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Old 01-03-2010, 01:25 PM   #1
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with a creatinine clearance of 29 when will dialysis need to be started?

at what creatinine clearance level is dialysis needed

 
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Old 01-03-2010, 03:27 PM   #2
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

There is no set point at which dialysis is started. The eGFR is used in conjunction with other lab work as well as how well you feel. I didn't go on dialysis until my creatinine was about 9 or 10. The other factors involved are fluid retention, electrolyte imbalance and how poorly you are feeling. You and your doctor will decide when to start. Have they told you what percentage of kidney function you have left? What is your creatinine? Do you have problems with potassium or a lot of swelling? These are all parts of the decision making process.

Keep in mind too that while things tend to decline, you may stay stable at this level for quite some time.

Hope this helps a bit.
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Dxd T1 1966, 2001 dialysis, 2002 kidney transplant, 2003 insulin pump, 2008 pancreas transplant

 
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Old 01-04-2010, 03:19 AM   #3
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Thank you for your reply. My creatinine is 2.43. My creatinine clearance has gone up and down. It was 31 in June and then went up to 37 and 38 in Sept. and now it's down to 29. I feel good, but very tired. I'm on the pancreas/kidney transplant list in my area and am near the top. They don't want me to have to go on dialysis if I don't have to because of other complications it can cause. So, I'm praying it can stay stable until I get some organs that are a match for me.

 
Old 01-04-2010, 05:33 AM   #4
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

I had my kidney transplant in '08 and a subsequent pancreas transplant in '08. Things are going well for me now. Best of luck with the surgery. It will take some time to recover and get used to the drugs, but it is well worth the effort.

Take care
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Old 01-04-2010, 06:41 PM   #5
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Thank you for the encouraging words. I've heard all about how hard the anti rejection drugs can be on a person. I'm kind kind of wishing it was all over with already. I know they have to tell people about all that can happen, but I guess everyone hopes the worst complications don't happen to them.
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Old 01-04-2010, 06:54 PM   #6
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

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Originally Posted by glogirl3 View Post
Thank you for the encouraging words. I've heard all about how hard the anti rejection drugs can be on a person. I'm kind kind of wishing it was all over with already. I know they have to tell people about all that can happen, but I guess everyone hopes the worst complications don't happen to them.
Glorgirl3
If you read all about the potential side effects of the anti-rejection meds, it will scare the pants off you. The truth is that if you do have significant side effects from any of them, your transplant center will change your meds. I have minimal side effects (a bit of hand tremors from when I was on prograf) and don't really get sick. I do get my flu shots and use hand sanitizer a lot, but basically don't have problems with any sort of chronic infections. The worst side effect I have is a bit of acne (in my nose believe it or not and on my scalp) from the rapamune (aka sirolimus). So don't worry too much about the drugs.

Best of luck.
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Old 01-04-2010, 07:01 PM   #7
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Cora once again shares her positive support. You are a true blessing Cora!

Glogirl, I am holding on to my kidney function too. Keeping a positive attitude is so important, because fear can easily overcome you. You must fight it off every moment, which takes making a strong commitment to yourself, and a lot of positive self talk.

Countering the loss of energy does not mean giving up. You can find joy in the smallest things...sights, smells, music. Make the space you spend time in lovely, by making it work for you. I particularly love to write, which I do here, which is a very satisfying. I find that even our toughest experiences can be sweet, when shared with another who feel alone.

There are so many others who suffer difficulties, who understand us. I am happy that you have reached out to others, so we can share with you.

Last edited by writeleft; 01-04-2010 at 07:02 PM.

 
Old 01-04-2010, 07:35 PM   #8
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Thank you all very much for the encouraging words. I pray a lot, which gives me much comfort. I think God led me here to this sight to put my mind at rest. I know that there is support in hearing of other people's experiences with their kidney problems. I love this website already and have just begun to read the many responses others have posted.
Glogirl3

 
Old 01-04-2010, 10:23 PM   #9
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

That is wonderful!

If I may share with you my experience here...it is a good one!

I found the Healthboards like many people do, after doing a web search. I was seeking other people who had survived multiple strokes. I had 4 simultaneous strokes at 43 years old, and I had been recovering for 4+ years by then. I hadn't used the computer since my strokes, but I was alone all day, and I was desperate for some connection with somebody. I responded to a woman who's mother had just had a stroke, and we posted to each other every single day for one year, three months. Nowadays, we continue our friendship personally. I helped her, she SAVED me! We have a bond that will never break!


In that 15 months, and hundreds of posts, 13,000 readers, I learned how to type again, how to spell again, how to think again. I remembered my love for writing, and found a new way to live. A way that embraced my illness. I have learned so much here.

My kidney disease is related to my strokes, and to my profession. I have a GFR in the mid twenties, but it is stable. I am feeling increasingly tired, but still can get excited to do things, just on a smaller scale than before. I am 49 now, and have my youngest in high school still. I have a good life, and I hope you do too.

Wishing you the best...Janet

Last edited by writeleft; 01-04-2010 at 10:24 PM.

