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High level of Urea & Creatinine, heart failure, lack of appetite, tired, bad smell in mouth

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High level of Urea & Creatinine
My mother has some heart failure and she began to take Revatio but then from February she got very high rate of Urea & Creatinine. She has the whole past year a level of 1.2 mg/dl of Creatinine and then ju,ped lately to constant 2.2.
The Urea was always on the high limit around 45mg/dl but now also jumped tp 91mg/dl.

She is extremely tired, has a very bad smell in the mounth, has lack of appetite.

The doctors said at teh hospital that those levels are not so high given the pills she is taking but still it seems to me that this situation may be XXXXXXX at long term.

What would recomend to follow up with?

Thanks in advance very much for any help here,
Time is flying and I am afraid for her health.
Posted Tue, 22 May 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 2 hours later
Hi Ruthy,
Thanks for writing in.
I do understand your concern. From the scenario that you have described, your mother has renal failure. This would imply a condition where the kidneys are not functioning at an optimum level. However, in your mother’s case, her levels suggest that the problem is not very severe and can still be handled. Now, this could be due to several causes.
First amongst them would be high blood pressure and diabetes which are capable of independently damaging the kidneys. This leads to a condition where the kidneys do not function properly and thus the urea and the creatinine rise.
The second would be an obstructive cause. This would imply a condition where there is an obstruction in the flow of urine. This would lead to a buildup in the pressure which could compromise the function off the kidneys. Unless, the problems has been quite long standing, this is reversible if the obstruction is removed.
The first thing that we need to start with is an ultrasound of the kidneys to assess the presence of any obstruction. If this is not present, we would need to investigate this further. If your mother has high blood pressure and/or diabetes, they need to be stringently controlled. This would help us manage this condition much better and also prevent further damage.
It is unlikely that the tiredness, loss of appetite, bad odour is because of Serum creatinine of 2.2. She needs to be worked up better. Please see a physician to get this evaluated so we get to the bottom of this quickly.
Hope this helps. I would be available for follow ups.
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