Q: Does dialysis reduce the blood creatinine levels? The reason I am asking this question is that my mother (56 years old) has recently started haemodialysis (she has a history of blood pressure) and the cause of the kidney failure is unknown to us but the doctor called it CRF. He has not performed any biopsy. She never had any swelling on her feet or face or any part of her body. Here is the profile of her blood work when we started dialysis: creatinine - 8.8, BUN – 95, phosphorus - 6.5 and albumin -4.2. The rest everything else was in the normal range. Now she undergoes dialysis three times a week. She has not gained any weight, which the nephrologist says is a good sign meaning her kidneys are still getting rid of the fluid. My question is if the kidneys are getting rid of fluid then why do we need dialysis? She has been on dialysis for 3 weeks and now they have done another blood work: creatinine - 6.2, post BUN – 21, urea reduction ratio – 78, phosphorus - 4.5 and albumin - 4.6; rest everything is in the normal range. By looking at these reports, do you think her kidney function has improved? If her creatinine level improves further, will she be off dialysis? I have read that if the creatinine comes down, it is a good sign. Is this true?

A:Kidneys besides removing excess water perform variety of other functions. One of those is removing metabolic wastes that various organs generate. Just making urine by no means should be construed as healthy kidneys because they could be able to get rid of water while not being able to excrete other wastes. Moreover, during first few years of dialysis individuals continue to make some urine. Likewise, dialysis is a means to rid of both wastes (including creatinine) and water both. The lab work of your mother beyond any doubt indicates that she does have end stage kidney failure and needs to be on dialysis. Biopsy is not necessary to diagnose the CRF and may sometimes help to detect its cause however. Due to incomplete background and history it is difficult to make determination whether her kidney function will recover.