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What are the options for treating chronic renal failure?

Q: My mom is a CRF patient. She got chronic damage of both kidney. We had consulted with reputed nephrologists. But all have same answer that go in for an operation or dialysis. Right now her 10 dialysis are over but she feels the same as earlier. After getting dialysis her whole right side body is paining right from neck to leg. The doctor prescribed Dollo tablet but after some hours it starts again & her fistula is in the left side. Is there no other option for kidney patient other than dialysis or operation to get well? My mother has no problem of blood pressure, diabetes & her urine is also passing. Is it not a positive sign? Her weight is also same after getting dialysis. Please reply soon with the solution of pain.

A:In the absence of detailed history and lab data, I am assuming that your mother does in fact have end stage kidney (renal) failure since you have been to many other physicians and they had similar opinions. However, it seems you are concerned about the symptoms (bodyaches, etc) that she has during dialysis and the fact that she is still making urine. I must allay your fears regarding making urine by saying that such patients continue to make small to moderate quantities of urine for weeks to months after being initiated on dialysis but such urine is not adequate to filter all the waste products that body is supposed to get rid of. The bigger issue here is she is having pains/aches on dialysis. There may be a variety of reasons for this. To name a few, it could be from type of the artificial kidney (dialyser) being used, low grade allergic reaction, anaemia or from the disinfectant chemical used to sterilise the dialyser after being reused. I suggest that you speak to the nephrologist of your mothers dialysis unit, who can closely inspect these causes and suggest a treatment. If it is due to some low grade allergic reaction, antihistamines such a diphenhydramine tabs or inj on dialysis work pretty well. Other alternatives to hemodialysis are peritoneal dialysis or kidney transplant, if a suitable donor becomes available. Peritnoeal dialysis (PD) is liked by many patients who do not do well on haemodialysis. It has the benefit of being done at home, done daily, requires less fluid and dietary restrictions and not associated with symptoms you have described. But it requires clean hygienic technique, great deal of motivation and availability of PD infrastructure in your city. Since I am not sure about your mothers age and other details, kidney transplant even though is the best therapeutic option, I can not comment on the fact whether your mother will be a good candidate for it or not.

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