's nice that your doctor agrees with you. My dad's doctor is very by-the-book and I feel he should be taking a more individualized approach. Good luck to you!
The thing is this...how fast has your father's decline been? Mine has been extremely slow like a point or two a year over five years. If his decline is faster, say he is dropping GFR point every lab, then sooner might be better for him. Your father does not want to end up with an emergency catheter placed in the chest for dialysis and this can and does happen.
I am a lot younger than your dad but his fitness levels put me to shame 🤣🤣.I started haemodialysis in May. I was determined not to have dialysis. My GFR was at 12% for a while, then i got Covid and it went down to 9%. I still felt fine and still work. My consultant tried to convince me to start dialysis but I still felt fine. However one day I woke up znd just felt awful. No energy and just feeling "blah". I had an appointment scheduled later that day with my consultant. I went in and just said..put me on dialysis. Your dad will know when its time. Its been a roller coaster ride the last few months. One step forward and two back. Its only now I feel OK. The biggest issues for me, was the time commitment. Between working and dialysis I feel I have no spare time. Also just trying to get the right mental attitude for dialysis has been difficult. However its not the worse thing in the world. I have met some lovely people (you don't realise how attached you become to them). Plus its nice having people around you, who are going through the same thing and understand some of the issues you are dealing with. This was a bonus I hadn't thought of. I hope your dad stays healthy for a long time without dialysis. Dont go by percentages, it how your dad feels. Believe me, he will know when the time is right. Wishing you both all the best. By the way I am in Scotland, so im not sure if protocol will be different from where you live.
It's good that you've reached out to this community. My hubby has gone through kidney disease, through dialysis, and now has a transplant which he received at age 71. Your dad is living a quality life, and that is exceptionally important. Before my hubby went on dialysis, he had a lot of digestive issues, had significant swelling in his feet, spent a great deal of time in the bathroom, roamed the house at night, stopped taking walks, and more. But the thing that put him into dialysis was sudden, soaring blood pressure. Only dialysis could bring it down. My personal suggestion is that I would do nothing unless a life threatening situation develops - his blood pressure becomes worrisome, swelling is unmanageable, and so on. I know of two individuals, a 97 year old and another who reached 100. Both had kidney function in the low single digits and both passed away from other causes. One passed in her sleep from dementia and the other also passed away in bed from a heart stoppage - she refused to change the battery in her pacemaker. They lived good, full lives. So, in my opinion, there's nothing to do until there's a clear need to do so. It's good that your father has had fistula surgery - he can be hooked up for dialysis when/if that time comes. This avoids the need for an emergency hospitalization to arrange an access. Well done! In my view, just keep an eye on him and let him enjoy life. You (and he) will know what it's time, if ever, for dialysis.
My 71 y/o husband was very ill, weak with no energy prior to PD dialysis. Started June 2021. Your Dad seems very active and I agree with others he will know.
However, my question is was he given the PD at home option? It changed our lives and my husband was a new man. He since has lost his sight so other issues changed his life.
Thanks for your response. I'm glad your husband did so well on PD. Unfortunately, that's not an option for my dad. He has a stoma in his abdomen from having his bladder removed 5 years ago. There's enough going on in that area already!
I started dialysis at around 6-8 eGFR, 21 years ago. I could be a little off but not by much. Happy I waited but I was 43 at the time.Thanks for supporting your Dad! Blessings
Adding my 2 cents worth. My eGFR was 5.8 last summer when i had PD catheter placement. My creatinine was close to 10, so the doc said it was "time" even though I still felt fine. Well between delays with issues with manual PD and then hernia repair surgery, I just started PD last week, 6 months after I was supposed to. I have no idea what my eGFR is since they don't measure that once you get signed on at the dialysis center here. But I still felt fine before starting PD. I'm supposed to do a 48 hour urine collection early next month so hopefully I'll find out how my natural kidneys are doing with that. So that's my experience to add in with others.
Hi. I'm 67 and my gfr ranges about 12-14, and my creatin is just under 4. i still feel pretty good and try to walk every day. each visit my nephrologist says i will probably need to start dialysis before my next visit in 4 months. And at the next visit she says we can wait another 2-4 months and see how i'm doing. i am really trying to eat better and excersizing so i can put it off as long as i can.
The transplant nephrologist told me she knew a lady who was 82 with a gfr of 8 and was still playing tennis!
I got my graft inserted when my GFR was 10 but waited until my GFR was 8 to start dialysis. I watched what I ate very closely it helped to keep me from retaining fluid. I finally gave in because I had started to really feel bad at that point and had zero energy.
I had the experience of emergency dialysis because of a drug interaction that shut my kidney down. I was lucky and a month and half I was able to get off. It damaged my kidneys and that was 10 years ago and my kidneys have slowly gotten to the point where this will be my question soon. One thing PD can be put in almost any where. My husbands is between his breasts out of the way of belts. It is so much easier on his body than the other and not hard to do. But if he cant do that if he is pressed to do anything get the catheter put in then wait tell be feels he needs to go on dialysis tell he feels he needs it. Don't just start is because he has it put in the manger of the dialysis clinic we go to Mother did this and it was a couple of years before she ended up really go on. Any kind is hard but in clinic is harder because it has so many dangers and way to many needles for me. I hope he has a long happy life and never has to find out how it works. Creatin level is important because it is how dirty the blood it thus the sicker you can feel.
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