@booma Yes, it is an individual decision, to be sure. If I had the chance to tell your brother, I would say "Bro, you get to make your decisions. The doctors will not go ahead without your agreement to any procedure. Being informed by your team what the pros and cons are, think about it all, and where you want to be in a year, in five years, in ten years. And look ahead."

@boomer88 I found your comment so interesting. I felt the same way. Almost 7 years ago my then-medical team told me at some point this rare kidney disease I had might eventually lead me to dialysis, and I thought "oh, it's a long long way off, I'll deal with it then". I have watched my eGFR drop, and then 2 months ago my nephrologist brought up port placement, and swept the carpet out from under me!

Let me relate my husband's story. In 2001 he was told about his high blood pressure, and put on medication for it. But the damage to his kidneys had already started. In 2011 he had to go on dialysis [choosing peritoneal], and and fought that, also thinking his independence was gone. He wanted one last cross country tour on his motorcycle, wanted to do a lot of things, still working full time, etc. In the end, he took that long trip, and several others. Never missed a day of work. And didn't lose his independence; he made his dialysis work for him by working at it. He researched and built an inverter and deep cell battery set-up that eventually allowed exchanges out in the desert in a tent trailer. He has told this story to many, and is proof dialysis doesn't have to be end-of-life-as-you-know-it. He was transplanted 10/1/2016, and is doing great.

To both of you, yep, I can relate to where you are, how you feel, in my headspace and body. Write it out, your feelings. your questions to be shared with your medical team. Look for and lean on your support team. Will you do that?
Ginger