Renal Recovery

[Karen]

My Dad had ARF last summer and he has just resumed some renal function. His Creatinine clearance test showed 19ML per minute. They want to cut him down to 2 times a week for 2 weeks and 1 time a week for 2 weeks. At first I thought it was the best news possible,
however he missed Thursday and had 2 lbs. additional fluid today. Also, he saw his vascular surgeon on Wed. and was told the vein could not be use, they have tried using it 4 times and were only successful twice. He had an upper arm fistula done in Dec. His nephrologist is
trying to push the weening off dialysis quickly because of the cathertar he has had since July. The surgeon now wants to try a graft. I want
my Dad off dialysis but not at the risk of health issues. He also has congestive heart failure. Has anyone come off dialysis and what is a
"normal" schedule to do so.? Also what should I look for in my Dad to raise red flags. Any help would be greatly appreciated.

[goofynina]

Hi Karen, First of all, i hope your Dad is doing well.  Please go to the introduce yourself section and tell us a little about you and your dad so we can have the opportunity to Welcome you properly to our forum.  Thank you..

Goofynina/Admin.

[goofynina]

As far as i know, the only way to come off of dialysis is if you get a transplant or if the kidney/s start working again (there are cases that has been known to happen)  Do they want to give your dad a transplant?  apparently his kidneys are not working well enough or he wouldnt have gained the 2lbs for skipping a day.  From the way i see it, dialysis is the best option for him at this time, do not take him off until his neph has totally declared his kidneys fully functioning. 

[Sluff]

I agree with  goofynina. If his renal function was there he would not have gained 2 lbs .

[boxman55]

If your dad is gaining weight from fluid then he needs to go back to dialysis if not it could start filling in his lungs and then he has big problems..Boxman55

[JerseyGirl]

Is your dad on lasix?  That would help get some fluid off.  However, I say to be prudent go with the surgeon's recommendation of getting a graft inserted for future treatment.  19 is not too high a number.  My guess is he will eventually need regular dialysis.  What was the cause of his acute failure?  Why did he miss a treatment?

[stauffenberg]

By definition, 'acute renal failure' is renal failure which is only temporary.  However, since the vasculature of the kidneys is extremely sensitive, any disruption of its normal functioning tends to weaken the kidneys permanently, meaning that many patients with acute renal failure can be removed from dialysis for a while, but then have to return, usually for the rest of their lives.  This is what happened to me: after four months of 'acute renal failure,' during which I was on and off dialysis, I eventually developed endstage renal failure and had to remain on dialysis until getting a transplant.

The glomerular filtration rate determines when it is safe to remove a patient from dialysis.  This usuallly reaches an acceptable level when the creatinine is around three times normal.  Diuretics only work to remove excess fluid accumulation if the patient has sufficient residual renal function, so in cases of severe damage, diuretics are no help.  I was able to prolong my time off of dialysis by having fluid withdrawn from my lungs by small punctures made in my back, but this procedure can only be performed in a hospital.  Paradoxically, recovery from acute renal failure can be promoted by drinking extra fluids, but at the same time, if renal function is not yet adequate, fluid restriction may be necessary to prolong the time off of dialysis.

With congestive heart failure the whole clinical picture becomes much more difficult, since fluid accumulations can worsen the heart failure.  I would try to be very slow and conservative about removing your father from dialysis.  There are many sites and many different forms of temporary dialysis access which can be used to maintain him on dialysis for as long as is necessary to permit a slow withdrawal of therapy.

[JerseyGirl]

I agree with Stauffenburg.  Unfortunately he is correct that usually these cases progress to chronic renal failure in the long run.

[Laurie]

I was diagnosed with Acute Renal Failure. After being on dialysis for about 7 months, my doctor said he didn't think my function was going to improve. I had surgery to have a fistula placed (which never worked). About a month later, I started getting really bad headaches while on dialysis, I would always make them take me off early. Finally, my doctor had me do a 24 hour urine collection. I got a call later that afternoon and was told I no longer needed dialysis. I had a check up every six months until October 2006. That's when I found out my kidney function is slowly getting worse. I always new the time would come when they would fail, but I thought I would be alot older. I am now on the Transplant list and waiting for the day I have to start dialysis.

[pierrat]

Wouldnt this best be a question to ask to your nephrologist? I'm sure everyone in here has good advice but ultimately you should be taking this up with a trained doctor who can give you sound medical advice.

[goofynina]

Wouldnt this best be a question to ask to your nephrologist? I'm sure everyone in here has good advice but ultimately you should be taking this up with a trained doctor who can give you sound medical advice.

I like to get my info here and then ask my nephrologist, half the time, i get better answers here than i do my neph, the patients seem to know more anyways 

[pierrat]

Wouldnt this best be a question to ask to your nephrologist? I'm sure everyone in here has good advice but ultimately you should be taking this up with a trained doctor who can give you sound medical advice.

I like to get my info here and then ask my nephrologist, half the time, i get better answers here than i do my neph, the patients seem to know more anyways 

Oh I can see your point, being too informed is seldom a problem. But at least for me, i give my doctor some credit. Perhaps its because my neph is someone I trust. Its not hard to imagine having a bad one and trying to remain healthy working around them.