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Just discovered 89-year-old mother has Stage 4 Chronic Kidney disease. She has not informed anyone in the family of this diagnosis. She lives alone and is not receiving any treatment for kidneys that we can determine. We're not sure what we can do to help her - if anything? IS she eligible for Dialysis at her age? What symptoms should be looking out for?

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Mom should make decisions about dialysis or not if she is cognitive. It takes a lot of commitment. There are transportation issues and who will do it. If you live in an area that is disaster prone with power cut off for long periods, then you have to evacuate with each potential storm.
If she does not want to commit and you want to know what happens, then she will just get sleepier, which is not a bad way to go. It is a slow progress so you will have to consider if there will come a time for 24/7 care,
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Reply to MACinCT
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CKD 4 can be managed by a low protein, low salt diet for years before one tips over to CKD 5 which means the kidneys have failed and renal replacement therapy is the only choice.

Go to the website NIDDK.org Through and search for the CKD diet. You will find guidelines there for a diet.
If your mother begins to retain fluid and her water pills aren’t doing the job, she may need dialysis. Usually dialysis begins with a eGfr of < 15%.

Low protein ( ask her nephrologist how many grams of protein is her daily limit). Low salt. No IV dyes. Use Tylenol for pain but don’t exceed 2gr daily. Daily fluid restriction. Low phosphorus foods (high phosphorus will cause itching). Lots to learn.

The possibility definitely exists that she may progress to needing dialysis. If that is the case, you, your mom and your family will need to decide if beginning hemodialysis on an 89 y/o will improve her quality of life. As someone wrote succinctly in a response, attending dialysis 3x/week can be exhausting for the person. Between transportation to and from, getting dialysis, etc will take the entire day. Dialysis will need to be done 3x/wk - no skipping. There is another form of dialysis, peritoneal, that a family or patient can learn to do at home. The main issue with this type of therapy is infection if the exchanges aren’t done using sterile/clean technique.

Try to visit with a renal nutritionist and have them look at your mom’s lab results and they will be able to guide you. There is a Renal Dietitian available at any dialysis center ( it’s a Federal requirement to assure Medicare compliance). Often one RD covers several dialysis centers. See if the renal dietician will see you and mom for a consultation (which may cost you out of pocket since mom isn’t on dialysis) yet but it’s money well spent. Often the dietician is an independent practitioner and able to bill insurance for their services, thus a fee for the consult. If through protein restriction you are able to keep her Creatinine down you can stave off dialysis.

Best of luck to you!
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Reply to Shane1124
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Judysai422 May 15, 2019
My dad has Stage 4 kidney disease, but unlike most, his potassium level is very low, Not high. It is critical to meet with the dietician because her diet needs to be tailored to her needs. Most general renal diet articles tell folks to avoid potassium, but my dad needs to do the opposite.
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My father is 87 and started dialysis september of last year. You do have to commit to 3 days a week. My father is there for 4 and a half hours each time. 15 minutes to hook him up, 4 hours on the machine, 15 to unhook him. And its forever. No missing days no days off. Its a huge commitment but for us it has been well worth it. On the days he doesnt have dialysis he feels so much better. He can actually do things. Before he was exhausted all the time. So 4 days of him being his old self is so worth it. Good luck to you. I hope everything works out for you. Be safe. Deb
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Reply to Dcurnan
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You should insist that she lets you go with her to see her Nephrologist, this is the doctor that can help you all understand what she is facing, how to best deal with her diet and what to keep an eye on.
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Reply to Isthisrealyreal
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Just read that dialysis will not effect her heart as earlier b7thought. Here's what I read about ur MILs diagnosis.

www.optum.com
A person with stage 4 chronic kidney disease (CKD) has advanced kidneydamage with a severe decrease in the glomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or akidney transplant in the near future.

This means the kidneys are not filtering the blood and toxins are present. Mom could do dialysis but...she will probably need it 3x a week and be there for 6 hrs. Who will take her?

In your profile, you say other? Diabetes will play a part. My friend was a Juvenile diabetic. From all the needles and IVs over the years, her veins could not take the normal dialysis.
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GeminiSister May 6, 2019
Thank you for your reply.
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Your mother's kidney disease is probably so closely linked to her heart disease that information about it specifically got lost in her overall healthcare information.

Her age itself wouldn't necessarily make any difference in weighing up the dialysis decision, but her general state of health will. It would be best if she and another family member talked through the whole picture with whichever physician is taking the lead on her care.

There is lots of information about kidney function and kidney disease at kidney.org; but do be aware that this and other sites are aimed more at renal patients as such, rather than older people with complex, interlinked, chronic disease.

I think you might find it tricky - and perhaps not much help anyway - to separate out what symptoms are caused by kidney problems from those caused by heart disease. How is your mother managing in general at the moment?
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Reply to Countrymouse
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This is something you need to discuss with her health care team, hopefully she has a renal specialist? Also you need to have a conversation with your mother about what she understands about her condition and what she wants to do about it, I'll link an article that you may find helpful

https://www.agingcare.com/articles/an-end-of-life-conversation-led-by-gawandes-questions-205721.htm
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