when to start dialysis

[Oceanviewed]

My GFR just hit 15 and my nephrologist says I can start PD dialysis as soon as I want and it may improve the way I feel. Seems like a huge decision to make as I dont think I feel that bad but who knows. How did people decide when to start dialysis and do you feel better now that you are doing it. Would appreciate any advice and sharing. I am 82 years old so transplant is not in my future.

[RonZone]

Hi, I waited until my eGFR was 6 before starting dialysis. I actually still felt ok, no real symptoms other than fatigue. It took me 6 months to work through all the kinks of getting started including having hernia surgery and all, but I finally got started on PD this past January. It took a while to get used to the cycler and all that you have to do, but now it's just part of every day "normal" life. I didn't think I felt that bad before starting PD, but now I know I feel a lot better. I have more energy than I did the three years before starting PD. I also probably will not look at transplant as a treatment. I'll just ride the PD train as far as it goes. It's not a permanent solution since the Peritoneum lining stops working after a few years, but it's the best choice for me I think. I do PD at night then have the full day to do what ever I want for the most part. And my diet is not as limited as it was pre-dialysis as long as I take my phosphorus binders with each meal and snack. So I'm a happy camper. Now PD isn't for everyone depending on previous surgeries and all that, so check with your Neph to see if you are a candidate. If not, Home Hemo would be the next best option, which is also very doable. Make an appt to speak with the social worker at your dialysis clinic of choice to go over all the options. Also there's a book called "Help, I need Dialysis" on Amazon that explains all the different dialysis options in great detail, more than what your Neph will tell you. It's recommended a lot on this forum. But feel free to ask ANY question and see if folks on here can help answer them. Some are going to be specific to your situation which folks might not be totally familiar with, so you will need to depend on your dialysis team to answer some of those. But if you do decide on PD, welcome to the club! It's very doable!

[Oceanviewed in reply to RonZone]

Thanks Ron that info was helpful. I will definitely get the book as I believe the more info one can get the better. Good luck on your journey

[RonZone in reply to Oceanviewed]

Yeah, more info is better! Good luck on your journey as well! Keep me posted on how you're doing.

[JDsDaughter]

Hello! My 86-year old dad has a GFR of 9 and has not yet started dialysis. He still feels pretty good, although certainly a bit more tired these days. He walks two miles a day, has a good appetite, sleeps well, and is not retaining fluids. Because of all this, his doctor has taken a more conservative approach as far as when to start dialysis, which we appreciate. He's not a candidate for PD due to previous abdominal surgery, but his fistula is in place so he's ready for HD when the time comes, should he choose to do so. If you dig around on this site, you may find similar topics of discussion you might find helpful. Good luck!

[Oceanviewed]

Glad your dad is doing so well. Its been a long time since I could walk two miles and i miss being able to do that. Hope he keeps it up.

[bumblebee_tuna]

Here are my 2 cents. PD does a pretty good job at keeping your residual kidney function. If I would do it again, I think I would start the PD process earlier, above 10 eGFR. It reduces the chances of urgent start and lets you get use to the process. You don't have to do a full prescription to begin with - maybe just a few ours of manual exchange with a couple of days off. And then gradually increase the prescription as eGFR goes down. Here is an article regarding incremental PD:

journals.lww.com/kidney360/...

[Oceanviewed in reply to bumblebee_tuna]

Thanks for the article. Basically you are saying the same thing my doctor is saying. Am thinking I should listen to you both. Thank you

[Beachgirl32]

Welcome . It depends how you are feeling when my efgr was 15 I was still feeling good. For me it was when I did notice after my mile walk I would get tired and have to rest after . But I still thought I felt ok but doctor said it was time before toxin started taking over I went on dialysis at 8 percent .I just been since February I admit it hasn’t been an easy road as I would like . I’m on pd dialysis it took awhile to get it where it should be even went in hospital cause I wasn’t getting enough dialysis so it important to always tell your nurse how you feel . I was thinking well I’m so tired cause I’m on dialysis I thought that how dialysis made you feel . Now we have where I get enough dialysis and I’m starting to feel my old self I can walk a mile and I can go out and enjoy things through the day so dialysis is now working on me like it should.

[Oceanviewed in reply to Beachgirl32]

Thanks for sharing. There is so much to consider and it feels like a big decision to make