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Hello Doctr, My Elder Brother Was Diagnosed Chronic Kidney Disease

Posted on Tue, 2 Apr 2019

Question: Hello Doctr,

My Elder brother was diagnosed Chronic Kidney Disease and he has been undergoing Haemo Dialysis since Oct-2018.

My brother is having terrific lower back pain for the past 25 Days. We have Admitted my brother in Apollo hospital, following tests has been taken, requesting you to please refer the attached reports.

CT scan for the Chest
MRI scan for the lower back
ECG
2d ECHo
Other test repots are also included.

or my Elder Brother, the Doctors are under the opinion that the Cause of Severe back pain could be related to Fungal Infection recommended the tablet voriconazole 200 mg till review.

Waiting for second opinion before consuming the tablet. Requesting you to please let us know if this backpain could be related to the Fungal infection and can we take this medicine (voriconazole 200 mg) when my brother is on Dialysis.

Thanks and Regards
Rajesh G

Follow up: Dr. Bhagyesh V. Patel (22 minutes later)

Hello Doctor,
I have uploaded 21 reports of my brother, however not sure if all the reports got uploaded.

Requesting you to please let me know the number of reports visible for you, i can optionally send all the reports to your E-Mail id.

Thanks and Regards
Rajesh G

Answered by Dr. Bhagyesh V. Patel (34 hours later)

Brief Answer:
systemic fungal infection. Voriconazole can be safely taken.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query and evaluated the attached reports consisting of total 10 attachments depicting various blood tests, culture reports, CT scan, MRI , Echo, bronchoscopy evaluation.

* As per my surgical experience, the issue is of systemic fungal infection with Aspergillus
fungi as suggested by the culture report of the bronchial lavage fluid.
Back pain also sounds to be part of the infection in the general system.

* The Variconazole ( 200 mg ) is an azole group of drug which can be safely prescribed
for the renal disorder patient as the drug is excreted unchanged through the kidney.

Kindly give me further details so that I can answer your query more precisely.

1. Currently what symptoms does your brother have, give all details.
2. Status of breathing comfort and urination details.

Awaiting for your response.
Regards.

Dr Bhagyesh

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhagyesh V. Patel (33 hours later)

Hello Doctor,
Thanks a lot for your prompt reply. I am having difficulty to upload the documents due to the size limit and the number of documents that can be uploaded.

Symptoms:
1) My brother is having breathing difficulty when he is lying down.
2) Occasional Fever with Cough many times.
3) Feeling very week.
4) Unable to stand or walk because of back pain.
5) Air is getting pumped out before the cough comes out.

I have uploaded all the documents to the following link, requesting you to please download the zip file.
https://we.tl/t-1UtpkoV62v

Thanks and Regards
Rajesh G

Answered by Dr. Bhagyesh V. Patel (3 hours later)

Brief Answer:
follow up consultation

Detailed Answer:
Hi XXXXXXX
Thanks for the details of other relevant information in the zip file.
I have gone through all the data in details.

* Overall, it is the systemic fungal infection with predominant involvement of the lungs
through Aspergillus fungi and secondary damage to kidney altering the kidney function
and the need for dialysis.

* The treatment protocols and therapy are at best of the expertise of the doctors.

* Only thing we can do is regular consultation of the physician, follow up with
continuation of the treatment and waiting for the body's response through immunity and
medication supports to fight against the pathogen inside for a faster recovery.

Wish him a quick recovery.
Regards.

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Arnab Banerjee