28 July 2026 | santosh hospitals

The kidneys filter approximately 180 litres of blood daily, removing waste products, balancing electrolytes, regulating blood pressure, and producing hormones that control the production of red blood cells. Chronic kidney disease develops when this function declines progressively over months to years.

Kidney function is measured as eGFR, estimated glomerular filtration rate. A normal eGFR is above 90 mL per minute. CKD is staged 1 through 5 based on eGFR. By Stage 4, eGFR is 15 to 29. At Stage 5 end-stage kidney disease, eGFR falls below 15, and the kidneys can no longer maintain the body's internal environment without external support.

Diabetes and hypertension together account for the majority of CKD cases in India.

Symptoms That Tell You Kidney Function Is Worsening

These symptoms appear as kidney function declines and the body's ability to manage waste and fluid diminishes.

● Persistent fatigue and a complete lack of energy as waste accumulates in the blood and anaemia develops from reduced erythropoietin production

● Swelling in the ankles, legs, and around the eyes from fluid retention the kidneys can no longer excrete

● Reduced urine output or changes in urine appearance frothy urine from proteinuria or changes in colour

●  Nausea, reduced appetite, and a metallic taste in the mouth are classic signs of uraemia as waste products accumulate

● Difficulty concentrating and mental cloudiness (uraemic encephalopathy in advanced stages)

● Breathlessness at rest from pulmonary oedema when fluid accumulates in the lungs

● Persistent itching all over the body from phosphate accumulation under the skin

When Is Dialysis Needed?

The decision to start dialysis is never based on a single number. A nephrologist at a kidney hospital in Ghaziabad weighs multiple factors together:

An eGFR falling below 10 to 15 mL per minute is the standard threshold for most patients. However, if complications appear earlier, severe fluid overload unresponsive to diuretics, dangerous hyperkalaemia above 6.5 mmol/L, uraemic encephalopathy causing confusion, or metabolic acidosis that is not correctable by other means, dialysis may be initiated sooner.

The goal is to start dialysis at the right time, early enough to prevent dangerous complications and not so soon that patients lose months or years of adequate kidney function unnecessarily.

Types of Dialysis Treatment Available

There are two main forms of dialysis treatment. The right choice depends on medical factors, home circumstances, and personal preference.

•  Haemodialysis blood is circulated outside the body through a dialysis machine that filters waste and fluid and then is returned. Sessions typically last 4 hours and are done 3 times a week at a dialysis centre in Ghaziabad. Vascular access through an arteriovenous fistula is the preferred long-term access.

•  Peritoneal dialysis: the peritoneal membrane lining the abdomen acts as a natural filter. Dialysis fluid is infused into the abdomen through a catheter, allowed to dwell, then drained. This can be done at home, often overnight, and suits patients who want more daily flexibility.

•  Both modalities achieve comparable clinical outcomes in suitable patients. The choice is made in discussion with the nephrologist.

The prospect of dialysis is daunting for most patients and families, but the reality of modern dialysis is far more manageable than most people expect before they start. Many patients live well on dialysis for years, maintaining meaningful daily routines and quality of life.

If you or a family member has been diagnosed with chronic kidney disease or has been told that dialysis may be coming, the right step is an early conversation with a nephrologist at Santosh Hospitals, the leading kidney hospital in Ghaziabad.

Frequently Asked Questions

Q1. Once dialysis starts, does it mean a patient's kidneys have stopped working completely?
 Not always completely. Many patients on dialysis still have some residual kidney function, which is one reason peritoneal dialysis or less frequent haemodialysis schedules can sometimes work early on.

Q2. Can kidney function improve enough to stop dialysis once started?
 In chronic kidney disease, dialysis is usually lifelong unless a transplant follows. In acute kidney injury, however, function can sometimes recover enough for dialysis to be temporary.

Q3. Is peritoneal dialysis less effective than haemodialysis?
 No — both achieve comparable clinical outcomes in suitable patients. The right choice depends more on lifestyle, home circumstances, and medical factors than on one being superior.

Q4. Why do some patients need dialysis at a higher eGFR than others?
 Because the decision isn't based on eGFR alone. Complications like severe fluid overload, dangerously high potassium, or uraemic confusion can push the timeline earlier than the standard threshold.

Q5. Does diet still matter once a patient is on dialysis?
 Yes, significantly. Fluid, potassium, phosphate, and sodium intake all still need active management on dialysis, since the treatment doesn't fully replace the kidney's day-to-day regulatory work.