@ldrlaw, I, too, have been on dialysis when my CKD went from Stage III to Stage V suddenly after a severe case of shingles - eGFR dropped from over 30 to 14. Because it was so sudden there wasn't time for a fistula so a central venous catheter (going to the heart) was placed and I went on the Handi van to the dialysis clinic here in my town 3 times a week.

Dialysis day really wiped me out and I came straight home, ate whatever was handy, and went to bed. The next day I felt fairly well and was able to do household tasks, personal hygiene, etc. The day after that was ok as well until evening, when I suspected the toxins were building up.

Prior to all this, I had switched to a vegetarian diet - almost vegan but I included free-range eggs in my meal plans (for the protein) and started looking up nutritional values for various foods and ingredients using the USDA website as a primary resource. This led to developing kidney-friendly vegetarian recipes which in turn resulted in my first two recipe collections.

While on dialysis, a fistula was placed but it failed. Then an av graft was attempted in my left forearm but it also failed. But an av graft in my upper left arm is still patent after two+years but has not been used because I was able to stop dialysis about six months after it started. I credit good medical management and faithfully following my diet.

It has been two years since I had dialysis. If I needed to do it again, I probably would for awhile, assuming the av graft remains usable. My decision whether to go back on dialysis will be based on life quality considerations. I'm much weaker now than I was then due to worsening diabetes, ongoing CHF and COPD, and a new diagnosis of gastroparesis and probably could not manage home dialysis (and live alone) so would elect hemodialysis at the local clinic.

With GP I now have two or three "good" days a week (the other four range from yukky to miserable) and currently am able to tolerate that. Adding dialysis and its concomitant fatigue might reduce the number of comfortable days. I won't know if it's worth it until that happens.

The other day my Neph told me I have greatly contributed to my own (and others') welfare with the research and the recipes and my renal diet because many people might not have been able to do the research and develop a diet plan and many would have thrown up their hands and decided to eat whatever they wanted even if it hastened death.

The reason I'm sharing all this is to say that sometimes a person might want to weigh the benefits of dialysis in terms of quality of life. If someone on dialysis is miserable most of the time s/he might elect to stop dialysis in favor of palliative care and comfort measures.

Whatever you and yours decide, please know I'm in your corner!