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If her altered mental state is caused by the uremia, this is not permanent. Once the uremia resolves, her mental status should return to normal. This is assuming that her mental status is actually being affected due to the uremia. Based on the information you provided, I do not see any indication for dialysis. but the need for dialysis would have to be determined by a nephrologist . The typical indication would be electrolyte abnormalities that are life-threatening such as high potassium levels. Hope this helps.