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High creatinine levels, lesions in lower limb, suggested scleroderma, neuropathy, cystitis. USG done. Taking amlodipine. Help

Regards of the day,
My dad aged 60 years is having high Creatinine level (3.5-4.3) since past 20 days. He is diabetic and hypertensive and taking Glycomet and Amlodipine since past 9 years. He was completely normal (Creatinine level-1.0) 20 days back when he got operated for urethral stricture (which went smoothly) and was put on :
1. Oflox 400mg 2. Pan 40mg 3. Ganaton 50mg 4. Sparacid 100ml 5. Fybogel 100mg powder 6. Cremaffin syrup 7. Tendrone ceam 7. DES OD 5mg. Also he noticed few petechiae lesions in lower limb after the surgery which slowly disappeared after 10 days. However the Creatinine got raised to present levels (3.5-4.3) and is stable at that level. We also got USG done (8 times, no diagnosis), CT Scan (no diagnosis) as well as Nuclear scan (showed cystitis and dilated calyx area), also skin biopsy of the lesion (H/P provisional report suggested scleroderma but clinical findings not at all correlating, so ruled out). Also ANCA test and Electrophoresis have been performed (reports awaited). No retinopathy/ neuropathy detected. Our nephrologist is suggesting now Kidney biopsy. Kindly suggest whether correct treatment protocol is being followed or should be think on some other management line.

Best Regards,
Sunil.
Mon, 30 Sep 2013
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Internal Medicine Specialist 's  Response
Dear Mr. Sunil,

I am Dr. (Col) R Karanwal, M.D. (Internal Medicine), Consultant Physician, for your assistance.

Thanks for reposing your faith in me and post your query on this website. I fully appreciate your concerns.

I feel that he has developed Chronic renal failure either as a complication of diabetes or, due to chronic urinary retention following urethral stricture. It can also be due to acute kidneys infection.

If I were your treating doctor, I would have stopped her glycomet immediately; maintain ideal diabetic control, preferably on Insulin; treat his bladder infection and advised standard treatment for chronic kidney failure.

Further, if you had visited my Clinic for consultation, I would have recommended

Please feel free to revert back to me in case of further clarifications, if any.

I am confident that you will benefit from the advice.

May I assure you that I am always available for your assistance. My endeavor would always be to give you a sound medical advice, to the best of my knowledge and vast experience.

HAVE A NICE DAY AND A SPEEDY RECOVERY.

Fond Regards,

Dr.(Col) R Karanwal
MBBS; M.D. (Internal Medicine)
Consultant Physician


(PLEASE NOTE :- My opinion/advice is based SOLELY on the details provided by you.)
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High creatinine levels, lesions in lower limb, suggested scleroderma, neuropathy, cystitis. USG done. Taking amlodipine. Help

Dear Mr. Sunil, I am Dr. (Col) R Karanwal, M.D. (Internal Medicine), Consultant Physician, for your assistance. Thanks for reposing your faith in me and post your query on this website. I fully appreciate your concerns. I feel that he has developed Chronic renal failure either as a complication of diabetes or, due to chronic urinary retention following urethral stricture. It can also be due to acute kidneys infection. If I were your treating doctor, I would have stopped her glycomet immediately; maintain ideal diabetic control, preferably on Insulin; treat his bladder infection and advised standard treatment for chronic kidney failure. Further, if you had visited my Clinic for consultation, I would have recommended Please feel free to revert back to me in case of further clarifications, if any. I am confident that you will benefit from the advice. May I assure you that I am always available for your assistance. My endeavor would always be to give you a sound medical advice, to the best of my knowledge and vast experience. HAVE A NICE DAY AND A SPEEDY RECOVERY. Fond Regards, Dr.(Col) R Karanwal MBBS; M.D. (Internal Medicine) Consultant Physician (PLEASE NOTE :- My opinion/advice is based SOLELY on the details provided by you.)