Hi. I am 47 and have been diabetic since i was 9. I have been sitting at around 23 gfr for the past 2 years. About 3 weeks ago blood tests showed raising levels in gfr markers and im now at gfr of 6. I had fistula done about 2 weeks ago. It taking nicely but not ready. I have started a fortnightly drug for anemia and struggling to eat well ( gone from 58.4 kg to 53.2 in about 2 weeks. Extremely tierd ,dizzy and cant move about much due to energy/anemia/and postural hypotension. Serum sodium levels have raised out of green zone and holding fluid in ankles and feet. Potassium is ok at the moment. My renal/dialysis team are not doing dialysis yet and seem to be waiting for me to get worse before they intervene. Im just wondering how bad i need to be before i should be on dialysis? I feel at major risk of something life treatening happening every minute at the moment. My local dialysis clinic is so busy, im waitng another 2 weeks before im even seen again or have bloods taken. Any advice on if i need to push things for faster help would be great. Thankyou in advance
I am just curious why you are doing hemodialysis vs Peritoneal dialysis? It’s proven to keep residual function going longer than hemodialysis and it doesn’t involve needles. I understand some will say “that wasn’t the question asked, he’s made his dialysis choice,” but for me personally it’s a question that has to be asked. My first instinct is that because of your diabetic status you were told the dextrose in the solutions will cause major issues with your A1C and insulin needs. You don’t need to start with dextrose based solutions. We start all patients with Icodextran sugar free and do one exchange a day. No PD cycler. If your numbers dropped that quickly then it’s reasonable to think that with nurturing medication moves and choices you could bounce back slightly. I encourage you to examine PD. Hemodialysis doesn’t care about your GFR, your urine output….it’s always ready to use your fistula and clean the blood. Peritoneal does care about urine output, RRF, and it helps to prolong it will you fight for a transplant. Please consider that option. Wishing you the best experience with this disease