When to Start Dialysis for Diabetic Kidney Failure Patients

When to start dialysis for diabetics with kidney failure?

Up to now, there is not yet a strict standard as to when to start dialysis for diabetics. Diabetes is an overall metabolic disease that can cause multiple complications. When diabetic kidney disease develops into end stage kidney failure, most patients have severe complications in other systems, including retinopathy, angina, myocardial infarction, arrhythmia, or even heart failure. Compared with non-diabetics, overall toxic symptoms such as water and sodium retention, anemia and weakness come more obvious and earlier than other patients.
What’s more, in diabetics, due to protein synthesis obstacles and decreased muscle total, common lab indexes for measuring kidney function (such as serum creatinine) can not reflect the severity of their disease. Thereby, it is generally considered that diabetics should start hemodialysis or peritoneal dialysis much earlier than non-diabetics.
As is pointed out by NKF-K/DOQI, remaining kidney function should be higher in diabetics when they start dialysis than others. GFR 10-15ml/min is a generally accepted indication for diabetics to initiate dialysis. As most diabetics often have combined vascular lesions and the fistula needs longer to become matured, fistula surgery should be started earlier. In other cases, if the following conditions occur, dialysis should also be started:Is There Any Alternative Treatment Other Than Dialysis
1) blood potassium>6.5mmol/l. High potassium can be life-threatening to kidney failure patients, because it may lead to sleepiness, arrhythmia,
2) Severe complications, including: How Can Kidney Failure Patients with Creatinine 14.6 Be Cured
◆Severe heart failure and swelling
◆Difficulty in lying on the back, suffocation and short breath
◆Unconsciousness, driveling or sleepiness
◆Severe anemia, decreased platelet and bleeding tendency
◆Metabolic acidosis Chinese Treatment to Kidney Failure Patients
◆Malnutrition, calcium-phosphorus metabolism disorder
If the above complications occur, even if GFR is higher than 20-30ml/min, dialysis should also be started. Correcting those complications are very crucial for decreasing life risks and improving dialysis.
What should diabetics know about dialysis?

As for dialysis, we need to hold an objective attitude towards it. For one side, dialysis is very beneficial for alleviating complications by removing accumulated in your body; for the other hand, however, dialysis will not improve kidney function. During maintenance dialysis, kidney function continues to decline. Henceforth, while controlling complications with positive measures, we need to block kidneys from scarring and repair kidneys with proper treatment, by means of which dialysis can finally be avoided and we can enjoy life with improved kidneys.