 
Old 01-05-2010, 07:41 PM   #10
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

I'm glad you are doing good. I have never had a stroke, but had to have a stent as a result of a blockage that was found during my testing for the transplant. I feel lucky they found it because I had no symtoms. I know that because of my diabetes, I'm prone to a lot of complications. I looked at my GFR and it has also been in the mid twenties for a few years now. I feel pretty good, but am also very tired and don't seem to accomplish much, just a little bit at a time. It's very helpful reading what other people have experienced while going through their kidney disease. I've found out that everyone is different and feels different even though their numbers may be the same. This website has lifted my spirits. Thank you.
Glogirl3

 
Old 01-06-2010, 01:22 PM   #11
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Hi Glogirl,

That is right where I'm at, and holding. Trust me, I don't accomplish much either. I find that when I have a spurt of energy, I go with it, even if it is at 11:00 pm, or 4 in the morning! I allow myself to rest when I am tired, and sleep when I need to.

My one responsibility is to my 15 year old son, and he is quite independent, and helpful. I do get up early every morning to get his breakfast, and drive him and his friend to school. I enjoy that. The other mother picks them up, so I am free all day...I hope we can be friends. I enjoy the Healthboards, because it is a place I feel at home, and I can visit anytime, usually in my pajamas

Janet

 
Old 01-06-2010, 07:03 PM   #12
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

So, what do you think caused your strokes? I didn't know strokes could cause kidney damage. Are you a diabetic? I'm learning so much. I've had diabetes for 38 years. I got it while I was pregnant with my daughter. They thought at first it was gestational, but it didn't go away when she was born. They didn't know as much about it back then. I thought there would be a cure by now. They told me that even when I get transplanted, they don't consider it a cure. There is a chance the pancreas won't work. They never can tell. I'm praying it will. It would be so nice not to have to count carbs and figure insulin dosages all the time. I'm still working, which makes me more tired. But, I can't retire yet. I used to travel with my job, but can't right since I'm close to the top of the list.
I don't know much about the rules of this site and am not sure where to find out. Is it under posting policy? Since you've been on it for so long, I would imagine you know all about it.
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Old 01-06-2010, 07:13 PM   #13
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

While many people consider transplant a "cure", any medical professional who is involved in it will be quick to tell you that it is simply another form of treatment. I have to say the kidney was waaaaay better than dialysis and having a new pancreas has been fantastic too. It is tough at first because of being nervous, ever changing drug dosages, and lots and lots of labwork. But it all works out in the end.

While there is a chance that the pancreas may not work, it is only a small chance. It doesn't happen that often. Keep in mind that you won't get off insulin right away. I was still on some shots for 2 months afterwards. I had my tx Feb 28 of '08 and April 27th of that year was my last shot of insulin (6 units of lantus). The neat thing is that your insulin requirements will drop gradually over the adjustment period.

Since I've had both, feel free to ask me questions about them.
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Old 01-06-2010, 07:28 PM   #14
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Why did you have to be on insulin at first? I was under the impression that it would start working right away. Is it that way for everyone? They really haven't told me very much about that. Just that it may not work. Is it because the pancreas is in shock at first from being transplanted? Is the kidney the same way? Does it also improve after being in awhile? Since my insulin sensitivity isn't as good as it should be, I'm on actose and my diabetic doctor told me I may still have to be on that after the transplant. I'm guessing that every person will respond differently. Did you gain weight after the surgery? I'm told the anti rejection drugs can cause that.
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Old 01-06-2010, 07:48 PM   #15
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Re: with a creatinine clearance of 29 when will dialysis need to be started?

Quote:
Originally Posted by glogirl3 View Post
Why did you have to be on insulin at first? I was under the impression that it would start working right away. Is it that way for everyone? They really haven't told me very much about that. Just that it may not work. Is it because the pancreas is in shock at first from being transplanted? Is the kidney the same way? Does it also improve after being in awhile? Since my insulin sensitivity isn't as good as it should be, I'm on actose and my diabetic doctor told me I may still have to be on that after the transplant. I'm guessing that every person will respond differently. Did you gain weight after the surgery? I'm told the anti rejection drugs can cause that.
Glogirl3
A pancreas transplant is much more difficult than something like a kidney. The pancreas is a spongy organ and doesn't come with a nice capsule the way a kidney does. You hit the nail on the head when you suggested that the pancreas is sort of in "shock". They also give the insulin to help support the organ while it recovers. The amount of time requiring insulin varies from person to person. I think a couple of months is pretty much average. After my hospital stay of about a week, I was basically only on a maintenance dose of lantus. It was a nice change from bolusing for each meal. I had the pancreas tx because I was diagnosed with type 1 when I was 2 years old. I had it for almost exactly 42 years.

As for the kidney, sometimes it takes a bit of time for the kidney to "wake up" but in most cases it starts working right away. While my cousins kidney was damaged when they took it out (long story of why that happened - it's not the norm) my creatinine went from about 9 to 2.5 within the first 48 hours. It is the "little kidney that could".

Gaining weight is certainly a danger after a kidney transplant. First off the steroids can be a problem. I went to a center that does steroid avoidance so I didn't have that issue. Also, because your diet can be so restricted when you have kidney failure there is a tendency to eat everything in sight after the kidney transplant. I did that and gained quite a bit of weight. I've taken it off now, but it took a while. The good thing is that you can eat lots more veggies and you can exercise better too.
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