At what creatinine level should Dialysis start?

[dpk0072]

My father in law is having creatinine level as 8.1 Doctors have instructed to get a Fistula ready and start Dialysis.

What I have heared and read is once you are on Dialysis then you can't come back from it.

I am avoiding Dialysis as much as I can ...

As I am from India I have talked to lot of people who have suggested / advised to take Ayurvedic medicines.

I have met patients personally and asked them about the treatment / medicines they are taking (Ayurvedic).

Age of my father in law is 66 years.

Before starting the Ayurvedic medicines he was having swelling in his face and legs ... after started the Ayurvedic medicines the swelling is not present.

Please guide and let know if the action taken by me is correct.

[dwcrawford]

It sounds risky to  me but I'm am neither an expert in traditional nor holistic medications or other treatment.  I just do what my nephrologists tells me to do.  Blind faith I guess you would say.  I think it will be interesting to see what kind of input you get from others on this site.  I'll be watching.  But I should say maybe  you'd want to do more research into dialysis in the meantime.

[Rerun]

dpk0072, hello and welcome to IHD.  Please go to the introduction section and officially introduce yourself. 

We have a doctor on this site from India and I'll PM him and have him contact you. 

I feel your father in law will die without dialysis.  He can always stop it but then he will die.  No one makes you do dialysis or stay on it.  But, if your kidney function gets bad enough then you toxins build up as well as fluid and just overwhelms your system.

Rerun, Moderator

[kristina]

Hello, dpk0072,

Please tell me: is the Ayurvedic medicine your father is taking a diuretic?

How come the swelling went down but the Creatinine still went up to 8.1?

Thank you from Kristina.

[RichardMEL]

The swelling is just excess fluid retention - if the medication has helped to lower that it's a good thing but there are several things I would be concerned about:

* Reducing excess fluid is just one facet of the kidney failure issue. The toxins will still be building up in the body and won't be as easy to remove

* The contents of the medicine might concern me for another reason - in terms of how high they might be in things like potassium, phosphates and so on - while they might help in one area, they could damage in others. When you don't really know what all the ingredients are this is always a potential issue.

I understand your fear about dialysis for your father in law and it is generally true that once you start D the only real way out of it is via transplant - of course some patients have been known to recover some function - so never say never I guess.

The thing to also consider about starting dialysis is not simply a matter of numbers. It is also about how he feels and what effects he is feeling (eg: tiredness, nausea, fluid retention etc). The traditional medicines may indeed help in a way, and also just the positive thoughts of taking same may also be helping in a small way but you do need to be guided by the labs and how he is going. If the docs say it is time to prepare an access then it probably is a good idea to seriously consider following that advice.

[dwcrawford]

I just wanted to add that a big problem is that there are no standards or control over what, how much and what quality go into those remedies.  Richard is right and there are probably some diruetics in that specific forumla making the fluids go down.  If that were the only goal, you could handle kidney problems with a simply cheap lasix.

Wish I could spell.

[dwcrawford]

OOps, thought I was posting to the guy asking about herbal remedies.  Did I mess up?  Sorry.

But I do have a question here?  Why after  8 months of dislysis and "perfect almost" labs and supposedly good clearances,  etc. do my creatinine and bun levels still run high?  Does that mean I can't stop dialysis yet?   joke

[RichardMEL]

OOps, thought I was posting to the guy asking about herbal remedies.  Did I mess up?  Sorry.

But I do have a question here?  Why after  8 months of dislysis and "perfect almost" labs and supposedly good clearances,  etc. do my creatinine and bun levels still run high?  Does that mean I can't stop dialysis yet?   joke

I don't think the question part was the joke so I'll respond

your creat and bun levels will stay high because they measure the toxins in your blood which are always building up between sessions. Remember the labs for creat are taken before dialysis, so they measure the peak amount of toxins in your blood prior to dialysis. If you took blood say 12 hours after dialysis I am willing to bet that your creatanine levels would be much lower as they would still be building up.

