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Why is my father's creatinine level not coming down with dialysis?

Dr Vijay Kher
Chairman,
Department of Nephrology and Kidney transplant Medicine,
Fortis Kidney and Urology Institute,
Fortis Escorts Hospital, New Delhi

Q: My father is suffering from chronic renal failure and Gullain Barre Syndrome (GBS). He has been undergoing dialysis for the past 6-7 months. His creatinine level has been low after dialysis. But in the past 2-3 weeks his creatinine level is not going down and is at 7 even after dialysis. The doctors have advised dialysis thrice in 15 days instead of once a week, which was even reduced to once in 15 days two months back. Why is his creatinine level not going down?

A:Once the kidney function is irreversibly damaged to less than 10%, then one requires dialysis which has to be done thrice a week for 4 hours each time. With dialysis urea & creatinine come down but by next dialysis (in 3 days the urea & creatinine will be up again as the kidney function is not sufficient to get rid of the waste products (we measure some of these as urea & creatinine).Once a week or once in 15 days dialysis is not adequate dialysis. Adequate dialysis is usually 3 times a week. Your father is not getting adequate dialysis.