Q: My dad has creatinine level of 9.3. He has diabetes from 12 years but at present he is normal. Can you please tell me at what level of creatinine is dialysis compulsory? What can we do to reduce his creatinine level?

A:Indication for dialysis intervention is based on the filtration function of the diseased kidneys calculated as Glomerular Filtration Rate (GFR). GFR is calculated using various variables, most important being serum creatinine value. It is not only the absolute serum creatinine level but also the age, gender and the body weight among various variables which decides the need for the dialysis intervention. Persistently elevated Serum creatinine level of 9.3mg/dl for a significant period as in your father’s case points towards less than 10% of normal kidney function for his age. He is in the stage of 'End Stage Kidney Disease' reflecting irreversible loss of kidney function. This is an immediate indication for long term dialysis intervention. Unfortunately, nothing can be done to lower the serum creatinine value except for regular maintenance dialysis treatment meant to remove the waste products and toxins.