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