When to come off HD after acute failure on top of chronic

[cgtrapp]

My husband had acute renal failure from cardiac cath procedure in Sept.  He was already CKD4 but not on dialysis nor planning for it in near future.  He has been reduced from 3x/wk to 2x/wk, and now down to 3hrs each time.  Creatinine clearance urine last month was 20.6, creatine 2.6.  Will be doing another 24hr cclr next week.
Has anyone else been able to stop dialysis for a while?  My husband hates dialysis.  He is 82 and has other medical conditions (hypertension, orthostatic blood pressure, lots of peripheral & autonomic neuropathy.  If he had to go 3x/wk, he would stop dialysis.  Still chafing at 2x/wk.  Just doesn't feel well or have a good quality of life.  Some was there before dialysis and it hasn't gotten better.

Claudia

[CebuShan]

  I wish I could stop dialysis!
What does his Dr. think?
If he has to stay on it, can you do home dialysis? I started doing that in September after being in center for 2 years and I wish I had started sooner!
Best of luck to you both!   

[cgtrapp]

We are waiting for lab work and then to talk to nephrologist.  Home dialysis is not a great option since the responsibility would fall to me.  He has limited eyesight, poor tactile senses in hands due to neuropathy.  I'm a lot younger and still work, and have decided right now it is too much for me to take on.  I worry about caregiver burnout.  My mom died 1yr ago and I'm still dealing with getting her house up for sale/cleaned out, etc.  The past 4 months with my husbands health changes have been very stressful.

Just wondering if there is anyone posting on this board who was able to get off dialysis even for a while.

[RichardMEL]

OK I don't fit that bill however I have seen it happen in my D unix when I was on the dreaded machine. It is pretty rare but here are some positive signs for you to consider(as I am sure you already have!):

1. They've described his condition as "acute" - and more often than not such situations do tend to resolve thmselves and function returns.

2. He's clearlybeing weaned down on d sessions - half his luck - and the numbers support this. I can see that he could come off  at this point.

As you did say though he was already at stage 4, and with his other conditions you've mentioned - and I am thinking specially of the chronic high blood pressure, that this kind of thing is probably a prime cause of damage to kidneys that as you noted was going to see him go to stage 5 at some point anyway.

I understand he is 82, has to deal with so much and dialysis is such a strain and makes life miserable for him as in is quality of life. I don't really know what to offer to that except that it does seem like right now he could be off D at least in the short term. Maybe with all his other things going on quality of life is difficult also and I do feel for his (and your) situations... hoping it will be some relief if that 2 sessions a week can become zero and give him something back.

oh and as someone with poor vision and co-ordination I totally understand your view on home hemo, also considering his age and other conditions, if he HAS to endure dialysis being in a monitored environment is probably the best thing for both of you.

[kiddogal]

My husband went on dialysis at age 77, he just turned 78.  He also hates dialysis and had to go on it due to chronic kidney disease.  He is doing OK on it, but it is a bitch of a life, for him and me.  I am 20 years younger than him (you said you were a lot younger than your husband too) and there is no way I would want to do home dialysis and he could not do it himself.  Burnout is right - I am totally burned out.  My husband has a ton of other medical medical issues, from a heart transplant 16 years ago, very poor eyesight, severe walking problems because his hip replacement has failed, and too many other problems.   I am glad he does in center dialysis because it gives me a 3 hour break from the 24/7 caregiving.  My sister, thank you God, has been helping me out lately taking him to and from dialysis some days.  It helps so much.  I hope your husband can get off dialysis.  How wonderful that would be.  Hang in there!

[cgtrapp]

I'm 23 yrs younger than my husband.  PD would be easier on him but it is 7 days/wk even with the cycler.  And there is no relief to hire anyone else even if I needed to travel for work training or a respite for me.  He would have to go to a nursing home that can also take care of PD patients but they don't do it often enough to really know much.  We looked at a place recently in case we needed it and it was really depressing.  It is easy to hire 24hr caregivers (CNA's) but there aren't people who know PD to help.   (That is an opportunity waiting to be filled.)

Kiddogal- has your husband ever thought about stopping?  With all the problems he has and his quality of life, does that affect your decisions to continue with in-center HD?  I know that you get a break when he is there, but is dealing with the rest of the things wearing you or him out?