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Kidney Diseases

Bilateral Medical Renal Disease w/ Cortical

09/18/2009

Question:

Dear Sir/ Madam,

After the lab test result doctor says that I need to go dialysis otherwise I die. The truth is we don`t have money to compensate the cost. Can you pls kindly advised other option/ alternative med for my disease? and the food I need to eat. pls see below my lab test result:

Hematology: Hemoglobin=76, Hematocrit=.24, RBC count=2.6, WBC count=8.1, platelets=adequate,MCV=92, MCH=29, MCHC=317,Segmenters=.62, Lymphocyte=.32, Monocyte=.02, Eosinophil=.06

Clinical Chemistry: Creatinine=6.69, Potassium=6.65, Creatinine Clearance=11

Kidney Ultrasound:*both kidney are small in size w/ increased echopatttern, *Right kidney measures 8X4.1X3.7 cm, w/a corticomedullary thickness of 0.63 cm, *Left Kidney measures 8.2X4.4X4.1 cm w/a corticomedullary thickness of 0.9 cm, *cotical cyst is seen in the right measuring 1.8 X 1.6 cm in the interpol region & 0.42 cm in the lower pole, *Urinary Bladder wall is not thickened, *Pre-Vioding Vloume: 193 cc, * Post-void volume: no significant residual.

Here`s med that my doctors gave me: Sodium Bicarbonate 65 mg (once daily) Ketosteril 600 mg (3 times daily) Kalimate sachet 5 mg (3 times daily) FE SO4 500 mg (3 times daily) Amlodipine 10 mg (once daily)

Appreciate if you could help to me..

Thank you very much.

Answer:

Your doctor is right: the patient (whom I believe you mentioned previously was your mother) is dealing with an advanced stage of kidney disease.  In end stage renal disease, since the kidneys are not doing their job of excreting waste products and fluids, the accumulation of fluid and certain toxic substances can cause problems and, ultimately, death.

It sounds like the medicines that she is receiving are appropriate: the ketosteril will help to minimize the amount of toxic waste products that are formed, and the kalimate will help to remove potassium (which can cause heart problems when the blood level gets high).  The sodium bicarbonate will help to neutralize acid, which accumulates in kidney failure, and the FeSO4 (iron) may help the body to make red blood cells.  The amlodipine will help to reduce blood pressure, since high blood pressure can accelerate kidney damage.

Another thing that may help is to keep salt and protein (especially meat) intake as low as possible -- again to prevent fluid accumulation and to minimize the amount of waste products that are made. 

It will also be important, as your mother becomes more ill and less aware, to keep her comfortable and to provide loving family support.  I hope for the best for your family in this difficult situation. 

For more information:

Go to the Kidney Diseases health topic, where you can:

Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University