Hi....from Halifax Nova Scotia.....I'm a new member.....I was diagnosed with CKD back in July 2016....my clearance is at 13.....my creatin is well over 300...I will have to do Hemo...as I have had several abdominal surg.....just wondering....do they wait until your at 10.....I have been reading tons.....but ....what is the final cut off time....before dialysis starts....



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There isn't really a 'cut off'. It's a joint decision between you and your medical team. It's in part based on labwork (is your potassium always dangerously high?), your fluid balance (fluid collecting on lungs rather than just on ankles) and also how you feel. Don't wait until you are down too low the way I did and then have to go onto dialysis on an emergency basis while you are halfway across the country (believe me, it wasn't fun flying home from Vancouver).

At this point, I'm sorry to say, dialysis is pretty much inevitable. So better to plan to start than to get forced to. Things will be easier for you that way. We are all a bit different as to exactly when we start, but realize that you are not feeling as well as you might think you are. Our bodies get used to the lower level of functioning and we don't always realize how badly we need the dialysis. Once I started and had been going for a while, I was well enough to go to Disneyworld (I dialysed at a clinic right next door).

The bottom line is that it's always better to plan, than to have to go on during an emergency.

Great response mrscora
I had my fistula 4 months before I started. I was at 12 and creatin in the high 300 and I started dialysis because I felt s***** all the time. Best thing I ever did. Doing home hemodialysis and haven't felt this good in years.

Thanks Diane. It's amazing how much better you start to feel. It took me a while to get everything sorted out, but I actually did a trip to Disneyworld while on hemo.

Are you thinking of a transplant? I felt even better once I got mine. But I could go back to dialysis.

Yes mrsCora I am waiting to hear about getting on the list. I just finished my last test January 4 th. So you had a transplant? What do you mean you could go back? It's nice to meet you!

I was on hemo for 1 year. I didn't do that well, but it was manageable. As transplant patients, we do have to face the reality that one day we may/will reject the organ and have to go back onto dialysis. Not a fun prospect, but do-able.

My creatinine is currently at 611. I'm doing transplant workup and my sister going through donor process. Our hope is to avoid dialysis altogether and go straight to living donor transplant. Looking at my trendline, the doctors think I'm 2-4 months from requiring dialysis so we're aiming to do transplant in about 3 months.

Keeping my fingers crossed for you Keith. Hope your sister's workup goes smoothly and you get scheduled for transplant soon.

Be prepared, however, sometimes it's a bit tough to get operating room time (depending on where you are). So you might need to at least start dialysis before your transplant. As I've said before - not bad but do-able. And in a way (sorry, don't mean to sound so obnoxious) it's not necessarily a bad thing to have to do a bit of dialysis before transplant. It keeps you going and also takes away that fear. There's enough stress when getting a transplant (feel free to ask me questions about that) without worry in the background about dialysis (and believe me, the thought pops up).

I found PD dialysis not a problem at all. Still work, travel, play pretty much as usual. And sitting down a few times tor a 'forced relax' period isn't such a bad thing. I watch news or read something while doing dialysis. I've been on PD for six years, still fell good, no issues whatsoever throughout the years. I'm heading into Toronto for transplant surgery this week, so we'll see how that goes! I have some other health issues that will complicate things, but they feel confident they can handle it. By the way, my creatinine has been in the 950-980 range for some time.

HI Betty,

10 is usually the cut off point to start dialysis, however I didn't start until my eGFR was 7.  It depended on how I was feeling.  I did have a fistula put in a month before though because they take about 8 weeks to mature and I wanted to be ready in case.  At 7 percent I was feeling pretty nauseated and extremely tired.  I've been on Hemo now since January 11, 2017 and I feel much better. 

Good luck!


Bloodwork this week shows my GFR at 7.9. My doctor at Toronto General says he focuses more on symptoms when deciding when to start dialysis. I'm very, very tired and getting foggy brain, but blood pressure good and not much swelling so better off without dialysis for now.

Meantime, my sister is looking good for a match in testing to date, so fingers crossed that we'll get transplant scheduled this Spring.

Hi All...from Nova Scotia.....Well...my clearance is at 11....see the Dr...on the 28th....I'm very nauseated.....and very faint .....my blood pressure has gone very low.....funny....because all my life it was over the moon high......I do have a heart condition.....and diabetes....but my sugars are good ....Dr. said because of my age (61).....and health problems ....I'm not a good candidate for transplant....I'm thinking to ask for another opinion.....I'm just of two minds....I sure don't want this....nor do I want dialysis .....yet....people have said I would feel so much better.....I use to live and work in the Arctic.....for 10 years...Had a lot of Duty Travel....with my job....with the Gov. of Nunavut....Not a glamorous life....haha.....I ended up with 10 Hernia's in my stomach from surg.   so I have a lot of mesh...there fore its Hemo dialysis for me....Keith....7.9  seems way low....I thought the cut off point was 10....and I understand the foggy brain also......Wishing every one well......Sincerely  Betty

Hi Betty

MrsCora is correct, there is no real cut off.  I was done to 7-6% . I finally agreed with my Dr I would start PD.  That was only cause the winter was setting in. I didnt want to do all the travelling during then.  But I felt I could of went longer.  I have seen , many people post they are not working and starting at 25%.. So it all depends on yourself.

Good Luck to you, take care




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