My recent test results..

[SRAM99]

I thank everyone in the forums who are giving me good support in dealing with CKD and high BP. i especially thank namaha and gangadharan nair for their detailed replies for my queries.. Recently, i got my medical condition reviewed. I am very sorry to state that my condition is getting worse. In December 2018, my serum creatinine is 4.6 and the nephrologist, suspecting kidney infection, prescribed Cudoforte capsules and increased hypertension dosage to 10 tablets per day.. the tablets prescribed are (1) Arkapres=150mg daily three times; (2) Calcigard Retard daily three times; (3) Mexovas daily morning and night; After using Cudoforte capsules, serum creatinine reduced to 4.3. The nephrologist advised me complete rest..

I got done another review in February and to my surprise, creatinine increased to 6.6 even though i took maximum rest for 2 months.. Again the nephrologist suspecting infections, gave me injections for 4 days.. The injection is Zonamax ES. every day creatinine observed and it came down to 4.6.. In all these 4 days, I am in hospital and my BP is monitored with additional tablet given Prezopress xl 2.5; this was suggested morning and night times.. In hospital too my BP varies frm 130/80 to 160/100 even though I am in complete bed rest..

since discharge from hospital in February, I am in complete rest at home and In March 1st week, I had my tests done again and creatinine is again 5.60.. The Nephrologist now giving me injections for increase in RBC in bone marrow. Electrolytes in blood are within range; Urine Albumin reads 2+; Platelet count is good. Hymaeglobin is around 9..

From October 2018 to March 1st week 2019, my weight increased from 82 kgs to 88 kgs.. I am obese and itz hereditary. But since I am supposed not to do cardiac exercises, I am not resorting to.. I am walking one km in the evening.. slow walking..

Urine outflow is normal.. for 3-4 litres of water intake, I am getting back all the 3-4 liters..

I am almost taking zero salt.

Now, kindly give me your suggestions..

(1) Shall i go for second opinion in any Superspeciality hospital; How about Asian Institute of Nephrology and Urology, Errum Manzil, Hyderabad;

(2) Kindly suggest any other best nephrologists in Hyderabad;

(3) Are there reasons beyond CKD for bp fluctuations; Can any blood clots in nervous system cause bp fluctuations? Why dosage of 10 tablets for bp is not at all effective??

(4) In general what will be the rate of damage in CKD patients for creatine varying to normal to dialysis stage..

I am really worried about my health condition and I am a salaried person and i couldn't discharge my duties effectively. I know CKD cannot be cured, but these sudden and sharp rises in creatinine is causing me sleepless.. I am spending about 10K for medicines, tests, consultation every month and this month another 5k increased. Please help in managing my disease with your experiences and suggestions..

I again thank you all the members of this forum..

[namaha Administrator]

Dear SRAM99

I am extremely sorry to hear your health condition. At this point of time , You should be under the able guidance of a renowned nephrologist.

I am not sure about Apollo Hyderabad, but Apollo Chennai has got a couple of excellent nephrologists.

Mr MK Mani is the Head with more than 35 years experience in dialysis, kidney transplant. Mr Subba Rao is another reputed nephro. Though I wish and pray that you recover without Dialysis and transplant, but at this creatinine level, any nephrologists would advise you to go for a transplant as early as possible to avoid complications. Chronic renal failure is a progressive irreversible damage. Unfortunately, the modern science till date has not been able to find a easy treatment solution for kidney failure.

The normal process is that they may advise you to start dialysis and then plan for a transplant.There are hospitals in Delhi which carry out pre-emptive transplant depending upon patient condition. Pre-emptive transplant is considered without Dialysis if you have a ready live donor and your conditions are not complicated. Nowadays , any blood relative can donate a kidney. It is safe for both the donor and the recepient and cost effective. Quality of life is much better than Dialysis and you can live like a normal person, though people live on dialysis for decades.

Request other members if someone can throw some light to help SRAM99.

May God bless you for your quick recovery!

[gangadharan_nair]

The typical human reference ranges for serum creatinine are 0.5 mg/dL to 1.0 mg/dL (about 45 μmol/L to 90 μmol/L) for women and 0.7 mg/dL to 1.2 mg/dL (60 μmol/L to 110 μmol/L) for men.

Cudo Forte Capsule contains a unique combination of probiotics that helps to reduce the extra loads of nitrogenous toxins in the body. It has combination of lactic acid producing organisms. Cudo Forte Capsule is used for Urinary tract infections, Immunity, Bacterial infections, Lactose intolerance, Bacterial infection, Bowel problems.

Arkapres 150Mcg (brand name) Clonidine (generic name)Tablet is used in the treatment of hypertension. It effectively brings down blood pressure by reducing levels of certain body chemicals. This in turn relaxes the blood vessels, allowing the heart to beat properly.

Calcigard Retard 20Mg (brand name) Nifedipine (generic name)Tablet is used to treat high blood pressure and to control angina (chest pain). Nifedipine is in a class of medications called calcium-channel blockers. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood and oxygen to the heart.

Moxovas 0.3 (brand name) Moxonidine (generic name) Tablet is used alone or in a combination with other medicines for the treatment of high blood pressure.

Zonamax ES Injection [Contains Cefoperazone (1000 mg) + Sulbactam (500 mg)] is a combination medicine used to treat infections of the respiratory tract, urinary tract, bone and joints, intraabdominal infections, skin and soft tissue infections, etc. caused by susceptible bacteria.

Prazopress XL 2.5 mg (brand name) Prazosin (generic name) Tablet XL is an antihypertensive medicine which is used to treat high blood pressure and Benign Prostatic Hypertrophy (prostate enlargement). This medicine should be used with caution since it may cause temporary loss of consciousness due to the sudden decrease in blood pressure (syncope).

You seek a second medical opinion from another Nephrologist. Please note that kidneys play an important role in controlling blood pressure. People who are 51 and older, African Americans, and people with diabetes, hypertension or CKD should reduce their sodium intake to 1,500 mg each day. (Not zero salt)

Links:-

en.wikipedia.org/wiki/Probi...

en.wikipedia.org/wiki/Cloni...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Nifed...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Moxon...

en.wikipedia.org/wiki/Cefop...

en.wikipedia.org/wiki/Sulba...

en.wikipedia.org/wiki/Prazosin

medlineplus.gov/druginfo/me...

medlineplus.gov/ency/articl...

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To begin with I know someone in a similar situation was told to reduce his proteins intake that puts excess load on your kidneys. Also drink as much water as necessary, not more than that. Take a second opinion as advised by others but also consult some holistic healer. They do have good options for Chronic ailments..

Nevertheless all the best.. take care😊

[makarim]

I sincerely prey for your recovery.please consult a renowned nephrologist from Appollo ,chennai or Hyderabad.Mr nair has given a vivid description of all your drugs.In my opinion start dialysis first along with all food restriction.If donor is o.k. then transplant.I wish you a speedy recovery.Thanks.