Brief Answer: Think positive, Be positive Detailed Answer: Hello madam, I ve read your details and I empathize with all the trauma you are going through. From the medical perspective , the decision to initiate Dialysis or not would be based on clinical and also on biochemical parameters. You have not mentioned your creatinine and BUN values. So I cannot advice on Dialysis based on your biochemical parameters. Clinically you can delay dialysis if none of the below symptoms are not troubling your life too much - Generalized weakness, - severe loss of appetite, - nausea , vomiting [ particularly at the sight of food] , - swelling of feet and face and other parts of the body, - breathlessnes. Since you told that you are in stage 4 kidney disease it would be wise to get a AV access done ie a AV fistula, so that you make things easy for yourself, just in case, you opt for dialysis in future. With colostomy in situ you cannot go for peritoneal dialysis. The second question of gaining weight, I would suggest you get a serum TSH repeated because uncontrolled hypothyroidism can lead to weight gain inspite of normal diet. Probably you require dose escalation of thyroxine. Secondly if there is a lot of edema due to renal dysfunction you will put on weight. So diuretics will help on that case. Restriction of fluid to 750ml to 1litre per day along with salt restricted diet should help. Hope I was of help. Wishing you good health.

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