My Dad has just 20% function left

[NICOLETTE2020]

Hi Everyone. My Dad had an aneurysm earlier this year and his kidneys have suffered. Now he has 20% function left. We don't have alot of answers because his last 3 appointments with renal team since leaving hospital has been over the phone due to Covid. He does have a proper appointment next week but my question is if his potassium and phosphate levels are within acceptable levels will the kidney function continue to decline or are blood levels and function not as closely related?

[Bhanwre]

N,

Kidney function improves if you are able to identify the reason for the damage and omit it's use (or if that is not possible, reduce it's use).

In my case, over the last 2 decades, I've noticed that by reducing my potassium intake (fruits & unleached vegetable intake) and my protein intake (bringing it down from 40gms/day to 25 gms/ day now) has helped me keep the functioning stable.

[RickHow]

First about doctor visits over the phone. This should not be a reason of not getting answers to questions you have concerning your father. There should be no difference in answering a question on phone, versus in person. If some time of test (blood, scan, urine, etc.) is needed for the doctor to answer then he should schedule it (via phone) and call you with results. An in person appointment is not going to change things. The doctor has no xray vision to see what is going on with your father just by being in the same room with him.

I assume your fathers aneurysm was heart or abdominal. A condition know as AAA (aortic abdominal aneurysm). Your fathers kidney function must have been already quite low and this is what led to the aneurysm, not that the aneurysm caused the kidney damage (it may have increased already existing kidney damage). People are not commonly aware that over 50% of people with CKD eventual become seriously ill or pass away not from actual kidney failure but from cardiovascular events caused by a "weak" kidney. So without knowing the actual facts of your fathers case it seems likely he had a "bad" kidney to begin with, which led to the aneurysm, which left him at 20% function.

Now perhaps it was a brain aneurysm (not as common due to kidney problems or visa versa). But there is not as strong a relationship between this type of aneurysm and kidney.

In any case the current situation is 20% function. You are hopeful, and wondering, if having normal potassium and phosphate levels, will the kidney continue to decline. Naturally you are searching for hopeful answers. Look at it this way, having normal levels is certainly much more beneficial than having negative levels. Negative levels, over time, would speed up decline. And these two things are important in the blood. But they are not major factors in decline. Abnormal levels can be a factor in causing other problems which lead to death, but do not usually cause end stage renal disease. Here is what a recent study concluded:

"In patients with stage 3–4 CKD, serum potassium level <4.0 mmol/l and >5.0 mmol/l are associated with higher mortality but not with ESRD." In more simply terms abnormal levels lead to problems which had higher than normal mortality, but are not associated with ESRD".

What you are searching for is what we all search for, and that is hope. That the kidneys will not decline further. Unfortunately in every human, our kidneys decline as we age. Your fathers kidneys are at only 20%. Kidney function is not normally restored. Once a kidney is damaged, it is damaged. Portions of the kidney are actually dead. Now you may hear of some that had kidney function totally restored. But this is only in cases where the kidney failed due to a variety of causes (such as urinary blockage, or blood flow blockage) which was discovered quickly (almost an emergency basis) and rectified.

You have a basic, and simple question, which your doctor should be able to answer on the phone. "Will his kidney function be restored, or is it highly unlikely?". Without details of his kidney function before the illness, age, etc., how quickly the aneurysm was repaired, it can't be answered on the internet.

[Sammi_n_Munk in reply to RickHow]

Wow. That is awesome advice Mr. How and very well put. That was very insightful and informative, and also so true. We do all want to hear that our kidneys will repair themselves, don’t we? I know I do! Lol! Unfortunately, that’s not very likely right now, but maybe (that is, hopefully) one day, it will be. Thank you for your wise words. 😊👍✌️

[RickHow in reply to Sammi_n_Munk]

thanks Sammi

[NICOLETTE2020 in reply to RickHow]

He saw the doctor yesterday and was told he is still at 20% and it will not improve. She also told him that any sort of infection or illness will cause function to decrease further.

[RickHow in reply to NICOLETTE2020]

Sorry your news was not what you were hoping for. I send you a link that discusses in everyday terminology all about stage 4 CKD (as your dad has). It not only talks about living with stage 4 ckd, but gives recommendations (diet, etc.), lifestyle changes, etc. All things to make things as normal as possible. It includes prognosis information based upon sex and age. the motto when I went to high school (many years ago) was "knowledge is power". Hopefully this article gives you some power and brings you some hopefulness.

healthline.com/health/stage...

[HealthBuddyMelissa]

There is more to consider than potassium and phosphate levels. Sodium, Creatinine, Vitamin D, PTH and Iron levels all should be monitored when someone has kidney disease. Blood pressure control, along with a diet for kidney patients can help preserve function. Is he Diabetic?

[NICOLETTE2020 in reply to HealthBuddyMelissa]

Not diabetic no. He is eating fine but some things like bananas need to be resricted.

[HealthBuddyMelissa in reply to NICOLETTE2020]

Why are bananas restricted? High Potassium, blood pressure medications?

[HealthBuddyMelissa]

Blood levels are a tool for how the kidneys are functioning. What have the doctors advised to help slow the progression, or possibly improve the kidney function?

[NICOLETTE2020]

They have told him his condition will not improve and decline as time goes on.They gave him some leaflets about what foods to avoid and he gets a dietician phone appointment but he is just eating what he likes and ignoring this for the most part.