UNEXPLAINED DIAGNOSIS

[annabrooke0918]

HELLO EVERYONE, NICE TO BE HERE, I AM A NURSE BUT MY SPECIALITY IS OBGYN SO I AM CERTAINLY AT A LOSS AND NEED YOU HELP!!!!!!  MY FATHER HAS BEEN HAVING PROBLEMS X ONE YEAR...HIS SYMPTOMS ARE AS FOLLOWS:  SHGORTNESS OF BREATH, FATIGUE AND VERY LOW HEMOGLOBIN.  HIS NEPHROLOGIST TOLD HIM HE HAS A KIDNEY DISEASE THAT WILL REQUIRE A KIDNEY TRANSPLANT HOWEVER NO OTHER INFORMATION HAS REALLY BEEN GIVEN TO US.   HE RECENTLY WENT TO ANOTHER SPECIALIST FOR FURHTER TESTING AND THE ONLY VALUE ABNORMAL WAS POSTASSIUM OF 5.9.  HE WAS GIVEN KAYEXELATE TO HELP DECREASE THIS WHICH DID WORK....BACK TO THE LOW HEMOGLOBIN, HE HAS HAD TO HAVE ONE BLOOD TRANSFUSION IN THE LAST YEAR CONSISTING OF 2 UNITS, AND HE RECEIVES RENAGEL INJECTIONS BI-WEEKLY FOR ANY VALUE BELOW 11.5--HE DOES NOT ALWAYS NEED THEM.  I WOULD LIKE ANY SUGGESTIONS OR INFORMATION THAT ANYONE MAY HAVE TO  HELP US TO FURHTER UNDERSTAND WHAT IS GOING ON---I HATE FOR HIOM TO HAVE A TRANSPLANT IF NOT NEEDED.  THANKS TO ALL IN ADVANCE!!!

[Vanessa Lacuesta]

Hi,

How many times was his GFR determined?

A GFR of 17 is low.Would you know how they computed for the GFR? Did they use nuclear GFR?

What were the serum creatinine levels in the past 3 months?

I understand how your dad feels about this. With a GFR of 17, dialysis will eventually be indicated. The value of 17 is categorized as severely decreased GFR. You need to discuss your father's case with his physician. Given that your father does not sound cooperative with possible future management, this is something that your physician and family members have to look into.

However, it is also important to look into reversible causes of decreased GFR which include the presence of hypotension , infections, heart problems, structural problems in the urinary tract and intake of certain medications that may be harmful to the kidneys. These conditions need to be managed first .

[annabrooke0918]

Hu Vanessa, thanks for the response.  I am sorry I am just now responding.  My father's GFR was 17.0.--He does have type II diabetes x 5 -7 years that is treated with glucophage--has had excellent A1c levels x 2 years and he also has controlled hypertension.  As for dialysis, no he has not undergone that at this point and states he will refuse to do so...he also refuses to take anti depressants which I really think he could benefit from..any ifo appreciated.  

Thanks,

LeAnn

[Vanessa Lacuesta]

Hi,

I believe that BUN and creatinine levels have been determined. Would you know your father's GFR?

With regards to his kidney problems, was there any underlying condition that could have caused this like diabetes or  hypertension?

Is he undergoing dialysis?