Kidney Disease


GFR is less than 20. Should we go for dialysis immediately


Mujtaba A Hasnain

It depends on multiple factors
Presence of high potassium, high acid levels, high urea/uremia, uncontrolled fluid status are indications of dialysis. This happens usually when GFR is less than 15. Thorough physician examination and review of blood test by nephrologist is v important.



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Less than 20 could be 19 or just 5. Need to know exact GFR. GFR is not only criteria nephrologist used. Usually dialysis in started once GFR approaches 10 or less.


If GFR less than 20 is persistent then preparation should be made for dialysis in future, that is formation of arteriovenous fistula. So that when ever needed dialysis may be started.
If you are having symtoms of advanded renal dysfunction ( uremia) at GFR of less than 20 , then you might need dialysis. It varies from patient to patient.


No need for dialsis immediately. Patient needs evaluation with detailed history and examination.


MBBS,MRCP Nephrology-SCE (UK),FCPS (Nephrology), MISN, MPSN | Lahore

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GFR value is just a reading
At this level dialysis is not required

But the reason of creatinine derangement must be known and treated to prevent future need of dialysis

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