My father had a heart attack last year because his creatinine was 7 that time. Then after 6 dialysis it became 2.5. Now his creatinine level is 3.9. Does he need immediate treatment because no doctor (nephrologist) is available in our town.

Dr. Sajeev KumarGeneral Physician34yrs exp

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No need to do anything now or panic. You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 per cent of your kidney function and have a gfr of <15. There is not a creatinine level that dictates the need for dialysis. The decision to start dialysis is a decision made between a nephrologist and a patient. It is based on the level of kidney function and the symptoms that the patient is experiencing. If the symptoms are bad enough for the patient to tolerate the ordeal of dialysis, then dialysis is started. The creatinine level is used to calculate the estimated glomerular filtration rate (egfr) but is less helpful in predicting symptoms that a given person will experience. 

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