The Chronic Kidney Disease Solution™ By Shelly Manning The information provided in this write-up about The Chronic Kidney Disease Solution, a guide, helps in motivating people to get rid of the chronic problems on their kidneys without using any harmful methods. It eliminates your kidney problem by focusing on the poor health of your gut and inflammation.
What are the indications for starting dialysis?
The indications for starting dialysis arise when the kidneys are unable to perform their essential functions effectively, either due to chronic kidney disease (CKD) or acute kidney injury (AKI). Below is a detailed list of the common indications for starting dialysis:
1. Symptoms of Uremia (Toxin Build-Up):
- Fatigue and weakness
- Nausea and vomiting
- Loss of appetite and weight loss
- Confusion, drowsiness, or difficulty concentrating
- Severe itching (pruritus)
- Uremic pericarditis (chest pain due to inflammation around the heart)
- Uremic encephalopathy (mental changes caused by toxin buildup)
2. Fluid Overload:
- Swelling (edema) in the legs, arms, or face that is unresponsive to diuretics
- Pulmonary edema causing difficulty breathing
- High blood pressure (hypertension) that is difficult to control despite medication
3. Severe Electrolyte Imbalances:
- Hyperkalemia (high potassium levels) unresponsive to medical treatment, which can lead to life-threatening cardiac arrhythmias
- Metabolic acidosis (low blood pH) that cannot be corrected with bicarbonate therapy
- Abnormal calcium or phosphate levels causing complications such as bone disorders or calcification
4. Declining Kidney Function:
- Glomerular filtration rate (GFR) or estimated GFR (eGFR) below 10-15 mL/min/1.73 m², particularly if accompanied by symptoms or complications
- Persistent elevated levels of blood urea nitrogen (BUN) and creatinine indicating toxin accumulation
5. Inability to Maintain Fluid and Electrolyte Balance:
- Low urine output (oliguria) or no urine output (anuria)
- Difficulty maintaining normal hydration status due to kidney failure
6. Acute Kidney Injury (AKI) – Emergency Indications:
The mnemonic “AEIOU” summarizes acute indications for dialysis:
- A: Acidosis – Severe metabolic acidosis (pH < 7.1) unresponsive to medical treatment
- E: Electrolyte imbalances – Life-threatening hyperkalemia or other refractory electrolyte disturbances
- I: Intoxications – Poisoning with dialyzable toxins such as methanol, ethylene glycol, lithium, or salicylates
- O: Overload – Severe fluid overload causing respiratory distress or heart failure
- U: Uremia – Complications like pericarditis, encephalopathy, or severe bleeding due to platelet dysfunction
Elective or Proactive Initiation:
- Preparing for long-term dialysis in end-stage renal disease (ESRD) with planned vascular access (e.g., arteriovenous fistula)
- To manage symptoms before they become severe in progressive CKD
The decision to start dialysis is based on a combination of symptoms, laboratory findings, and patient-specific factors. It is made collaboratively between the patient and healthcare team to ensure the best quality of life and outcomes.
The Chronic Kidney Disease Solution™ By Shelly Manning The information provided in this write-up about The Chronic Kidney Disease Solution, a guide, helps in motivating people to get rid of the chronic problems on their kidneys without using any harmful methods. It eliminates your kidney problem by focusing on the poor health of your gut and inflammation.