CKD stage 3+heart attack+diabetes +anemia

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I am from India(asia)

 

My father 53 years age is having diabetes from past 17 years ,on 30 april suddenly he had an heart attack due to high BP as no blockage was found BP 240/120 .On the examination of Kidney he was diagonised with CKD stage 3 his cretanine was 2.0 and also high leakage of protine potassium was 4.7 and sodium was 136,Hameoglobin was 10.5 and elevated sugar level,Doctors advised for insulin and strictly odered to control BP.

Again tests were done after 1.5 months 17july 2017

His cretanine is 2.1

BP is 80/135

Hameoglobin is 8.1

there is decrese in protine leakage

we are very much worried what to do ? Mam can this disease be cured

how much time is there for my father to prevent dylasis .

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  • Posted

    Hello ishant,

    Your father's haemoglobin is very low.  This menas he is anaemic and your doctor must find out why as  there are multiple causes.  It will probably make him feel very tired and needs to be sorted out quickly.  He might just need iron medication for a while. Quite a lot of elderly people have CKD Stage 3 as kidney function decreases with age and in itself, it need not be much of a problem yet but it sounds as though the protein leakage needs investigating.  Do you know his GFR?

    • Posted

      NO i dont know about GFR,Dr has started EPO injection 1 per week and some iron tablets .hope to recover
  • Posted

    Ishant,

    My creatinine was stable at 2.0 for four years, until last December. My hemoglobin was down to 5.6 without treatment. My protein leakage was not elevated. And my blood pressure ran very low.

    My nephrologist has been treating the anemia. He first tried EPO injections. But they caused lots of peaks and valleys in my functioning. So about 2 years ago he switched me to an oral medication which is working much better. My hemoglobin is now typically 11.0-11.5. He has also recently discovered that I've had severe chronic dehydration due to a sodium deficiency. He is treating that now resulting in an improvement in my blood pressure.

    For your father, it is critical that he get both his A1C and his blood pressure in range. Then, with treatment for his anemia, he will likely feel a lot better. Further, his nephrologist may be able to stabilize his renal function for some time or at least slow the progression.

    Best wishes,

    Marj

    • Posted

      hi marj

      and thanks for reply

      Dr. has started EPO injection 1 every week and some iron tablets .hope to recover early

    • Posted

      Ishant,

      Glad to hear that your Father is receiving treatment for the anemia now. He should feel much better soon. I, too, am a diabetic and so know how it feels to have elevated A1C. I don't struggle much with blood pressure. But the anemia alone can cause me to feel pretty poorly. But a few months after my doctors had my treatment plan in place I found that I was feeling and functioning much better.

      It's wonderful that you're there for him. That will be a tremendous help for him.

      Marj

    • Posted

      thanks marj

      currently he is feeling better ,he is only taking 2.2 liters of water is this quantity enough . he doing morning walk of about 30 minutes daily .should he take bed rest or continue the routine .sometimes in evening he feels that his head is very heavy.

    • Posted

      Hi Ishant,

      EPO works well for me- 1 weekly injection, plus B12 injections every 3 months and oral folic acid every day.  My Haemoglobin has been in the normal range for 5 months now.

  • Posted

    Hi,

    Creatinine would be 201 in the uk (we measure slightly differently) so quite high but not drastickly so at this point.

    I am thinking the BP you have put the wrong way round it is more than likely 135/80 (if it were the other way I would be concerned)it is just about within the limits but considerered acceptable for CKD3 just!.

    HB level is just under they like it between 10 & 12.  HB is different from iron but both are linked. Iron tablets may help but if they haven't done anything after three months they wont and it is bad to stay on them.  This is what I was told by my neph who has been part of my life since I was a small child.  I had an infusion with EPO injections which I did myself (the EPO) and that sorted me right out, I didn't need any further intervention for a good 18 months.

    It depends on the cause of the CKD if it is linked to the diabities then he may remain stable if BP and sugar levels remain under control but manageable more than curable.

    • Posted

      Helen, you mention that your nephrologist has said that It is bad to stay on iron tablets. Is that only if the iron tablets aren't working or is it for any extended use of iron tablets. Also, does this apply to iron tablets that are also phosphorous binders, e.g., Auryxia?

    • Posted

      Extended use, I was told if they dont work over a three month period they are not going to work.  Phosphate binders are different all together and I am sure mine said not to be on iron at the same time you will have to read what it says on the package.  I didnt have phosphate binders for long and I wasn't on iron tablets I just remember them saying something about iron its best to ask your dr the drugs may be different in the UK to the US

    • Posted

      hi helen

      and thanks for reply

      Dr. has started EPO injection 1 every week and some iron tablets .hope to recover early

    • Posted

      Hi,

      Yes it should do, EPO should be used in conjunction with iron therepy for best results.  It takes about two weeks to get into the system properly so after that results should be noticed, any tiredness or breathlessness should start to ease and your father should start to feel a little more himself.  Its not nice to be tired and breathless but these symptons seem to appear for many (not all) at stage 3.  I hope your father feels a little better very soon he has been through an awful lot.  Lots of rest he needs and the love of his family which he obviously has.

    • Posted

      hi ,

      currently he is feeling better ,he is only taking 2.2 liters of water is this quantity enough . he doing morning walk of about 30 minutes daily .should he take bed rest or continue the routine .sometimes in evening he feels that his head is very heavy.

