Is Dialysis Efficacy In Treating Uremia

Why are mortality rates for dialysis patients so high?

Because these patients lack the functions of one of the most complex organ systems in the human body, they are already at a huge disadvantage and more likely to suffer morbidity/mortality independent of dialysis.The kidneys are involved in 24/7/365 maintenance of blood sodium, potassium, chloride, bicarbonate, calcium, magnesium, phosphate, glucose, insulin, amino acids, pH, urea, etc. As such, when severe kidney damage has occurred, the following can happen:salt retention, leading to hypertension and peripheral edemahyperkalemiareduction in ammoniagenesis leads to acidosisEPO deficiency, leading to anemiahypocalcemia due to inability to convert vitamin D to active form, eventually leading to secondary hyperparathyroidismhyperphosphatemiaprogressive bone losshyperinsulinemiauremialoss of appetite, nausea and vomiting, gastritis and hiccupspericarditis due to inflammation of serosal surfacesencephalopathy, seizures, sensory neuropathy, “restless legs” syndrome, burning feetincreased bleeding time due to platelet dysfunctionwhite blood cell impairment, associated with an increased risk for bacterial infections...etc.Get the idea? Dialysis patients do not have the ability to maintain homeostasis of several variables in their body, which can (and often do) lead to significant problems and/or death. This is why nephrology is its own speciality--this one organ's pathologies are complex enough to require years of study/experience for true mastery. Dialysis is a fantastic invention, and the modern version is relatively easy, very safe, and life-saving, but it is not a true replacement for a functional kidney that constantly works.Epidemiology:End-stage renal disease (ESRD) is increasing at an alarming rate proportional to the epidemic increase in type II diabetes (which is, in turn, related to the epidemic increase in obesity), and these patients consume a heavily disproportionate percentage of healthcare resources. By the end of 2009, a whopping 398,861 patients were on some form/regimen of dialysis, and the cost of treating these patients is astronomical, with each hemodialysis patient costing Medicare nearly $80,000 per year, helping bring the total cost of the ESRD program to nearly $40 billion in 2008.

Is Ketosteril a good medicine for treating CKD?

In a country where not enough facilities for kidney replacement therapy are available or is considered too expensive (after all, it is a lifelong treatment, quite labor intensive and costly), it might still have a place by supplementing the much needed essential amino acids while on a low protein diet to prevent or treat uremia see  http://en.wikipedia.org/wiki/Uremia due to kidney disease.  See for an expanation why ketosteril could help:http://www.kidney-support.org/re...http://www.kidney-cares.org/crea...In most modern countries where renal replacement therapy such as hemodialysis, peritoneal dialysis and renal tranplantation are sufficiently available, it is considered obsolete.See http://en.wikipedia.org/wiki/Ren...

Is anyone working on faster dialysis machines? My dialysis takes 4 hours, 3 times a week.

We have learn over time that it is difficulty to reduce dialysis time and obtain optimal results with dialysis. With renal failure there are a large number of uremic waste product that built up in in a renal failure patient. These waste product have different molecular weigh and come off on dialysis different time course. Many of these larger molecular waste product that much longer dialysis . Perhaps the most effectice dialysis is nocturnal dialysis which can be done in center or at home and is usually a 8 hour treatment while you slept at night 3 days a week

Which level of creatinine can demand dialysis?

Thеrе iѕ nоt a creatinine level thаt dictates thе nееd fоr dialysis. Thе decision tо start dialysis iѕ a decision made bеtwееn a nephrologist аnd a patient. It iѕ based оn thе level оf kidney function аnd thе symptoms thаt thе patient iѕ experiencing. If thе symptoms аrе bad еnоugh fоr thе patient tо tolerate thе ordeal оf dialysis, thеn dialysis iѕ started. Thе creatinine level iѕ uѕеd tо calculate thе estimated glomerular filtration rate (eGFR) but iѕ lеѕѕ helpful in predicting symptoms thаt a givеn person will experience.There may not be a need for dialysis as learning about your treatment options for kidney failure will help you make the best choice for you. Fortunately, there is an effective treatment available to cure kidney disease at THE KIDNEY DISEASE SOLUTION. It gives a tried and tested remedy to kidney disease.

Are pre and post creatinine levels the best way to determine the effectiveness of a dialysis?

