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History of TB. USG shows impaired kidney function. High creatinine level. Transplant required?

My daughter is 11 year old. Her weight is 27 Kg. She was detected with Tuberclosis when she was 1 year old. She was given medicine for 9 month for the same. She use to still have the temprature nearing 100 . Then an ultrasound was done where she was detected with impaired Kidney function. So many tests were conducted but reason for her impaired Kidney function could not be detected.The critenin at that time was around 1. It remained at the level of 1.2 for a 4-5 years. Slowly it started growing . At the age of 9 it increased to 2.2 and within 1 year time it rose to 2.9. Now her Critenin level is 4.30. Kindly guide me if she can continue by these kidneys or she would have to go for transplant.
Asked On : Mon, 15 Apr 2013
Answers:  3 Views:  58
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General & Family Physician 's  Response
Your daughter is suffering from chronic kidney disease.
Chronic kidney disease is characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease (ESRD).
There is no treatment now which can make her kidneys normal.
Treatment consists of medications to delay the loss of kidney functions and once these medications fail to arrest the further damage,dialysis and renal transplant become the ultimate treatment.
Since her creatine is rising progressively over years,it clearly denotes that sooner you have to plan for kidney transplant.
Answered: Mon, 15 Apr 2013
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Pediatrician, Critical Care Dr. Tejas Shah's  Response
Thanks for posting your query here.

She has chronic renal failure and recently her Creatinine has been increasing.

Only Creatinine is not the criteria for renal transplant. There are many medical treatment options available (to minimize the effects of chronic renal failure). She needs to have further blood tests like Hb, Platelet count, Calcium-Phosphorus, Urea and Bicarbonate levels etc. I would suggest to get in touch with Paediatric Nephrologist who are specialist in dealing with chronic renal failure.

If the kidney function don't stabilize with medicines, then she would need to have dialysis (which helps to remove impure waste from the body).

Nephrologist will be able to guide you regarding transplant. However, as I mentioned, Creatinine is not the only test to determine need for transplant.

Hope I have been able to guide you further in this matter.

Dr Tejas Shah
Pediatrician- Intensivist
Answered: Tue, 16 Apr 2013
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General & Family Physician Dr. Sunil 's  Response
Thanks for posting you query.
Tuberculosis can lead to chronic kidney failures but ant-tuberculosis drugs she took could be the cause of renal dysfunction. During therapy against tuberculosis frequent levels of creatinine are monitored, if levels increase then drugs are discontinued.
Creatinine 4.30 is not indication of kidney transplant, it is indicated when kidney function (GFR) decreases below 20. You child should be monitored for blood pressure and hydration. Hemodialysis is first management before considering transplant.
Talk to your doctor about further management.
Hope it helps.
Take care!
Answered: Mon, 15 Apr 2013
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