Alternatives to dialysis for kidney disease

Alternative measures must be used after an elderly woman refuses dialysis for chronic kidney disease.

woman

Case
Jane is 78 years old and living independently. Her son brings her to the ED following a fall at home.

Although she sustained no significant injuries from the fall, her blood tests reveal a normochromic normocytic anaemia with a haemoglobin of 93g/L (normal range: 110-165g/L).

Her biochemistry shows a metabolic acidosis and elevated urea and creatinine of 15.9mmol/L (3.1-8.1mmol/L) and 260µmol/L (49-90µmol/L)

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