Dialysis will usually be recommended if your symptoms suggest that your kidneys have lost most of their filtering ability, and the levels of waste products in your blood are dangerously high.

The medical term for this situation is uremia.

Uremia

Uremia is where your blood contains many of the waste products that are usually passed out of your body when you urinate.

The initial symptoms of uremia are prolonged fatigue (tiredness) and drowsiness. You may later experience symptoms such as itchy, dry or flaky skin.

Other symptoms of uremia include:

• an unpleasant metallic taste in your mouth
• an unpleasant ammonia smell on your breath (ammonia is a chemical that smells like stale urine)
• loss of appetite
• feeling sick (nausea)
• being sick
• muscle cramps
• sleeping problems (insomnia)
• mental confusion
• seizures (fits)

Filtration rate

If tests show that your kidneys have lost much of their filtering ability, dialysis may be recommended, regardless of whether you have started to experience the symptoms of uremia.

Dialysis is also often recommended for people with diabetes because the combination of diabetes and uremia could lead to serious complications, such as nerve damage or malnutrition.

Chronic kidney disease is diagnosed by assessing the filtering ability of the kidneys using a measurement called the glomerular filtration rate (GFR). The GFR measures how many millilitres of blood your kidneys are able to filter over a given time.

Using a blood test, GFR can be estimated to a reasonably high degree of accuracy. A person with healthy kidneys would have a GFR of 90 or above.

A GFR below 15 would indicate kidney failure or near kidney failure and dialysis will probably be recommended.

Read more about how chronic kidney disease is diagnosed.