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Do I need dialysis?

Q: I am a 42 years old type 2 diabetic with stage 3 chronic kidney disease. My creatinine is 2.2, urine protein 24 hours is 127mg/24 hours and urinary creatinine is 45.4mg/100ml. My haemoglobin is 14.2, blood sugar fasting - 127, PP - 240. The reason for my failing kidney was I had taken lot of pain killers in my earlier days and that have cause the problem. I am having gout. The positive part of the whole deal is that my kidney post the USG shows no problem only slight reduction in size right kidney - 8.5 and left kidney - 8.3. Do I need dialysis?

A:You do have stage 3 chronic kidney disease (CKD) characterised by irreversible loss of approximately at least 60% of kidney function at your age. To ascertain the exact cause of CKD and also know about the severity of disease process, one would need to perform kidney biopsy. The focus should remain on strict blood pressure control, avoiding exposure to potential kidney toxic medications like Voveran and Nimulid and close monitoring and treatment of CKD complications like anaemia and bone disease. The goal is to delay the progression to the stage of End Stage Renal Disease (ESRD), the stage characterised by dialysis requirement once there is a loss of >90% of normal kidney function.

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