    • Posted

      till how many weeks should he take the injections EPO .My father is very active and prevents from taking bed rest .? should he take bed rest or continue his routine

       

    • Posted

      My nephrologist has told me that I'll have anemia the rest if my life and so will need medication for it very likely for the rest of my life.

      And, yes, your father should continue a routine of daily exercise like walking. I exercise daily too. I'm not able to do as much as I could before my kidney function deteriorated to 14-15% function. But I definitely feel better when I exercise. However, I am quite tired at night. So my evening routine has changed considerably.

      I'm so glad to hear that your father is feeling well enough now to be able to walk daily. That is good news.

      Marj

    • Posted

      are you taking injections EPO or oral medication?

       

    • Posted

      I was initially taking EPO injections. My nephrology gist shifted me to an oral medication about 2 years ago. The oral medication works better for me. But many find the EPO injections to be a better option.
    • Posted

      Hi,

      You take it as long as you are told to until your HB levels are between 10-12 his dr will advise. I made myself excersise I found it helped I did HIT training 3 times a week.  I am not suggesting your father does this as he is considerably more senior in years than me but walking is good.  Due to his heart condition he should gradualy build up, so a short walk like to the garden gate and back is good and build up as he feels able.  Only he is the judge of how he feels.  I walk now after transplant, I have issues with my leg on the side of the transplant so I have to rest but we have a dog so good incentive to walk.

    • Posted

      Walking is very good he should continue with this as long as he feels able and his dr agrees.  Walking is really good smile
    • Posted

      there is a doubt in my mind.........As the doctors have ristricted protine intake and adviced not to take protine etc.......will this not create protine defficency in body
    • Posted

      Ishant,

      I have all sorts of dietary restrictions too. At first I was concerned about malnourishment. But it has become clear to me at this point that that is not happening. I'm careful to eat exactly what my nephrologist and renal dietician have told me to eat. That has helped me to feel better and function better. It has very likely also slowed the progression of my chronic kidney disease.

      My doctors (i.e., both my nephrologist and my internist or primary care physician) add vitamins supplements to my daily diet as I need them so that my nutritional needs are met between the food I can eat and the vitamins I take.

      It did seem strange to me initially as I have always eaten 5 servings of vegetables and 1-2 servings of fruit a day before I was put on this renal diet. So it took me some time to adjust. But I've been following this renal diet, as prescribed by my nephrologist, for 4 years. It just took some time to get used to it. But it is fine now.

      There are lots of menus and ideas for handling the food restrictions on websites like Davita snd Fresenius. These recipes and dietary suggestions are posted by renal dietitians. I fix quite a few of these recipes.

      I have also found an app called HealthWatch 360 to be very helpful. It is free and available for both iPhones and android devices. With this app I can easily check the full nutritional make-up of any item I'm considering buying at the grocery store so I know exactly how much phosphorous, potassium, calcium, and so forth the item I'm considering purchasing contains. This app also allows me to type my own family recipes into the app. It will then tell me the nutritional amounts for single servings of these recipeS. This has helped me include some of my family recipes in my diet while following the dietary restrictions I now must follow.

      Marj

    • Posted

      Hi,

      My doctors said the opposite, there is no need to reduce it as it makes no difference.  A lot of CKD people lose lots of protien through the urine and while eating loads would never make up the loss I was told to carry on as normal.  You have to listen to what you are advised though as it is obvious different medical professionals offer different advice.  You could try asking the question why do you have to avoid it and see what comes back on that, at the end of the day it is your decision what you eat but I will always stress that you lsten t what you personally are told by your dr.

    • Posted

      After 1 month again Homoglobin and Cretanine tests were done

       Homoglobin is 7.6 and Cretanine is 2.2 .....We are feeling very much frustrated and in Tension .........what should we do he is taking EPO injections till now he has taken 3 injection and is also taking iron tablets .....................

    • Posted

      His creatinine is actually looking workable if they can get it stabilized. Mine ranged from 1.8-2.2 for 4 years. Other than severe anemia, I felt quite well at that point. It took my nephrologist about 12 months to set up a treatment plan for my anemia that is working--my hemoglobin is typically 11.0-11.5 at this point, with medication. When I was on EPO it fluctuated but was generally between 9.5 and 10.5. He now has me on a phosphorus binder that is also a mega iron supplement. It is called auryxia. I take it three times a day. I'm not suggesting that you request a specific medication. Rather, I'm encouraging you to work with your father's nephrologist to get an effective treatment plan in place. And, it may take some time.

      Marj

    • Posted

      Hi,

      I would stick with the iron tablet/EPO mix for another two months if there is no improvement after that time ask for an iron infusion to go with the EPO.  Iron tablets did nothing for me and my neph said if they don't work after 3 months they won't, they didn't and so they gave me an infusion instead and that did the trick.  EPO and iron will do nothing for creatinine that is something completely different if GFR declines creatinine goes up.  Just wait and see and then go back and discuss and review and decide with neph.

    • Posted

      hi helen,

       i am very much tensed about my fathers health ,

       Frankly speaking just tell me how much time is left with my father.before he goes for dialysis .........we are presently at India's best hospital CMC vellore, tratment has just started many tests are to be done.

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