Question: Dear Doc - I had written to you earlier as well . Regarding my mom , patient is CKD , CABG , Hypertension etc etc. I got her admitted in hospital last friday 14th March as a pre-emptive routine check . She was found to be having UTI plus elevated serum creatinine . Nephro at the hospital , started her on Anti Biotic and Diuretic (Lasix around 4 times in a day) . She was mobile and walking with support while she was admitted . She was discharged on 17th March and we brought her home . From 18th onwards we started observing weakness in her , episodes of sinking while walking and very drowsy. She was wheeled in the emergency once again on 19th early morning . She was diagnosed by the neurosurgeon as having OSA . They did conduct PSG and put her on BiPAP . Since then , there has no improvement in her health whatsoever . She has been only sleeping and in an disoriented state , lack of appetite . Her CO2 level is now 51 (from earlier 55) . She has mild apnea . They repeated her blood test , which revealed Ammonia as 47 . Serum Creatinine as 2.08 and Potassium as 2.9 . They are performing an EEG test on her as of now. I wanted to know your views from what I have shared + Can you please help me advice , under what condition does dialysis becomes essential and unavoidable ? Also is it like this that once dialysis is started , patient has to continue with dialysis for the rest of life ? Please do help me understand this better.