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Renal transplant and hip replacement done. Endoscopy and colonoscpoy done. Reason for blood loss?

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General & Family Physician
Practicing since : 2008
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1988 Missed abortion in 3 months
1990 Again missed abortion
1992 Sept First delivery after 9 months complete bed rest
1995 2nd Delivery after 9 months bed rest
1996: renal transplant. Over a period the bones have become brittle. She has had an itchy and broken skin
2008 because of a hip problem three screws were inserted to support the hip
2012 March, the hip had got infected and the patient was bed ridden for 5 months
2012 Aug. removed the screws and got a hip replacement done under local anasthisia. the same evening I become critical and the kidney shut down. The BP fell to 60/30. The patient recovered after 24 hours where attending doctors had given up hope
2012 The hip implant had again caught infection. discharge weekly was about 500 ml. Culture reports proved positive. regular albumen and Plazma transfusion continued with blood transfusion 1 unit every two days.
The implant was taken out on 24 Feb. The kidney again shut down and took a week to revive . The blood transfusing continues. We did give 5 units of albumen. We have done endoscopy and colonoscpoy but could not detect reason for blood loss. HB hovers about 6 to 9. One liter of fluid was pulled out of the stomach on the 10th March 2013
The patient is on traction and compression for 6 weeks till 15 April 2013.
Posted Mon, 15 Apr 2013 in Kidney Conditions
Answered by Dr. Raju A.T 9 hours later

Thanks for your query.

The defect in calcium metabolism due to renal disease could have lead to osteopenia and subsequent bone infections. Serious infections will further affect the kidneys due to electrolyte imbalance and toxins released into blood. This could be a vicious cycle.

Kidney is involved in production of a hormone called Erythropoietin which is essential for production of blood cells. The reduced levels of the hormone due to kidney disease could be the most probable cause for the anemia she has.

Hope, I answered your query.

Please let me know if there are any other concerns.

Above answer was peer-reviewed by
Follow-up: Renal transplant and hip replacement done. Endoscopy and colonoscpoy done. Reason for blood loss? 6 hours later
My question is is there any remedy or is there a different line of treatment for this situation or is the line of treatment in order
Answered by Dr. Raju A.T 8 minutes later

Thanks for writing back.

Yes, considering the anemia to be due to erythropietin deficiency. Treatment with synthetic erythropietin is a feasible and an effective option. Treating anemia will solve most of the symptoms she has and also maintain the bone and kidney health.

Hope, I answered your query.

Wish you good health.

Above answer was peer-reviewed by
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