Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Can Dialysis Improve COPD Symptoms In An Elderly Person?
Question: My dad is 85. He's had COPD, dependant on oxygen continously for 3 years, diabtic for 3 years. He is unable to do much other sit in his chair. He is already fatigued, moves very slowly, and goes out about twice a week. His doctors have been monitoring his GFR and it's down to 19. They want him to start dialysis when he gets back from 3 months in a warmer climate.
I have been trying to find a legit article that gives reasonsble pros and cons about dialysis for his senario. His admits to being a bit depressed. He knows his life expectancy is short. I want something that will help him decide (quality of life). He wants to die at home. Can you point me in the right direction for something that can make an educated decision?
By the way, he has pulmonary edema and has been updated to Lasix 30mg bid. Ankles are still quite swollen...
Meds: Simivastin 10 mg - 1 daily
Lisinopril 20 mg - 2 daily
Lasix 30 mg - 2 daily
Allopurinol 100 mg - 2 daily
Toporol XL 50 mg - 1 daily
Tricor 48 mg - 1 daily
Aspirin 81 mg - 2 daily
Fish oil 100 mg - 2 daily
Vit.D 1000 IU - 4 daily
Breo Ellipta 200 mcg - 1 daily
Xopenex 1.25 mg 3 ml nebulizer - 3 to 4 times daily as needed
Fenofibrate 145 mg - 1 daily
Misc. vitamins 3 to 4 times a week
Calcium, Glucosamine, Multivitamins
Jannuvia 100 mg - 1 daily
I have been trying to find a legit article that gives reasonsble pros and cons about dialysis for his senario. His admits to being a bit depressed. He knows his life expectancy is short. I want something that will help him decide (quality of life). He wants to die at home. Can you point me in the right direction for something that can make an educated decision?
By the way, he has pulmonary edema and has been updated to Lasix 30mg bid. Ankles are still quite swollen...
Meds: Simivastin 10 mg - 1 daily
Lisinopril 20 mg - 2 daily
Lasix 30 mg - 2 daily
Allopurinol 100 mg - 2 daily
Toporol XL 50 mg - 1 daily
Tricor 48 mg - 1 daily
Aspirin 81 mg - 2 daily
Fish oil 100 mg - 2 daily
Vit.D 1000 IU - 4 daily
Breo Ellipta 200 mcg - 1 daily
Xopenex 1.25 mg 3 ml nebulizer - 3 to 4 times daily as needed
Fenofibrate 145 mg - 1 daily
Misc. vitamins 3 to 4 times a week
Calcium, Glucosamine, Multivitamins
Jannuvia 100 mg - 1 daily
Brief Answer:
Not to go for Dialysis.
Detailed Answer:
Hi
Greetings from Dr.Divakara.P
Thanks for choosing HCM.
First let me explain how it will be is he gets dialysed. A wide bore cannula will be inserted near his neck which may be kept for 2-3 weeks . Through this cannula dialysis has to be done for which he needs to visit hospital 1-2 times a week . Every dialysis session he has to sit for 3 hours. Inspite of all this there will be marginal improvement in his health condition as Dialysis shall only improve Pulmonary edema but not COPD /Oxygen dependency.
Now if you don't dialyse him his condition shall gradually deteriorate due to worsening pulmonary edema .
Now there is no right or wrong decision with regard to whether dialysis has to be done or not . But considering his age , life expectancy , his depression and outcome after dialysis my personal opinion is not to go for dialysis.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Not to go for Dialysis.
Detailed Answer:
Hi
Greetings from Dr.Divakara.P
Thanks for choosing HCM.
First let me explain how it will be is he gets dialysed. A wide bore cannula will be inserted near his neck which may be kept for 2-3 weeks . Through this cannula dialysis has to be done for which he needs to visit hospital 1-2 times a week . Every dialysis session he has to sit for 3 hours. Inspite of all this there will be marginal improvement in his health condition as Dialysis shall only improve Pulmonary edema but not COPD /Oxygen dependency.
Now if you don't dialyse him his condition shall gradually deteriorate due to worsening pulmonary edema .
Now there is no right or wrong decision with regard to whether dialysis has to be done or not . But considering his age , life expectancy , his depression and outcome after dialysis my personal opinion is not to go for dialysis.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
He is going to have the cannula in his wrist, he was told.
That would be my thought too. Could you to describe:
1) Quality of life on dialysis, such as: Dietary restrictions, pain, weakness,how he would feel afterwards, etc.
2) What will happen (COPD aside) is he does NOT - i.e. what would the decline of pulmonary edema be to death be like? How would it differ from death from COPD?
Thanks. XXXX
I've heard some older people feel they have to do dialysis since the doctor told them to, that they regret starting it and sometimes quit.
That would be my thought too. Could you to describe:
1) Quality of life on dialysis, such as: Dietary restrictions, pain, weakness,how he would feel afterwards, etc.
2) What will happen (COPD aside) is he does NOT - i.e. what would the decline of pulmonary edema be to death be like? How would it differ from death from COPD?
Thanks. XXXX
I've heard some older people feel they have to do dialysis since the doctor told them to, that they regret starting it and sometimes quit.
Brief Answer:
Not difference from death due to COPD.
Detailed Answer:
Hi
No initially the Cannula would be put in the neck and after few weeks a small port will be made in his elbow ( AV fistula ) through which subsequent dialysis shall be done.
There shall be lot of dietary restriction like reduced intake of water ( not to exceed 800 ml per day ) has to avoid fruits , all vegetables has to be peeled and used .
Pain shall not be much , weakness actually improves initially but with subsequent dialysis weakness keeps on increases.
Worsening Pulmonary edema causing increase in his breathlessness , inability to walk for few steps ( finds difficulty even to go to bathroom ) and eventually can't even lay down as breathlessness increases on lying down and at last he shall become breathless even in sitting position and can't even complete one short sentence due to breathlessness. This progressive breathlessness will lead to death eventually. There is no significant difference from death due to COPD.
With dialysis most elder people will go into serious depression.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Not difference from death due to COPD.
Detailed Answer:
Hi
No initially the Cannula would be put in the neck and after few weeks a small port will be made in his elbow ( AV fistula ) through which subsequent dialysis shall be done.
There shall be lot of dietary restriction like reduced intake of water ( not to exceed 800 ml per day ) has to avoid fruits , all vegetables has to be peeled and used .
Pain shall not be much , weakness actually improves initially but with subsequent dialysis weakness keeps on increases.
Worsening Pulmonary edema causing increase in his breathlessness , inability to walk for few steps ( finds difficulty even to go to bathroom ) and eventually can't even lay down as breathlessness increases on lying down and at last he shall become breathless even in sitting position and can't even complete one short sentence due to breathlessness. This progressive breathlessness will lead to death eventually. There is no significant difference from death due to COPD.
With dialysis most elder people will go into serious depression.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
