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Ultrasound showed stage 4 of kidney failure. Is there a need for dialysis?

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My mother is 89 years old and bed ridden. About a month ago, she had a home check up. The nurse who did the ultrasound said that my mother was is the late stage 4 of kidney failure. Her kidneys functioned at about a 20 level. I went on-line and read that we should prepare for possible dialysis soon.
We sent the results to a physican who has cared for my mother in the past. He said that for a woman her age, this type of low kidney rating was fairly normal, and that she was nowhere near anything like dialysis. He said that she should be able to function for a good while without any additional care.
It seemed strange to me that i would read and hear two such different opinions on this matter. I would like to know your opinion, and what you would recommene I do next.
Thank You
Posted Wed, 20 Mar 2013 in Kidney Conditions
Answered by Dr. Avinash Ignatius 2 hours later
Thanks for your query!

1. It is not possible to detect the level of kidney function by an ultrasound.

2. Only a DTPA scan can relatively accurately measure her kidney function.

3. Her level of kidney function can be approximately calculated if her serum creatinine values are available.

4. The need for dialysis is not decided only based on blood reports but also the persons symptoms.

5. If she is otherwise comfortable, eating well has no breathlessness - she is unlikely to need dialysis.

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