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When is enough, enough?
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When is enough, enough?

My relative is a 50 year old male who hasn't seen a doctor in over 15 years, so no idea what was happening before now.  7 days ago he was admitted to ICU.  Initial diagnosis was, liver failure, kidney failure and aspiration pneumonia  (he is a chronic alcoholic).  So far, nothing is improving.  They will do bronchoscopy today for the lungs and have left the liver at 'fatty liver" and "enlarged liver".  No additional diagnostics are being done for the liver since, for now, the kidneys and lungs are priority.  His serum creatinine on admission was 8.2.  After 4 days of full dialysis it went to 9.3 and today (after 6 rounds of dialysis) creatinine is 8.9.  He has little urine output less than 10 cc total.  the urine has been a cola color until today, now it appears mostly red.  Obviously the goal with dialysis was to rest the kidneys and hope for some regaining of function, which has not occurred.  How long will they continue to do dialysis with no result?  Does he have to suffer through the rest of his body breaking down (vents, etc.) before they say "hey this isn't working?  He also has ramdomylitis (sp?).  He was passed out approximately 14 hours before anyone knew.   Thanks.
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Hi and thanks for using the forum.

I am sorry to hear about your relative.  He is a young man to be so sick.  It sounds like your relative has acute renal failure resulting from the rhabdomylosis.  Rhabdomylosis is when muscle fibers in our body breakdown and cause the release of a myoglobin into the bloodstream.  Myoglobin breaks down into harmful components and can cause kidney damage/ failure.  This is consistent with the information you gave me about your uncle being passed out for 14 hours before he was found.  The treatment for rhabdomylosis focuses on hydration and diuretics to flush the kidneys out, and in cases where there is renal failure, dialysis.  The goal is to give the kidneys time to heal and prevent the build up of toxic substances in the body that the kidneys would usually filter out.  I know 7 days feels like such a long time, especially when a family member is in the ICU, but it can take time to see a result from the treatment and I think it is fair to give it some more time.  With a diagnosis of rhabdomylosis and with acute renal failure, the treatment of choice is dialysis.  There are simply not a lot of other options.  Also, sometimes the kidneys cannot be saved, and people need to stay on dialysis for the rest of their lives.   Hopefully this is not the case.  I hope this answers your question.  Good luck,.

Bridget
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