Kidney dialysis myths and answers

Diamonds are forever. However, kidney dialysis may or may not be forever. It just depends.

Patients who are hospitalized who suddenly lose the ability to make urine or detoxify their blood may only need kidney dialysis for a short period of time. Dialysis is considered a bridge so that the kidneys, which are stunned, can wake up and start working again.

On the other hand, patients who have a slow, worsening progression of their kidney function over time are less likely to recover function. These folks will likely need “kidney replacement therapy” which usually is defined as something else (like dialysis) doing the work that the kidneys would normally do.

Consider the following: most people start with 100% kidney function and 2 million “filters” to make urine and detoxify. Those who have high blood pressure and/or diabetes lose kidney function over time (the number of working filters decreases). Eventually, there aren’t enough filters to clean the blood. When people have around 15% of their kidney function remaining, most need to start on kidney dialysis.

Here is the bad news: for the most part kidney function stays the same or gets worse over time. It seldom gets better.

Here is the good news: people either need dialysis or they don’t. Many people do just fine whether they have 60% function or 100% function. So if you find out you have 60% function, your goal is to keep the kidney function where it is at and my goal is to help you do that.

There are many urban myths out there. For example, many people erroneously believe that if they “drink more water” their kidneys will get better. Unfortunately, unless you are severely dehydrated, this common belief is false. A vicious cycle occurs when you are on a water pill to get rid of fluid and you are trying to drink significant amounts of fluid to “flush” the kidneys to make them better.

Therefore, go to your primary provider and get your blood checked. Keep your weight, blood pressure, and blood sugar controlled. And if appropriate, see a kidney doctor / nephrologist sooner rather than later. I can do more for you to decrease the risk of progression of kidney failure when your kidney function is 60% as opposed to when it is 15%.

Michael Aaronson is a nephrologist who blogs at his self-titled blog, Michael L. Aaronson M.D.

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