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What Causes Elevated Creatinine Level In An Elderly Person With High BP And Heart Problems?

Posted on Sat, 16 Jan 2016

Question: My father aged 72 years,has high bp, heart problem for which angioplasty done two years back,diabetes from last 16 years. From last 18-19 months started showing problem related to kidney like high creatinine, ranging around 3.5 to 4.5,irregular urea,uric acid,sodium, potassium,bun and little low hemoglobin level and was under diabatic nephrology treatment since then.last month his creatinine level shooted up to 5.6,bun 51.32,urea 91,phosphorous 4.9,potassium 5.37,hemoglobin 10.2,rest under controlled level and after few days started showing vomiting and chocking tendency, heavy weakness.we consulted Dr. In XXXXXXX hospital XXXXXXX and he prescribed alfakit, anfoe 4000 injection,eido fe forte,synprotik capsule,sevgia 800,Q XXXXXXX geritam, but although hemoglobin is now 11.3vomiting tendency reduced,having good urine,weakness reduced,feeling hunger but urea increased to 97.3, creatinine to 7.2,bun 49.04,calcium 7.9,phosphorous 4.9.we consulted other place they suggested dylisis. Can we delay dylisis for a year through medicines,? is it be good or worsen the problem? If dylisis is necessary and urgent which one is good and cost effective. Father lives in small town so very frequent visit in dylisis centre would be problematic.plz suggest ...

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Peritoneal dialysis is better

Detailed Answer:
Hello

Thanks for the query

It looks like your father is suffering from end stage renal disease. It is not possible to sustain life for a year without dialysis and it is compulsory.
You will have two options and here are their salient point

1. hemodialysis
- cost effective
- has to be done in a hospital
- it is done 2-3 times a week and each session for 4 hours depending on the patient general condition
- blood pressure variation is very high with hemodialysis
- native kidney Urine output drops with this dialysis
- usually not available to small towns

1. peritoneal dialysis

- it is slightly more expensive than hemodialysis
- hemodynamic stability is maintained
- can be done at home easily
- requires clean hygienic practice while doing it
- it has to be done 3 times a day, each session taking about 15 to 20 min of care taker's time
- patients are prone for abdominal infections and hernia

I would suggest Peritoneal dialysis for your father going by the age and distance from the city

I am sure you have more doubts, please get back to me I will be happy to clarify them

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rakesh Madhyastha (1 hour later)

thanks a lot for the valuable input, want some more info like
1) if we shift him to XXXXXXX to solve small town medical facilities issue then which one will be better, safer and long lasting considering his age , diabetic and hypertensive condition.
2) will the dialysis will reduce or end the current medicine requirement for renal treatment.
3) which will be more cost effective in the one time medical operation or procedure for the dialysis.
4)what will be the cost of the each session of the dialysis in hemodialysis in dialysis centre.
5) what will be the cost of the each session of dialysis in the second system which can be done in home.
-) if proper hygiene is maintained then chances of abdominal infection or harnia can be avoided or not.
regards,

Answered by Dr. Rakesh Madhyastha (14 hours later)

Brief Answer:
Dialysis

Detailed Answer:
Hello

Thanks for getting back. I shall answer your questions one by one so that I dont miss any.

1. Peritoneal dialysis is better considering his age. It will preserve the remaining kidney function and there wont be much hemodynamic variations during dialysis
2. The current treatment will continue. Often requirement of antihypertensives will come down to a certain extent
3. I am not sure I understand this question? Could you please rephrase it?
4. In our center it is 1800 rs per session. XXXXXXX will be more expensive maybe 2.3-2.5k per session. It really depends on center, some centers in XXXXXXX offer dialysis at price ofRs 800 as well. But decent one's will charge above 1.5k
5. Peritoneal dialysis will cost you 25,000 rupees per month if you use Baxter dialysis fluid.
6. I have patients on peritoneal dialysis for more than 5 years without a single infection.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rakesh Madhyastha (1 hour later)

in question 3 I wanted to know the cost comparison of the operation of the both.like if we select hemodialysis dr. will create fish XXXXXXX and vain etc. same way in peritoneal also some operation is needed to create the way to use dialysis by patient in home.which one is costlier..

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Cost of the operation

Detailed Answer:
Hello

Thanks for the clarification. The initial cost of operation is slightly higher for peritoneal catheter insertion than fistula. About 10,000 rupees more than fistula surgery. Again it depends on various centers and the type of ward you choose

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. Prasad