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hi my name is dr. Mike Evans and this is a quick overview for people with kidneys that are failing who need some insight into the treatment options including the different types of dialysis as well as how to know when its time to start dialysis so lets start with a kidney 101 you know we talk a lot about balance and health and your kidneys are the superstar of balance whether its fluids or body chemistrys or blood pressure our kidneys orchestrate with other major organs to keep this delicate equilibrium going 24/7 all this while filtering out waste products created by our bodys metabolism so when your kidneys start to shut down your body has a hard time keeping a balance you might retain fluid or waste products your potassium or sodium might become abnormal your blood pressure might rise this can all make you feel rotten and raise your risk for serious illness so you need a new way to filter and balance your fluids and electrolytes and this is where decisions about kidney transpla