Q: I am a 26 years old woman suffering from hypertension and my kidney has shrunk in size, because of which my creatinine level has come to 4.2 and blood urea is 96. I have been doing pranayama for the last one year and maintained the creatinine level at constant; at times it has also gone down to 3.8-3.9. Can I go for dialysis now? I came to know that dialysis removes all toxins and brings the creatinine level to normal. It is possible to get the creatinine levels down with dialysis and then try not to let the levels increase?

A:Review of your history is suggestive of advanced chronic kidney disease characterized by irreversible kidney damage possibly secondary to hypertension at a young age. You probably have less than 15% of normal kidney function at your age. Dialysis is an intervention started when one loses more than 90% of kidney function or/and develops symptoms of extreme weakness, fatigue, poor appetite, shortness of breath, excessive fluid accumulation, etc. resulting from the accumulation of toxins otherwise removed by well functioning kidneys. Dialysis is a life long treatment for kidney failure intended to keep the patient stable in addition to medications needed to treat some of the common complications of CKD including anaemia, kidney bone disease and hypertension. It’s not possible to get off dialysis in view of the irreversible permanent damage to the kidneys. Other option is to seek a kidney transplant, which has relatively better outcome concerning long-term morbidity and being cheaper than dialysis over a long run.