Trying to help my father (CKD) patient

[JB1969]

I read a lot of posts in the past few days and I have learned so much more about CKD. My father is a CKD patient for over 3 years. His stages keeps fluctuating between stage 2 and stage 3. My major concern today is his acidity, gastric ulcers and bleeding issues. Moment he stops taking his medications ( PPI, sucralfate, H2 blocker) his ulcers comes back.

I think it is the medicines that is causing him so much problem - the phosphate binder, Sodium Bicarbonate, blood pressure medications, vitamins, supplements. I really don't know. It's time to evaluate his medications.

We also plan to do his H.Pylori test- stool. Lets see what is the outcome.

We have taken up with his doctors but so far we are not able to help my father. I am worried and I really want to help him. I am here to understand from you little more so that I can go and talk to his doctors. Thanks - Jubi

[orangecity41 NKF Ambassador]

I am male, age 78 and was diagnosed at stage 3b, over 3 years ago also. I was put on a renal diet. I too was taking PPI daily for acid reflux, but since on renal diet I do not need the pill very often. Has your father's doctor brought up a renal diet for him? If not perhaps bring up that possibility at next appointment.

[JB1969 in reply to orangecity41]

Thanks. His Doctor had an informal discussion about what food to take and what not to. I have started following DaVita Diets instructions as well. We may have to find a dietician who can plan a program for him. Thank you for the suggestion. I wish you well.

[orangecity41 NKF Ambassador in reply to JB1969]

Correction I should have said CKD diet and not Renal.

[KidneyCoach NKF Ambassador in reply to orangecity41]

Were you put on a renal diet or a CKD diet? They do differ. For those with CKD before stage 5 it is usually low protein. Once in stage 5 and on dialysis its usually high protein as the dialysis process removes protein. Best to check on this. Blessings

[orangecity41 NKF Ambassador in reply to KidneyCoach]

It is a CKD diet. Thanks for advising is a difference between CKD and Renal diet. My prescribed diet is low phosphorus, sodium and potassium, and specific amounts for meats/meat substitute, dairy, grains and fruit.

[JB1969 in reply to KidneyCoach]

Thanks for this information. I will check with the DR.

[Siobhancatherine in reply to orangecity41]

Hi. I am just wondering if this diet has helped ur kidney function. No one has mentioned a renal diet to us. My dad is also stage3.

[orangecity41 NKF Ambassador in reply to Siobhancatherine]

The diet has slowed down the progression of the disease for me. Best to ask your father's Doctor if a CKD diet is appropriate. May factors were considered for my diet such as phosphorus , sodium and potassium levels.

[Hidden]

JB, Each of us are individuals, so what works for one might not be any good for another. By wanting to get all the meds evaluated with the doctor is going in the right direction. Include the supplements for they can sometimes cause an unwanted effect. I take sodium bicarbonate myself, enough to keep my pH regulated (7, +/- a little) and checked on a daily basis as it can get all out of whack in a day or two. I prefer to stay a little on the alkali side in deference to my Kidneys.

Maybe you should get another Dr.s opinion for your Dad if his current one is not as focused on the problems as you are.

[JB1969 in reply to Hidden]

Thank you for your reply. I have asked Dad to check his PH level every day from now onwards. He would check once a month kind. Sometimes we tend to forget small small things that we can do at home to check. He takes 2000 mg Sodium Carb and I hope we can regulate the same depending on his acidic level. He gets major acid reflux and doctor referred to it as 'silent reflux". Thanks so much- Jubi

[Hidden in reply to JB1969]

JB1969: You are very welcome. That pH seems like a small thing but it can cause so much discomfort. I check mine early morning at least every day and most evenings late, and adjust my sodium bicarbonate accordingly. Is your Dad's acid reflux caused by a Hiatl hernia? If so, that is treatable but it may require surgery. There is a lot of information on the internet. As we get older, surgery may not be a welcome option, as in my case. I sleep on an adjustable, hospital type bed. That allows me to elevate my torso to sleep which keeps stomach acid from leaking into my esophagus. Also, I do not eat late in the evening to minimize the presence of stomach acid. Having the bed controls at my fingertips also allows me to elevate my feet to minimize swelling. My bed is not the fanciest available and the small investment has been so worth it. Your Dad is so fortunate to have you to look after him. Good luck to you.

[JimVanHorn]

I thought that stomach ulcers can be cured with about 6 weeks of antibiotics. So you need to ask your doctor about this. We do not diagnose here, but maybe he needs to get a second opinion on his therapy from a second doctor. I wish I was in stage 2 or 3, I am in stage 5. The main medication for CKD is his DIET!! It s hard with stomach issues and he may need to see a dietitian who knows about CKD. When I say diet I am not talking about how much food he eats or how much he weighs, I am talking about him eating low sodium, phosphorus, and potassium foods and drinking the proper amount of water that his nephrologist recommends for him. Each of us are told to drink a certain amount of water and it changes with the stage we are in. I wish you luck.

[JB1969 in reply to JimVanHorn]

I thought the same Jim. He was never put on antibiotics. We asked the doctor about it. He suggested another endoscopy and my father declined. Apparently he really got hurt the first time. He had to take antibiotic for the injury he had due to endoscopy. We are planning to do his stool test for H.Pylori. Lets see what happens. I got your point. Will monitor his diet and consult a dietician asap. He is drinking 2 liters of water a day as instructed by his doctor. He Potassium, Phosphorous and Sodium are in normal range as per his latest blood report. However his uric acid is high. Thanks for your reply. This means a lot to me.

[JimVanHorn]

With the antibiotic for stomach issues, it is not some specific super strong antibiotic, it is that you take it for a longer time, like maybe 6 weeks. An endoscope should be done with your father while he is under twilight sleep. He will have to have at least one more. It takes about 10 minutes and he is in and out in no time. It can be done in a clinic without going to the hospital. He should tell the doctor what it is he does not like about this test and they can make some changes. Keep asking questions, I will do my best to answer you, I was a pharmacist at CVS, but I am retired now.