Reaching the academic and insurance approved guidelines to start Dialysis, and meeting the GFR (kidney function) to have the diagnosis of Renal Failure or End Stage Renal Disease, ESRD; these two milestones are not a reason to be trapped in the world of Dialysis.
Certainly, there is plenty of evidence in the medical literature to support starting Dialysis as soon as you reach these milestones, but the ” literature” does not know about the unique “YOU” in particular, i.e. your personal preference, your life style, how you feel in general, other illnesses you might have, your social support etc…
If you reach the milestone needing Dialysis, the first thing you need to do is to STOP, take a breath and talk to yourself first, your Primary Care Provider, your Nephrologist and all individuals involved in providing you with support.
Do not forget also to visit the Dialysis center, talk to the staff and to a patient that you know personally and ask plenty of questions. After you conclude your evaluation and all your questions are answered, then STOP AGAIN, and talk to yourself to make a decision. Any decision you make is the best decision you make for YOURSELF, because you know yourself the best.
Nobody should have any authority to order you to follow a certain approach. THIS IS YOUR LIFE.