And no you didn't mess up - right thread!

[dwcrawford]

You are right, that wasn't a joke.  I thought maybe putting my silly stuff in italics  might help with part of my Problem.   and oh yea, thanks for the answer.  That makes sense.

[RightSide]

your creat and bun levels will stay high because they measure the toxins in your blood which are always building up between sessions.

Remember the labs for creat are taken before dialysis, so they measure the peak amount of toxins in your blood prior to dialysis.

But how much can the BUN build up in just 48 hours after your previous dialysis treatment?   Assuming 3 dialysis treatments per week, when they take your blood for the BUN test, you've only eaten 2 or 3 days worth of meals since your previous dialysis treatment.

Wouldn't the BUN be much higher if you weren't on dialysis at all?

[RichardMEL]

Yes I imagine it would be because you wouldn't be having the toxins removed. The mere fact that the waste products measures go up so much in 48 hours is an indication of how poor the residual renal function (if any) is and that if you didn't have dialysis how bad it would get in 96 or more hours..... If the BUN didn't go up much between sessions then you might suggest that things were going OK and maybe you didn't need it (eg: Maker).

[dpk0072]

First of all i would like to thank all for giving me your valuable inputs ...
Sorry for replying and getting back so late ...

Some history about my father in law ...

on Sept 2009 he went to the dentist for tooth problem ... dentist suggested to get all the reports before going ahead ...

He was a sugar patient from the past 5 years ....

After the test his creatinine level was 2.0 ... dentist suggested him to visit a neurologist .. which he ignored.

on 23 Sept 09 was admitted to hospital due to severe Diarrhea ... was discharged from hospital a week later creatinine level was 3.1
Doctor suggested medicines related to kidney failure symptoms and the hell of medices started.

Nov 10, Swelling on face and legs creatinine level increased to 5.1 hemoglobin count less 8 started taking injections in stomach for the same.
Nov 25, Swelling on face and legs continued creatinine level increased to 6.5 hemoglobin count stable after taking weekly injections.

Dec 10, Swelling on face and legs reduced creatinine level increased to 7.1 hemoglobin count stable after taking weekly injections.
Dec 20, Swelling on face and legs reduced creatinine level increased to 7.3 hemoglobin count stable after taking weekly injections. Doctors suggested to get the Fistula created to start dialysis
Dec 31, Swelling on face and legs increased creatinine level increased to 7.9 hemoglobin count stable after taking weekly injections.

Jan 01, 2010 Swelling on face and legs increased creatinine level increased to 8.1 hemoglobin count less. Checkup to a new Hospital to reconfirm the condition.
Jan 03, 2010 Swelling on face and legs increased creatinine level increased to 8.1 hemoglobin count less. Checkup to to a New Ayurvedic Doctor. New set of medicines prescribed. List of edible items inform what not to have and what to have.


Jan 06, 2010, Swelling on face and legs reduced creatinine level increased to 8.6 hemoglobin count stable after taking injection. Ayurvedic Medicices with Alopathy started.
Jan 20, 2010, Swelling on face and legs coming and going reduced creatinine level increased to 8.6 hemoglobin count stable after taking injection. Ayurvedic Medicices with Alopathy medicines stopped.

Jan 30, 2010, No Swelling on face and legs creatinine level REDUCED to 8.1 hemoglobin count stable after taking injection. Ayurvedic Medicices continued.

This is the first time which i saw creatinine level redicing to .5, hemoglobin count being stable. My Father in law is still on Ayurvedic medices .. we are no more taking any alopathy madices ...

Earlier he used to feel dull, aways used to feel sleepy ... being a very active person through out his career we were very much troubled by this ... again he has also become very weak, but, after
going through the Ayurvedic medicines I have seen improvement in him ...

Still hope to see the progress on this ... presently the medicines are going on ... he doesn't have diabetes now ...

The only thing what we are giving him is the injections on his stomach for increasing the hemoglobin count ... which we have been told to stop ...

