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Dr. Andrew Rynne

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Exp 18 years

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My father is 75 years old and on dialysis s both of kidneys of him are not functioning well. He has been diabetic patient for last 38 years. He is CRF ans presently the frequency of dialysis is biweekly. I want to know: 1. What should be the preferred frequency of dialysis. 2.Whether dialysis can be termed as good ao bad based on some criteria. 3.What should be the levels of creatinine and urea just after dialysis. 4. How much reduction in creatinine and urea is expacted in single attempt of dialysis. 5. What are the chances of reduction of frequecny of dialysis for such patient. 6.WHether some other treatment ( Ayurvedic, Homeopathic etc) shouldbe taken along with Allopathy. 7. Whether this diseases can be cured in allopathy.
Wed, 28 Oct 2009
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As per history the condition is presumed to be End stage renal disease with Diabetic Nephropathy on Biweekly dialysis. Chronic renal failure (CRF) requiring dialysis or transplantation is known as end-stage renal disease (ESRD). 1) The preferred frequency of dialysis depends on the blood urea and creatinine levels. If the Glomerular Filteration Rate falls to less than ~20% of normal, symptoms of uremia may begin to occur. They almost are invariably present when the GFR decreases to less than 10% of normal. If these values are on a higher range, dialysis frequency may be more. If its moderate then the frequency reduces. 2). Since dialysis does what is supposed to be done by kidneys(an essential organ for disposing waste), it is more a good than seeing bad in it. 3) As it is the problem of CRF the levels cant come to normal or subnormal, maximum reduction in creatinine and blood urea levels should be tried at each session without interupting the comfort of the patient. 4) The reduction of creatinine and urea after dialysis depends on the pre dialysis creatinine and urea levels, the nephrologist takes the final decision on this, even if the values are on a higher range. 5) Allopathy medicine never recommends ayurvedic and homeopathic treatment. 6) The disease cant be cured as its a damage to both kidneys, kidney transplantation is the other option. The problems are age of the patient, availablity of donors to donate kidney, the transplantation surgery after that, complictions of transplanted kidney. To summarise, Dialysis is the longer the better, the slower the better, more often the better, the gentler the better. Let me give few good medical tips regarding diet for CRF patients on dialysis. Dietician's consult is crucial. a) The diet should maintain a balance of electrolytes, minerals, and fluid in patients who are on dialysis. b) Diet includes high in protein and low in sodium, potassium, and phosphorus. c) Fluid intake is also restricted. d) Before dialysis, you may be asked to limit protein to slow the progression of kidney disease. At the start of dialysis, you will need much more protein. Many patients need to take vitamin supplements. e) Diet alone can usually meet the requirements for the fat-soluble vitamins (A, D, E, and K). Vitamin D may be supplemented, depending on your calcium, phosphorus, and parathyroid hormone levels.
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