Gfr 17

[Dialysisforme]

I am an 87 year old Male with diabetes, heart disease, and stage four kidney disease. My Nephrologist sent me to a class on types of dialysis and I will be seeing him in January. I am thinking he will probably want me to get a fistula. A little concerned, but take it one day at a time

[Bassetmommer]

Get the fistula asap if that is the route you are going with. It takes a long time for it to be really useable. I rushed mine and had nothing but problems. Now a year later, much less issues.

[PDcaretaker]

My husband is 79 and went on Hemo-dialysis in July. After reviewing the dialysis options, he decided to He has finally gotten the PD catheter and fistula. You want the fistula soon since the one you have now is to your heart and a higher risk for problem than the fistula or a PD. His dr said it takes 6 - 8weeks for the fistula to heal and be able to use so getting it done asap is a good thing. The fistula allows for HEMO (blood) dialysis to be done at a center and is much safer than the one they gave you up near your neck. My husband chose Peritoneal Dialysis (PD), which is done at home and uses a fluid in the stomach cavity to get rid of kidney waste. He can do it while he sleeps and it leaves his days free to do whatever he wants versus having to go to the dialysis center every other day for 5 hours.

[anemraz]

Given your age, I highly recommend that you carefully consider all your options. The older a person is, the higher rate of fistula failures requiring secondary interventions. My mom is 71 and has had nothing but problems. We have now settled for a catheter. Suggest you look into peritoneal dialysis.

[bumblebee_tuna in reply to anemraz]

PD is a little hard with diabetes but if you only need a few days a week to begin with, it might be something to consider.

For a fistula - I would meet with a good surgeon and see what they say.

And also consider - If you can manage the diabetes well maybe you can avoid kidney failure. Damage from diabetes is sometimes recoverable, at least partially.

[22171 in reply to anemraz]

My husband is 85 and has had his fistula since he started dialysis 2 1/2 years ago. He has had no problems, and it is considered safer. He is content with HD at the center. Fortunately he only goes twice a week. He did get the fistula about a year or more ahead, and it was ready when he needed to start.

[anemraz in reply to 22171]

Unfortunately they gave up on fistula for my mom. It is the gold standard but not for everyone. Twice weekly dialysis for us too. My mom is much happier on twice weekly than 3x a week.

[22171 in reply to anemraz]

Whatever works smoothly is good. We are also hoping he can continue 2 x a week. Quality of life is the most important. I’m glad it works for your mom as well.

[ChordomaChampion in reply to anemraz]

How did they decide on 2x versus 3x? Is it less effective?

[anemraz in reply to ChordomaChampion]

In my mom's case, they looked at her labs. She's stable on twice weekly dialysis since 2022 with strict adherence to diet and liquid intake. Some patients are not able to keep up the same way. She's 71 and was finding thrice weekly routine extremely hard. She wouldn't even get out of bed. She's much more active now.

[JDsDaughter]

Get the fistula so it's ready to go, even if you don't need it for awhile. My dad got his at 85 when his gfr was 15. Now he's 87 and his gfr is 6, but he's functioning well enough without major symptoms that he's still not on dialysis. His fistula is still healthy and ready.

[Darlenia in reply to JDsDaughter]

Good advice. I've noticed too that seniors do often seem to get by with a very low eGFR. Apparently everything simply slows down and needs aren't as great.