Life is hard on dialysis.
You can only drink about one liter of fluid a day because the more you drink the harder it is to remove blood volume through dialysis.
Diet must be dramatically changed to low potassium, low phosphorus. “Forget about potatoes, tomatoes, avocados, bananas, and cut down on chocolate, beans, ice cream, cheese and yogurt,” said Dr. Danuta Trzebinska, medical director of UCSD’s dialysis center.
“You’re not going to feel good, and will still have a lot of fatigue. Some have a lot of depression. The quality of life is not great.”
Many have significant depression.
The average age is 59. At UCSD, the youngest is 25. Two out of every five dialysis patients hadn’t seen a nephrologist before they were told they needed to start the process, and were unaware they were in kidney failure.
And dialysis doesn’t work miracles, Trzebinska said. For people whose kidneys no longer make any urine, which is most of the patients, dialysis restores only 8 percent of their normal, healthy kidney function.
Plus, said Wendy Lester, administrative nurse manager of the UCSD unit, many are on 10 to 15 medications a day, “and it’s difficult to coordinate. Some will decide this is just not the way I want to spend the last few years of my life.”
And if they have diabetes, as many do, they have to avoid foods high in carbohydrates.
Sometimes, she said patients just decide to give up.
“Doing this year after year after year, I can see that it gets old,” Trzebinska said. Of the 60 patients who died in the five years through 2016, 24 died because dialysis became too hard and they stopped coming, she said.