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Diabetic nephropathy - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2308 Questions
User :   Hi! my father is diabetes patient and 3 weeks back his creatinine was measured as 4.5 mg/dl . 2 days back his creatinine level was observed to be 3.21mg/dl, but blood haemoglobin is decreased to 8 g/dl. My father is 57 year old and what are the possible treatement he should undergo to come out of this problem?                                                                 
Doctor :   hi
Doctor :   Dr. XXXXXXXX here.
Doctor :   let me read what you have typed.
User :   Hi Dr ...
Doctor :   the problem that your father is having could be due to the damage to kidney.
Doctor :   what were his recent sugar levels?
User :   Can it be cured??
Doctor :   is he regular with diet, medication and exercise for sugar control?
User :   recent sugar levels are normal
User :   around 70 - 91 is fasting
Doctor :   uncontrolled sugars, can damage the kidney known as diabetic nephropathy.
User :   ok
Doctor :   was anytime a test called HbA!C (glycosylated hemoglobin) done for him?
Doctor :   *HbA1C
Doctor :   it checks for sugar control over past 3-4 months time.
User :   I dont kniow exact test type but it was Haemoglobin and normally it is 14 and his was 8
Doctor :   kidney damage can lead to anemia or educed hemoglobin depending on the extent of damage
User :   oh\
Doctor :   as the hormone for hemoglobin formation is reduced if kidney is damaged
User :   What is the chance of his kindey start functioning normally?
Doctor :   what I would suggest at this point of time is to do these
User :   I mean creatinine level comes down to less than 2
Doctor :   1) get his HbA1C checked along with a renal scan to look for changes in kidney
Doctor :   2) get his Renal erthythropoitin levels checked to see if the hemoglobin formation is affected
Doctor :   3) let him avoid meat and protien in diet for sometime, stick to simple and bland diet
User :   ok
Doctor :   4) get a diabetologist consultation for him along with a nephrology consultation.
User :   ok
Doctor :   the combined approach will make sure that every aspect is taken care of
User :   If kidney tranplant is not possible than how long can he avoid dialysis?
Doctor :   have you followed what I have said?
User :   I would like to try for kidney change
User :   but just in case?
User :   yeah
User :   I understood it
Doctor :   that can be decided after the nephrology consult, to see if it is necessary
User :   If I want to take my father to nephrologist at vellore. What step I should follow?
User :   As I am have never been to southern part of India
Doctor :   you will have to take appointment there or get a referral letter from your treating doctor, referring to a nephrologist in Vellore.
Doctor :   once you have that, it is easy to take consult there
Doctor :   you can also call up Vellore hospital and find out when you can get the next urgent appointment
Doctor :   and visit there on the given date
User :   thanks. for the information. Based on his haemoglobin and creatinine level can we estimate his CKD stage?
User :   Can I get ... hospital contact number online?
Doctor :   you will also need ultrasound findings and other few special tests to comment on the CKD stage.
Doctor :   yes, you can get it .
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