I will be posting the progress on this as an when i get reports ...

[kristina]

Hello, dpk0072,

Please tell me, what exactly does the Ayurvedic doctor do to help your father in law

and what kind of Ayurvedic medicines does your father in law take?

I would like to understand and thank you for your information.

Kind regards form Kristina.

[dpk0072]

Hi Kristina,

Following is my reply

Please tell me, what exactly does the Ayurvedic doctor do to help your father in law

Ans: When we visited the doctor first time, after checking him he informed us the condition of my father in law is not good, but yes he assured us that
The condition will improve if we follow the diet and the prescribed medicines.
And yes the condition has improved, I won't lie as 100% but yes where my father-in-law was in month ago is much better as of now today.

and what kind of Ayurvedic medicines does your father in law take?
Ans: The medicines are prescribed depending on the patient's condition. Now, again this won't be the same for you / other patient. Though the name may be same but quantity may vary.

Presently my father in law is strictly following the described diet / medicine by the doctor.

Please let me know if you want any more information. I would love to help.

[RichardMEL]

Hmm the creat level is very high and the swelling in face and other parts continues - yet nothing seems to being done about this (I mean the renal disease???) WTF? Clearly toxins are badly building up in his body, and the swelling most likely is from fluid retention. How many signs do you need that your father in law most likely needs dialysis? Yeah, the creat went down in one test from 8.6 to 8.1, but honestly that's pretty minor change, and creatine can fluctuate between tests due to all kinds of things - ranging from the diet in that particular period, to the time of day the test was taken.

I know you want to stick with the natural medicines and all that but I'd be seriously concerned for him at this point. He's tired due to the low hemoglobin, which the epo injections would be helping with, but also the toxins running around the body will be making him tired and feel unwell.

Is he seeing a nephrologist at all?

[praj]

hello everybody
 my uncle is facing d same prob as dpk0072's fatherin law.. d diff s swellin s in lungs n he alrdy went 4 dialysis 3mnths ago.. n mw hez facing serious prob wid creat level 8 , prob in breathing n low hb 5.. hez in icu nw... doc s sugesting 2 go4 dailysis for 6 tyms!! hez on ventiltr coz f lung swelling..  plz help me wth ur sugestions

[kremizin]

hello everybody
 my uncle is facing d same prob as dpk0072's fatherin law.. d diff s swellin s in lungs n he alrdy went 4 dialysis 3mnths ago.. n mw hez facing serious prob wid creat level 8 , prob in breathing n low hb 5.. hez in icu nw... doc s sugesting 2 go4 dailysis for 6 tyms!! hez on ventiltr coz f lung swelling..  plz help me wth ur sugestions

praj...do you live in the Philippines?   just asking...the way you spell your words...reminds me of how they do it here.hehehe.

on topic...my mother's creatinine is now 6.9 and the neph doesnt see any indication yet that there is already a need for dialysis. crossing my fingers. i believe that it will all depend on how the patient feels...

[Riki]

hello everybody
 my uncle is facing d same prob as dpk0072's fatherin law.. d diff s swellin s in lungs n he alrdy went 4 dialysis 3mnths ago.. n mw hez facing serious prob wid creat level 8 , prob in breathing n low hb 5.. hez in icu nw... doc s sugesting 2 go4 dailysis for 6 tyms!! hez on ventiltr coz f lung swelling..  plz help me wth ur sugestions

dialysis would probably help reduce the fluid on the lungs and allow him to breathe on his own again

[praj]

thanks 4 replying..
hi kremizin.. no I'm frm India..
actually he went for dialysis twice yesterday n now hiz Crete s 4.2, with 6 bags f blood hb restored to 10..
but still on ventiltr as d lung swelling s nt reduced yet.. doc s saying dat v hv to kp him on venti for 4 days more.. im worried abt is d swelling s coz f kidney disfunctn or coz f sm other infection..(which doc s unable to diagnosed yet) hez wbc count s also increasing..
sorry if I'm spelling wrong