Dialysis mainly includes hemodialysis and peritoneal dialysis. It is one important renal replacement therapy for treating end stage renal diseases. It can help replace functions of the failed kidneys to remove excessive water, electrolytes and other metabolic wastes and toxins out of the blood so as to sustain patients’ life. Even though, many patients do not want to take dialysis because they are scared that they can not get rid of dialysis once they begun.
Once a patient consulted that his creatinine is 7.8 and his doctor planed to put him on dialysis. He did not want to begin dialysis because he did not have any symptoms and his electrolytes are in normal range.
All doctors can understand patients’ unwillingness, worries and fear for dialysis because they are more clearly understanding the side effects and complications that dialysis might bring to their patients. What is more, in most cases patients have to take regular dialysis every week once they started and this maintenance therapy would take a huge amount money which is another concern for many patients.
Weather it is serum creatinine level, water and electrolytes levels, they should not be the sole determining factor for beginning dialysis. Some patients may suffer from obvious symptoms and discomforts when serum creatinine rise to 5 while there are some other patients who do not have obvious discomforts and do not take dialysis until their creatinine is higher than 10.
The following are the usual indicators in clinic to start dialysis:
Chronic renal failure:
Oliguria, increased night urination
Severe high blood pressure
Insomnia and headache
Nausea and vomiting
Retention of body fluids (swelling, pulmonary congestion)
But there are also some contraindications for dialysis:
Heart failure, arrhythmia and those that can not bear in vitro cycle
Acute cerebral hemorrhage or other severe hemorrhage
End stage of malignant tumors and severe renal failure