Reduction in dialysis frequency

Patient

Q: My diabetic father is 81 . He has been on kidney dialysis for approx 3 months 3x per week. They have now cut him down to 2x per week. His leg has swelled up ;and has quite a bit of sores on his body. Would there be a reason why they would cut him down to 2x per week.

Doctor

A:   The effect of dialysis is to eliminate toxins from the body that are normally removed by the kidney (renal replacement therapy). If your father’s deterioration in kidney function was acute (for example as a result of reversible cause such as infection), then the dialysis may be a temporary option until the kidney function returns towards normal. Therefore as the kidney function improves, dialysis is required less often. If the deterioration in kidney function was due to a chronic insult, (e.g. diabetes), then dialysis will be required on a lifelong basis. There are many reasons why dialysis could be reduced from trice to twice a week, which may include; increased duration but decreased frequency, cost-effectiveness, patient convenience or staff convenience. I would advise discussing this with your father’s nephrologist, to determine the cause for the reduction in his case.

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