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Suggest Treatment For Sepsis In A Hypertensive Person

Posted on Mon, 31 Jul 2017

Question: I had severe sepsis in May. I also have 's, sleep apnea with clap, diabetes under control, severe hypertension with meds increasingly resistant, headaches, Muscle cramps,c.f. indicated brain atrophy brain microangiopasty, 100 protein in urine since sepsis. What kind of ongoing damage could be occurring.

Answered by Dr. Dr. Monika Dede (1 hour later)

Brief Answer:
Please see the detailed answer below.

Detailed Answer:

Hello,
I have been through your question.

Based on your lab data, existence of protein (100 )in urine test - you should know that indicate a renal impairment. I have seen carefully your above mentioned problems and I think that even sepsis and diabetes can cause chronic renal problem.
In this situation I suggest to do blood urea nitrogen, creatinine, abdominal ultrasound (to evaluate renal impairment) and to meet a nephrologist for a better evaluation.

I hope my answer helps you.
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Monika Dede (16 minutes later)

Do you think my renal impairment will continue to worsen later requiring dialysis.In light of my health issues as whole how would rate my overall prognosis

Answered by Dr. Dr. Monika Dede (18 hours later)

Brief Answer:
Please see the detailed answer below.

Detailed Answer:
Hello,
Thank you writing back.
I am sorry for my late response.

You should know that further kidney damage will depend on the high blood pressure and situation of diabetes (glicemia levels during your life) poor control of blood glucose.
It is known that during its early course, diabetic nephropathy often has no symptoms and symptoms can take 5 to 10 years to appear after the kidney damage begins.
Based on your history, (HTA and Diabetes) I think that prognosis can be more difficult to predict because the onset of diabetes is not usually well established.
Diabetic nephropathy is the most common cause of end-stage kidney disease, which may lead to hemodialysis.

I hope my answer helps you.
I wish you good health.
Regards.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. Monika Dede (22 minutes later)

Also I had acute over chronic kidney exercise in May during my sepsis event. Does that mean damage is more severe and further along than you first thought.

Answered by Dr. Dr. Monika Dede (22 hours later)

Brief Answer:
Yes this means that the damage is more severe.

Detailed Answer:
Hello,
I am sorry for my late response.

Based on your data , this means that the kidney damage is more severe.

I hope my answer helps you.
Regards.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Monika Dede (1 hour later)

I am on a 24 hour urine collection from Dr. To check for protein. I drank love a gallon of fluid Tuesday and my collection is about 32 ounces. Also feeling dizzy and was out the heat yesterday and did not . I have multiple sclerosis and I usually sweat heavily when I am in high temperatures the humidity was over 60% and heat index was 98 degrees Fahrenheit. Any thoughts on these developments. Am I in immediate increased medical danger.My 24 hour urine collection a 570 protein reading how much more danger am I in now.

Answered by Dr. Dr. Monika Dede (23 hours later)

Brief Answer:
This is often a sign of kidney damage and disease.

Detailed Answer:
Hello,
Thank you writing back.

Based on your lab data you should know that you have a higher amounts of protein in the urine( proteinuria) and this is often a sign of kidney damage and disease.
I suggest to meet as soon as possible a nefrologist to define better the diagnosis.

I hope my answer helps you.
Regards.

Above answer was peer-reviewed by : Dr. Kampana