When Is the Best Time to Start Dialysis

When Is the Best Time to Start DialysisWhen is the best time to start Dialysis? The choice of dialysis timing should be based on the primary disease, clinical manifestations, laboratory examination results and economic conditions.

-From the perspective of etiology, for patients with renal interstitial damage, although serum creatinine is up to 600~700 umol/L, dialysis can often be delayed if the patient has a normal daily urine volume without obvious risks such as water and sodium retention and high blood potassium.

-For patients with severe high blood pressure, diabetes and advanced age, dialysis should be started as early as possible.

-If the patient's general condition is good, for example, appetite is good, urine volume is not reduced, there are no symptoms of water and sodium retention and heart failure, creatinine clearance rate is more than 15 ml/min, dialysis can be put off.

-In some cases, early dialysis should be given for severe clinical manifestations (for example, drowsiness, convulsions, nausea, vomiting, bleeding tendency, severe acidosis, high edema, and heart failure), despite serum creatinine and urea nitrogen levels are not high.

Due to the long-term restriction of protein intake in patients with chronic renal failure, blood urea nitrogen is maintained at a low level. The patients especially old people, have little muscular volume and activities, which can make serum creatinine level low. Therefore, urea level and serum creatinine can not be used as the only indicators to measure whether dialysis should be started or not. What you should see is the creatinine clearance rate.

At present, most nephrologists advocate that the indication of starting dialysis is: creatinine clearance rate is less than 10 ml/min, (for diabetics, it should be 15 ml/min). Other reference indicators are:

  1. Blood urea nitrogen ≥28.6 mmol/l;
  2. Serum creatinine level≥707.2 umol/L
  3. Severe hyperkalemia
  4. Severe metabolic acidosis
  5. Symptoms of uremia
  6. Retention of water and sodium (edema, elevated blood pressure, high volume heart failure)
  7. Severe anemia, pericarditis, bone disease, peripheral neuropathy and lethargy, coma, convulsions, epilepsy, etc.

When is the best time for dialysis? Too early or too late both do not good for your health. For more information on Kidney Failure Treatment, please leave a message below.


***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***

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