Can
I Get Off Dialysis?
How Can I
Avoid Complication of Dialysis
Majid
Ali, M.D.
Can I get off dialysis? I have
been asked this question many times since 2005 when
I published my data showing that chronic kidney
failure can be reversed. My answer: There is only
one person who can answer this question: You.
In my published article, I
reported that none of my patients who saw me with
incremental kidney failure (creatinine level below 4
mg/dL) before starting dialysis went on to dialysis
under my care, However, I have not been able to
reverse kidney failure for patients who were on
dialysis for more than a year. There are many
reasons for this. First, dialysis costs $70 thousand
to $100 thousand per patient per year. However, no
reimbursement is allowed for nondrug natural
therapies to reverse kidney failure. So most
patients were unable to follow my program fully for
more than three months to test this possibility.
Second, I was not able to tell them that I had been
able to help some patients indeed get off dialysis.
Lacking such knowledge I was not surprised when they
could not fully commit to the project. Third, the
disease processes that make dialysis necessary often
cause widespread tissue damage in organs other than
the kidneys. So the reversal of kidney failure also
requires control and/or reversal of other coexisting
disorders. For years, I patiently waited for one
such patient who was willing and able to explore
this option in a meaningful way. Finally, it
happened. Below is the case study of the man who
made his dream (and mine) come true.
I am ambivalent about posting
this account on Wiki-Medical. I fear that it might
create high hopes for many who may not be able to
undertake this journey. The success of one man by no
account assures that of another. Yet, withholding
such information seems to be a serious ethical
lapse. So, here its is.
I’ll Not
Take Dialysis No More
A 69-year-old man consulted me on
February 1, 2011. He had received hemodialysis for
eighteen months.
"I’ll not take dialysis no
more."A 69-year-old man announced as he entered my
consultation room the office February 1, 2011.
"Are you on dialysis now?" I
asked.
"Yes, I was for 18 months."
"You must know it is not safe to
go off dialysis like that."
"I know. I know. This is my
decision," he spoke firmly, looking at me with
penetrating eyes.
The number of people who take
their lives every year by discontinuing dialysis in
the United States runs into thousands, some years
exceeding 12,000. This was a shocking number when I
first encountered it while co-writing
"The Pathology
of Maintenance Hemodialysis" (1882), the first
textbook on the subject, with professor Alfred Fayemi of Mount Sinai School of Medicine, New York.
In the following years, even higher numbers of such
loss of lives were routinely cited without raising
any eyebrows. My mind drifted to conditions that
might lead women and men to this decision.

v
"What caused the kidney failure
that led to dialysis?" I asked.
"I don’t know," he replied
indifferently.
"Did you have high blood
pressure?’
"Yes."
"Any heart disease?"
"Yes, they gave me a
defibrillation treatment after I had a stroke. That
was a year before they put me on dialysis."
"Did you a coronary artery
stent?"
"That too. I don’t want dialysis
anymore."
"Why?"
"Why? Because I’m disgusted."
"Are you depressed?"
"No. Not depressed but
disgusted."
I examined him. He was in
congestive heart failure with fluid in his lungs,
swollen legs, and a rapid heart beat with premature
heartbeats. Then in the presence of his family, I
spoke at length about the dangers of abruptly
stopping dialysis. Finally, I told him that I would
diligently work with him to see if that would be
possible but only if he resumed dialysis. To my
surprise he agreed. Fast forward to mid August 2011
The
Hospital Said I No More Need Dialysis
"The doctors at the hospital told
me I don’t need dialysis anymore," he beamed as he
was ushered into my consultation room.
"Good! That’s good! Did they
really say that?"
"Yes, yes."
"When did you get your last
dialysis treatment?"
"Almost three months ago."
"That really is good!" I felt a
surge of excitement and wondered what his blood
creatinine level might be. It was eight or more,
there would be little reason to really get excited.
"So the doctors at the hospital really didn’t think
you needed more dialysis?" I asked, recognizing the
irrelevance of the question.
"No, they didn’t give me another
dialysis appointment.
I stood up and examined him.
There was no edema of legs, nor fluid in lungs. His
heartbeat was stable, though with premature beats
every now and then. There was no undue abdominal
protuberance indicating free fluids in the
peritoneal cavity. Still, there was the unanswered
question of the blood creatinine level. I had to
wait for the laboratory to settle that. Next day,
the answer arrived: a blood creatinine level of 4.5
mg/dL. That validated the decision of the hospital
doctors to discontinue dialysis.
Don’t Count
the Chicken Yet
I anticipate skepticism from
nephrologists (kidney specilaists) who never
consider the possibility of discontinuing dialysis.
Don’t Count the Chicken yet, many of them will
admonish me. The condition of the patient can
rapidly deteriorate necessitating dialysis. Point
made and taken, however, it is also possible that he
will continue to follow our program for reversing
kidney failure and for improving cardiovascular
status through improving the oxygen homeostasis.
That’s the point!
So the message of the man in the
story is possibility, not promise. Why can benefit
from this case study? Only those who are open to the
possibility and able to test it out.
Success in
Failure
What if one tries to get off
dialysis and fails? My program for reversing kidney
failure and for improving cardiovascular status
through improving the oxygen homeostasis helps
everyone. It goes a long way to prevent serious
complications of dialysis. The dialysis machines, as
good as they are, are never a full replacement of
natural kidneys. So, even in failure, one succeeds.
That’s the second point!
Video
Seminar on Saying No to Dialysis
I present my full program for
reversing kidney failure and for improving
cardiovascular status through improving the oxygen
homeostasis in a two-DVD
set available from
www.majidalimd.com.
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