What should I do if I have kidney failure?

1) Is it true I have end stage kidney failure?

Answer: It is certainly a very difficult moment and I do understand your feeling being diagnosed as end stage kidney failure. Patients usually go through stages of denial, anger, bargaining, depression and acceptance. Do not blame yourself or others and discuss your condition with your nephrologist. End stage kidney failure does not equal to death penalty, there are various options available await you!

2) Why ME?

Answer: The number one cause of end stage kidney failure in Malaysia is diabetes mellitus, however, there is a big portion of patients having end kidney failure without a definitive cause. This is due to late presentation and your nephrologist will never be able to give you an answer. We think it is most probably due to underlying glomerulonephritis ( inflammation of the glomeruli- functioning units of a kidney). You are not alone, there are about 4500-4700 new haemodialysis patients every year in Malaysia and the figures is on a upward trend!

3) Am I going to die?

Answer: With the best available renal replacement therapy either haemodialysis, peritoneal dialysis or kidney transplantation, patients with end stage kidney failure can live longer than before. However, without treatment, patients with end stage kidney failure can succumb to the illness.

4) What should I do now?

Answer: Discuss with your nephrologist the best next course of action. You may want to decide what modality of renal replacement therapy suits you most.

5) Deciding modality of renal replacement therapy

Answer: It is up to individual decision. Due to scarcity of organ, unless your immediate family members or your spouse want to donate their kidney, waiting for kidney transplantation from deceased donor will take a very long time in Malaysia. Therefore, you have to decide either to go for peritoneal dialysis or haemodialysis if there is no potential donor for you.

6) Which modality is the best?

Answer: Of course,the best available renal replacement therapy is kidney transplantation. As for haemodialysis or peritoneal dialysis, various studies have shown conflicting results, as in Malaysia, the mortality rate among haemodialysis patients seems to be lower than that of peritoneal dialysis patients. However, there are a lot of confounding factors contributing to this result, my advice to you, choose the modality that suits you most- meaning the modality that suits your life style, your work and your social support.

7) Can I avoid dialysis?

Answer: It is possible if you can find a potential donor for kidney transplantation FAST, however, you must bear in mind that you might nead a few sessions of dialysis to clear the toxins in your body before your operation.

8) Is it painful undergoing dialysis?

Answer:

• It depends! If you undergo peritoneal dialysis, it is painless because there is no needle involved in the process. However, as for haemodialysis, due to needling of fistula, patients might experience pain during the process.
• However, after multiple punctures of the fistula, haemodalysis patients might get used to that.

9) How long can I live undergoing dialysis?

Answer: It is untrue to say that dialysis patients can not live long. Annual mortality rate of dialysis patients ranges from 10-15% and it is usually due to cardiovascular event ( heart attack).

10) Can I return to work?

Answer:Yes, a lot of dialysis patients go back to work and you might want to discuss this with your employers.

11) Can I have children if I am on dialysis?

Answer: Doctor might not encourage you to get pregnant if you are a lady. However, it is OK if you are a male patient although it might not be easy because of reduced sperm count.

12) Follow Up

Answer: A follow – up appointment for review by the doctor will be made for you upon discharge from the ward. Chronic dialysis patients need life long regular follow up.

13) Phone enquiries

Answer: It would be appreciated if you could also restrict all telephone enquires to the listed visiting times and nominate one family member to make calls due to the busy nature of the ward/clinic. Thank you.

Download this information sheet!