When Should Dialysis Start

Dialysis is an important kidney replacement therapy to help discharge metabolic wastes and harmful substances out of the body and purify the blood.

Why people need to take dialysis?

Under normal circumstances, the kidneys have the functions of producing urine and clearing metabolic products outside with urination. In case of kidney diseases due to various reasons, the kidney functions will be damages and the wastes and toxins will accumulate in the body and cause many discomforts and symptoms. Dialysis is also called artificial kidney and it can act as the failed kidney to discharge the accumulated harmful substances out of the body and alleviate the symptoms and complications.

When should dialysis start?

The kidneys have great compensatory ability and under normal circumstances one kidney can suffice to maintain normal life activity. That is why people can donate one of their kidneys. In the early stage of chronic kidney disease, patients do not need to start dialysis. Usually when kidney functions drop to 15% or less will dialysis be required by the doctors or if the patients have severe indicators and symptoms.

GFR is commonly used to measure kidney functions and chronic kidney disease can be divided into five stages according to remaining kidney functions. Here I only mention stage 4 and stage 5. In stage 4, the GFR is 15–29 mL/min/1.73 m2 and patients should start to prepare for dialysis and in stage 5 (it is also called end stage renal disease), the GFR is below 15 and renal replacement therapy---dialysis and kidney transplant should be started.

When can dialysis stop?

It is common that ESRD patients have to take a few times’ dialysis per week and can not get rid of it, so many patients concern when can dialysis be stopped. Since dialysis is needed to replace functions of the failed kidney, so the key point is to improve kidney functions so that dialysis can be stopped, or patients have to take dialysis.

How can kidney functions be improved?

One way is kidney transplant and the other is to repair kidney damaged and recover kidney functions. The combination of western therapy and Chinese therapy can both alleviate the symptoms and recover kidney functions.