Dialysis and CKD. If you have stage 4 chronic kidney disease (ckd), it is unlikely that you need dialysis at this time. How long ago were you informed of your ckd? I would go to a nephrologist, have a 24 hour urine collection for creatinine clearance and protein, blood work looking at intact parathyroid hormon and phosphorus levels as well as a renal ultrasound. These will answer the question if you need dialysis.