Dialysis question - advice please

[RiaJam]

Good morning!

As some of you know my brother was in ICU for many weeks due to COVID. He is now in a specialist renal hospital as his kidneys are still not working. He is doing well apart from this.

I have seen him a couple of times on the ward - he is very ‘skinny’ but seems to be perky enough in himself. He is a ‘do’er’ and has a very strong mind. He seems to be his normal self with no indication of trauma about what happened: ‘it happened and it is what it is. Now I just have to get stronger and get back to normal’.

Yesterday he was due to have a biopsy taken of his kidneys to see what is happening and to try and ascertain why the aren’t working. He was asked to lie on his front completely still for 20 minutes. Due to the lung damage from COVID he was not able to do this for 20 seconds let alone 20 minutes as he was unable to breathe. Needless to say the biopsy did not go ahead yesterday.

My concern is that they had stopped his nutrition (via NG tube) the night before. When I arrived there at 3pm yesterday they still had not reintroduced ‘food’ or liquid. So.......my question is ‘how are his kidneys going to work if there is nothing going in for over 24 hrs - nothing in, thing out kinda thing.

He has lost over 5 stone and is diabetic (T2). His blood sugar was 6.1 while I was there but I can’t really understand, if he is not having any food / drink, how are his kidneys supposed to work. He is seeing SALT today re his swallowing so may be allowed food after almost 4 months. The concern is the damage being done to his kidneys while he remains in this ‘body starvation’ mode. Surely he should be given water to sip if nothing else? Any advice gratefully received.

Thank you all.

[FamilyHistorian]

RiaJam

I don’t know about the kidney question but I had swallowing issues. In the 2 hospitals that I was in they treated the feed a bit like a prescription and wouldn’t re-start it / change it without authority of SaLT. I too lost a tremendous amount of weight and had to learn to swallow by doing exercises with chipped ice. This progressed to to water and then to flavoured water - oh joy! Through out this time I was fed via a tube. I managed to get the feed to 12 hours over night so that I wasn’t tied to the feed during the day. When I moved to the other hospital late evening I took my feed with me but wasn’t allowed to have it as it hadn’t been “prescribed”! The following day they agreed the feed and upgraded my food to mush. On the day I went home the tube was removed.

[Sepsur]

I am not medically trained in any way but I do know that patients with kidney failure are commonly advised to drink plenty of fluid.

I am starting two trial leukaemia drugs which can lead to further kidney damage - for this issue to be reduced - I have to drink over 3lt of water a day.

[RiaJam in reply to Sepsur]

Thank you Sepsur. I will ring the hospital and ask them. Good luck with your treatment.

[Sepsur in reply to RiaJam]

Thank you 😊

[RockRunner]

I don’t know if the stores in the body will be sufficient but I can say re the kidneys that even after acute failure they can recover. So what they are like now will not be like they potentially are in 3 months. My husband had complete failure for the 2 months he was on a ventilator and a further 20 days in ICU. In ICU they are usually on a filter rather than dialysis which they are on 24/7. This is necessary but messes up the kidneys and in effect puts them to sleep because the work is being done for them. It can take up to 3 months for recovery. My husband’s were very badly damaged and we were told he would likely need permanent ongoing dialysis. However one consultant on the renal ward was convinced they would recovery, not to the full extent but enough not to require dialysis. He said it’s just time. Since he has been discharged his function has gone from 9 to 12%. Still low but enough to keep off dialysis. He is having bloods every week and attending renal clinic every week but has been told he still has a while to g before we know the maximum his kidneys will recover. So the biopsy may not be relevant for indicating what they will do long term. Keeping everything crossed. In our renal hospital all their CoVid patients with acute kidney failure had their kidneys recover. My husband was more sick than the others but consultant still confident x

[RiaJam in reply to RockRunner]

This is marvellous RockRunner. Thank you so very much for taking the time to reply. It has boosted my confidence that my bro’s kidneys will recover. Thank you. This is a really helpful group. Wishing your husband a recovery to full health. X x

[Marcita]

My mom had Covid and did lots of dialysis. She's fine now.