Great question! There are several values that can be used to determine adequacy of Dialysis of which creatinine is one. Usually, most dialysis units trend URR (urea reduction rate) which looks at pre and post Dialysis blood urea nitrogen, and fluid removal (measured by pre and post treatment weights). Another tool used is the measurement of the Kt/V. This is a very lengthy calculation, but the great thing about this calculation is that it takes body size into account. The minimum Kt/V is 1.3, but some studies have reported that this is better at closer to 2.0.While there are many things to look at for markers of good Dialysis, none are perfect. With hemodialysis we are attempting to do in 3–5 hours, 3 days a week, what our kidneys do 24/7. It is believed that there may even be other molecules that contribute to the uremic state in patients that we don’t even measure. And there are many things we do measure that play apart in the overall health of a Dialysis patient, such as, potassium, calcium, phosphorus, sodium, and albumin. Each of these are trended and watched for highs and lows.Dialysis itself is complex as we are readjusting the blood chemistry every 3 days or so. Ultimately the best indicator of adequate dialysis is how the patient feels, their energy level and appetite.

My father is 63 years old and his creatinine level is 6.3 but the nephrologist is still giving him some medicines/injections without suggesting dialysis. Is it risky to use medications rather than starting dialysis?

At 6.3 creatinine, when patient’s urine is normal, he is only given some medicines for blood pressure control and diuretics. At even 10 creatinine level, doctor didnt start my dialysis as there was no water retension, no swelling on any body parts. My dialysis was started when even after taking diuretics, which helps urine flow, were not working as it should be.So dont worry, have faith in your doctor. Yes, if he says to prepare and go for a fistula surgery, than go for it. It is used for dialysis and its a minor surgery, which takes about 2 months to develop the vein thickning for dialysis. But if your father is extremely careful about his diet as suggested by a nephrologist, he might be far from stage of dialysis.All the best to your father and take care that he consumes as less salt as possible.P.S Dont go for any kind of Ayurvedic or Homeopathic treatment as it doesnt work in chronic kidney failure. So please dont trust when they say, they will help reduce creatinine level. Because this damage is irreversible. It will progress, depending on how much care you are taking of blood pressure control and diet.

Is a serum creatinine level 6.79 dangerous and need to be any dialysis and treatment?

Generally speaking, Serum creatinine of 6.79 would mean kidney functions of less than 10% and coupled with symptoms ( uremic symptoms), biochemical changes like high potassium / fluid retention etc calls for some type of dialysis support or kidney transplantation

How do they determine if you have stage 5 chronic kidney deserve and how do they determine if you need dialysis?

Great question!!End stage renal disease has 5 stages, typically diagnosed by how much kidney function remains. Kidney disease is often detected with a simple blood chemistry panel or urinalysis. The urine may show protein or glucose and the blood might indicate an elevated BUN and creatinine or decreased GFR.So, it would make sense the Nephrologist would determine Stage 5 ESRD by monitoring blood BUN and creatinine levels, 24-hour urine creatinine clearances, uremic symptoms, fluid overload, and electrolyte imbalances.Dialysis is absolutely necessary at Stage 5, or death is imminent within days to a couple weeks. At this time there is 10–15% kidney efficiency.On a personal note, death by ESRD thru hospice is very peaceful. The uremia causes a bit of a fog, nothing to fear.However, if your decision is to begin dialysis follow the guidance of the Nephrologist. This is a true description of my uremic patient. Within a month he perked up and is doing quite well now, but another couple days would have been his last.……Sitting slumped over in his chair across the waiting room was a fella who probably weighed 90lbs, but was so bloated the scale read 132lbs, 42lbs of fluid! His hair was disheveled and greasy looking, his face had dried food or maybe vomit in the creases. His eyes barely opened and were lifeless, when I spoke to him -nothing, just a blank stare. The fluid collected under his glasses looked like puffy clouds. His coloring was dull, dusky gray, like a corpse. Carrying around this much fluid had taken it’s toll and was now starting to leak from his skin. Tiny droplets, and water blisters formed on his legs. His respirations were shallow and quick. Barely able to follow any commands, he struggled to move from the wheelchair to the dialysis chair. Finally, arriving at his destination for the next four hours, his lips appeared bluish purple and he was completely exhausted. He shivered from a bone-chilling body temperature of 35.1 C. He spent the next two hours vomiting, then fell into a deep slumber for the remainder of his treatment.