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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Alternative Treatment For Dialysis?

This is for my father in law Mr. B. K. Majumdar aged 83 yrs old diabetic patient now blood creatinine 4.7 and urea 86 mg /dl has been asked for dialysis by local Mysore doc. Wanted to have an opinion if any alternative is available at your hopital? Whom should we consult? looking for an appointment through phone but not getting through to this dept. A line of advise would be highly appreciated

Thanks sourav

YYYY@YYYY

Wed, 16 Mar 2016
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Internal Medicine Specialist,  's  Response
Hello,
Dialysis is also Known as renal Replacement Therapy.
for calculation purpose i am assuming the patient's weight to be 60 Kg as it is the reference weight for Male.
The formula used in his case is Weight In Kg X (140-Age in Years) divided by Serum Creatinine X 72 which is about 10.11 mL/min in our patient.

Now as per the 2005 European Guidelines-
1. Dialysis should be initiated when GFR is 2. Before GFR has fallen to 6 mL/min irrespective of symptoms.

Diabetic patients may get the benefit from an earlier start, hence your doctor has advised Dialysis.

Alternate Options to Hemodialysis (HD) would be Peritoneal Dialysis (PD) and Kidney Transplant.
Considering the age Dialysis would be the only available option.

Choosing between HD and PD-
Continuous ambulatory peritoneal dialysis (CAPD) is preferred in young children, elderly patients in whom vascular access is not available and are haemodynamically unstable.

If the patient has some residual kidney functions then you can start him on CAPD and later he can be shifted to Hemodiallysis once he becomes anuric (means urine output is less than 100ml/24 hours)

Hope this make things easy for you to come to a conclusion.
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What Is The Alternative Treatment For Dialysis?

Hello, Dialysis is also Known as renal Replacement Therapy. for calculation purpose i am assuming the patient s weight to be 60 Kg as it is the reference weight for Male. The formula used in his case is Weight In Kg X (140-Age in Years) divided by Serum Creatinine X 72 which is about 10.11 mL/min in our patient. Now as per the 2005 European Guidelines- 1. Dialysis should be initiated when GFR is 2. Before GFR has fallen to 6 mL/min irrespective of symptoms. Diabetic patients may get the benefit from an earlier start, hence your doctor has advised Dialysis. Alternate Options to Hemodialysis (HD) would be Peritoneal Dialysis (PD) and Kidney Transplant. Considering the age Dialysis would be the only available option. Choosing between HD and PD- Continuous ambulatory peritoneal dialysis (CAPD) is preferred in young children, elderly patients in whom vascular access is not available and are haemodynamically unstable. If the patient has some residual kidney functions then you can start him on CAPD and later he can be shifted to Hemodiallysis once he becomes anuric (means urine output is less than 100ml/24 hours) Hope this make things easy for you to come to a conclusion.