in answer to my question

Deb wrote:

t's me again. Ironically I am a health care professional in dialysis and very familiar with ESRD. Because of this I also know too well the outcome of many noncompliant diabetics.

Diagnosis of ESRD is only conclusive through examination of a person's blood work, of course. Some physical symptoms include fatigue, muscle aches and cramping, dry and itchy skin, and lessening of urine output. Many ESRD patients still make urine. The blood work tells most conclusively whether the kidneys are efficient in removing toxins from the body. Most diabetics, especially uncontrolled ones, should also be under the care of a nephrologist in order to monitor the level of kidney function. Once it goes below a certain level, hemodialysis is indicated.

The majority of hemodialysis patients are such due to uncontrolled diabetes. You would not be surprised to learn that even that does not ''wake up'' most of them to become compliant.

''Uremia'' also manifests in mood disturbances, mental confusion, depression, and even hallucinations if severe enough.

my reply:

Hubby has been diagnosed by his physicians as Stage 4 ESRD.  He is under the care of a nephrologist.  He has said when the time comes, he will refuse dialysis.  He's had 8 treatments (when he had his spinal fusion surgery and his kidneys completely shut down) and he says he won't go through that again.  He's the 1 in a million who actually felt the blood going through his veins and had severe exhaustion after each process.   

I have researched uremia and know what he will go through when he is there.  It's between stage 4 and then that I'm wondering about.  

He does seem to have a lot of memory problems.  I'm not sure it's mental confusion, or just loss of memory.  He's been in depression for at least 3 years.  And I think I need a better description of mood disturbances.  I could joke that his mood is always disturbed.  :o)  As for mood swings - yep - he can be a sweetie one moment and a horror 10 minutes later.  

He is coming home for about 10 days next week to make another round of doctor's visits because they are refusing to renew his prescriptions without a visit.  His last labs were 9/13 and were:
A1c 9.1
Triglycerides 1441
gfr 36.1

It will be interesting to see what they are this time.  As it turns out, I will be gone to an art retreat most of the time that he is here.  

Thanks, Deb, for replying.  I was sort of hoping that a spouse who has lived through the end times could share their experiences with us.  And while I'm sure each story is different, it seems to be something that no one writes about.

DW