GFR Question

[JennyQ]

How low does a GFR need to be before dialysis is started?

[Michelle2016]

It’s the rule that the person will need dialysis if eGFR is below 10. You can find eGFR value from her lab results.

Best wishes.

[Simon Dog]

They have delayed as much as possible her getting on kidney list.

Probably a non-issue, the the wait is generally years and her wait time will be calculated from first day of dialysis, not when she is listed.

[JennyQ]

She went back to her country.  They ran lots of test on her in her country and would not give her dialysis because they said she does not need it.  She has been off dialysis for 14 days and she feels great and she looks great.  She is nervous because people are freaking out.  Dialysis itself is a monster.  For several years it has been like a grey blanket thrown over our lives.  If she can do without it, then we will do without it.  I was asking about creatinine and other parameters trying to determine just what defines that she must be on dialysis.  We are already in this situation and we are not going back to dialysis until she shows symptoms.  Now they may come back to us and tell us to get on dialysis or lose position on transplant list....get kicked off.  Probably will.  They may even kick us out of dialysis center.  Label us trouble makers.  But we are going to see this through.

Currently looking for new nephrologist for at least a second opinion.  Probably going to switch dialysis centers if we must return.  And maybe second transplant center.

So hope that explains my questions on creatinine and GFR.

Has anyone here ever gone off dialysis or has doctor ever taken one off diaylsis to see how they do?

[GA_DAWG]

A low creatine level is a good thing and would mean she has some function at the very least. There are other numbers though that could be higher and indicate the need. While it may be true that she does not need a kidny, you cannot go by just one number, all of them have to be considered. Hoping for her that she does not need a kidny AND can get off dialysis. It is at times a bit hard to know who to trust. I approach it kind of the same as a mechanic. If I don't trust him to tell me the truth, I need to find a new one. Transplant centers are really hard to trust at times. The one I am listed with lost the head of the department to another hospital in a different state. Since then it has been like a cluster-you know what at this center. They also lost several other doctors. They called and wanted to know why I had not had some tests done for the eval. I told them I had and they were like "Oh yeah there's the results" for some, but others were lost completely. Makes you wonder.

[Michael Murphy]

The numbers are really not useful in determining when to start dialysis.  Two people with exactly the same numbers, one feels ok, the second feels like crap.  One does not have to start while two should start since Dialysys will improve how they feel I spent several years with my nephrologist telling me it was time.  I waited till I showed symptoms. 

[Paul]

Please delete this post for me.  I wish to delete this post.  Thank You.

If memory serves, that is against the rules.

[Charlie B53]

Sorry Jenny, we have a general rule NOT to delete posts as the information is often of benefit to others as well as the original poster.

There is another general rule that those persons editing and deleting there own posts may be sanctioned/suspended depending on the severity of the offense.

HOWEVER, you can ask a Moderator with good reason to have a thread moved to a Members Only area, or on rare occasion to an Administrator Only area, thus making the thread not available to the general public.

These communications are best done my Private Messages.

Cass is the Mod for this area.

Take Care,

Charlie B53
Mod

[deckerj]

It’s the rule that the person will need dialysis if eGFR is below 10. You can find eGFR value from her lab results.

Best wishes.

I remember reading about this on a forum for med students studying for their CK exam, and it actually turns out that the best approach isn't to get hung up on eGFR, but rather to take everything into account. First and foremost, how well does potassium seem to be controlled? How well are your body fluids doing? How are other electrolytes working? Are we seeing any major cardiovascular problems? Is the patient having difficulty maintaining an appetite?

Judgement calls have to be made based on all of this.

Apparently for younger people, the eGFR can be allowed to go as low as 6, but in general, practically nobody will start dialysis until the eGFR hits 15.

By the way, I am NOT a doctor, just relaying what I've read elsewhere.

[Charlie B53]

Lab results are not a good indicator of when Dialysis is needed.  The labs merely indicate that Dialysis is in the future of the patient.

Symptoms are the determining factor.  When the patient begins to exhibit symptoms that can no longer be ignored, then it is time to begin Dialysis.

Many patients do not begin to have negetive symptoms until under 10%.  Others, like myself, swell up like a balloon at 20%.  At 20% my legs would weep and leak terribly every day, soaking my socks and shoes.  IN matter how well I showered and bandaged them I would get an infection that would land me in the hospital for almost two weeks at a time.  It became so bad the Dr's forced me into medical retirement to get me off my feet.  That sucked.  After almost two years of this I had a long talk with my Neph about Dialysis.  Would Dialysis remove all this swelling?  YES.  Then sign me up!   He did.  Within the first week I lost about 40 pounds of water.  My legs look almost normal in size.  Color still sucks from the damage from the years of stretching.