Patient's Query
Hello doctor,
I am seeking your guidance regarding my grandmother, who is 81 years old. She was diagnosed with kidney shrinkage and CKD stage 3 in April 2025. Since then, she has been on regular treatment, but over the past year, she has been hospitalized many times for different issues.
As a family, we are becoming increasingly worried and confused about whether this is part of the natural course of her illness or if something more should be done.
Since her diagnosis, her health journey has been as follows:
Her current medications include Clinidipine 10 mg (SOS), Ecosprin 75 AV, Dytor 20 mg, Myklo K2, Uprise D3, Megace 40 mg, and Solikem.
What worries me the most is that during this admission, her blood pressure has become quite low, often around 88/47 mm/Hg or 96/56 mm/Hg. She does not have swelling in her legs at present.
Her latest kidney tests have also alarmed us. Her serum creatinine is 1.3 mg/dL, but her estimated glomerular filtration rate (eGFR), which had been around 33–40 mL/min/1.73 m² for almost a year (Stage 3 CKD), has suddenly fallen to around 17–20 mL/min/1.73 m² over the last few days, suggesting Stage 4 CKD. This sudden drop has made us very anxious.
I would really appreciate your opinion on a few things:
We understand that age and CKD can bring challenges, but seeing her go through repeated admissions has been emotionally exhausting for our family.
We would be grateful for any guidance on whether we are on the right path and what more can be done for her long-term care.
Kindly assist.
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query and can understand your concern.
I have carefully reviewed the details you provided about your grandmother's health.
I understand your concern, especially given the number of hospitalizations she has experienced over the past year.
Based on the information available, it is unlikely that her repeated admissions are due to chronic kidney disease (chronic kidney disease, which is the gradual loss of kidney function over three months or more) alone. Patients with creatinine values around 1.3 to 1.7 mg/dL typically do not develop the symptoms you have described solely because of kidney dysfunction. Therefore, it is important to look for other contributing factors as well.
Low blood pressure in an elderly patient is concerning. It could point to dehydration, an infection, reduced heart function, or another acute issue. Even a temporary drop can reduce blood flow to the kidneys and cause a significant fall in eGFR [estimated glomerular filtration rate — a measure of how well the kidneys are filtering].
If she was given pain medications for the spinal fractures — particularly anti-inflammatory painkillers — those could have contributed to both the kidney decline and the blood pressure fluctuations. Any such medications should be reviewed with her doctor.
With blood pressure running low right now, her antihypertensive medications may need to be adjusted temporarily. This is common blood pressure medicines are often paused or reduced and then reintroduced gradually once things stabilize.
To better understand the reason for the recent decline in kidney function, I would recommend the following investigations if they have not already been performed:
The recent drop in eGFR [estimated glomerular filtration rate] doesn't necessarily mean permanent kidney damage. Dehydration, infection, low blood pressure, or certain medications can all cause a temporary dip in kidney function one that often improves once the underlying cause is sorted out.
At this stage, I would focus on identifying the cause of her low blood pressure and recurrent hospitalizations rather than assuming that CKD alone is responsible.
It is also important to avoid medications that can further impair kidney function, particularly non-steroidal anti-inflammatory painkillers, unless specifically advised by her doctor.
Nothing in what you've shared suggests you need a new doctor right now. But if she needs a second opinion from an experienced nephrologist is a reasonable next step both for reassurance and to get a fresh look at her overall management.
I would recommend following up with the results of the suggested investigations, as they may provide important clues regarding the cause of her recurrent admissions and recent decline in kidney function.
I hope this answers your query.
Please let me know if I can assist you further.
Thank you.
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