Nephrologist (Kidney Specialist) Questions Dialysis

Is there an alternative to dialysis in case of kidney patients?

My mother is 70 years old and has been diabetic for the last 32 years. Her creatine levels are rising up continuously and have reached 5.5. The doctor has been suggesting dialysis however she is reluctant to undergo the same. What is the alternative we have to dialysis? What will happen if she declines?

8 Answers

If se declines, other than dialysis not much options.
If need consult call at 559-625-8674
Sorry to hear that her creatinine is worsening but unfortunately, there are only 2 ways of having kidney replacement therapy - dialysis or kidney transplant, if she is eligible to get one.
If she declined dialysis and or transplant she will get progressively weaker and malnourished. Eventually leading to death over many weeks or up to 1 year or so.
For chronic kidney disease slowly progressing to end stage kidney disease there are only 2 treatments available that preserve life at this point in time. Dialysis and renal transplantation. There are 2 forms of dialysis: hemodialysis and peritoneal dialysis. Renal transplantation is an alternative that requires a thorough pre transplant evaluation and not everyone is a suitable candidate. Specifics of these treatments should be discussed on individual basis with the patient’s nephrologist.
If a person does not wish to receive dialysis the only other alternative is conservative support until the patient reaches the point where she/he needs hospice care and comfort measures.

Adriana Cano.
Alternative to dialysis is kidney transplant. It depends on her comorbud conditions and also availability of living donors. She has stage 5 kidney disease. If she does not like dialysis (and not a candidate for transplant), conservative measures to be done. Needs to check electrolytes, volume status and acid base balance. She should be on a low salt diet. Try to avoid processed food/meat, etc.
If she declines dialysis, she can have electrolytes imbalance mainly high potassium (which can be dangerous) and also retain fluid and may develop heart failure: edema, etc., also can develop uremic symptoms like nausea, vomiting, poor appetite, lethargy, jerky movements, and finally can develop seizure, coma, etc.
Let your mother talk to her kidney doctor in detail about it and may attend a dialysis clinic for PRE ESRD education.
Hope this will help you.
none just more illness
Options at her age include dialysis (hemo or Peritoneal dialysis if she has support at home). Transplant could still be an option if she is felt to be a candidate which will need to be evaluated. If she has a lot of Comorbidities then she will not be a transplant candidate. If she does not want to do dialysis, and has a lot of other chronic diseases, then she may want to pursue only comfort care with medical management.
We have an excellent team which does that at Dallas Nephrology Associates and can update you regarding prognosis and what to expect. You can call at 2143582300 and make an appointment so we can discuss options.
Transplant maybe an option depending on your mother's health status. You may want to discuss with your nephrologist a referral to a transplant center for more information and evaluation. Waiting times can be long depending on the state. You may also want to discuss with nephrologist options for home dialysis which can be an option depending on her medical condition.