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Bypass heart surgery done. Taking medicine for high creatinine level. Looking for treatment, medication and diet

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My father, age 66 yrs, is having high Creatinine level - 5.42. First time high Creatinine diagnosed in 2012 February, it was 3.9. He was given medicine - Ketasteril, and after 6 months Creatinine dropped to 3. But now it XXXXXXX up high. His other findings -
Urea - 130, Uric Acid - 9, Sodium - 133, Potassium - 4.48, SGOT - 46, SGPT - 58. Left kidney is small (63mm) and right kidney has approx 4-5 mm sized calculi.
He is diabetic, but mostly sugar levels are within normal range. He had bypass heart surgery about 5 yrs back.
The doctor we consulted straightway said he needs dialysis. He said the diabetes medicine, Glyciphage made the Creatinine level go up. Now my father is taking Jalra tabs. But I saw online that Jalra should be avoided by people with kidney problems.
Please advise what treatment and medicines shold be followed with diet, before going for Dialysis. Looking forward to your help. Thanks a lot.
Posted Mon, 11 Mar 2013 in Kidney Conditions
Answered by Dr. Ravi Bansal 1 hour later

Your father is suffering from CRF stage 5, if he has breathlessness or poor appetite, he should be taken for dialysis. I think you should follow the advice of your doctor.

Ketosteril will not be useful now. His liver functions are also abnormal and needs investigation. Glyciphage is contraindicated. Please stop it. Jalra may be used in very low dose if patient is tolerating. Best is to go for insulin for sugar control under guidance of your doctor.

Diet: no juices, less salt, no raw tomato, restrict total liquids as per output. Rest all vegetarian diet and twice per week non vegetarian can be allowed. If his condition is fine, kidney transplant is also a good treatment option.

Further any specific drug doses are best decided by the treating doctor.

Hope I have cleared your doubts. If you have any further queries, let me know.
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