Patient's Query
Hello doctor,
My father has been suffering from CKD (chronic kidney disease) for the past year. His creatinine level is 11.05 mg/dl, urea is 144 mg/dl, and uric acid is 5.10 mg/dl. He has no swelling or breathlessness, but his phosphorus content is high, 5.80. We have not started the dialysis at the moment.
Could you please guide the right way of treatment? He is on Insulin, but his fasting sugar is 59, and his hemoglobin is 8.90 at the moment. Urine output is equal to input. His current medicines are these: Minipress 0.25 mg, Moxovas, Zyloric, and Arkamin.
He is having a constipation problem. I have attached his reports for your reference.
Please help.
Hello,
Welcome to icliniq.com.
After seeing all the details and your father's reports (attachment removed to protect patient identity). I would like to ask a few questions.
With these reports, it is clear that there is no urgency to rush into dialysis, but it will be required soon. So, a fistula surgery should be done as soon as possible, as it may take some time to start working. Phosphorus (PO4) has to be controlled with diet and medicines.
Strict diet restriction of PO4 (800-1200 mg/day) can be done by sitting with a dietician. You can start with Tablet Revlamer 400 mg (Sevelamer), one tablet with meals twice a day. Ensure that blood pressure (BP) is in control. Do not give night doses of insulin if morning sugar levels are low.
Avoid all long-acting Insulins. Use only human Actrapid Insulin (HAI) for sugar control. For constipation, you can start Lactifiber two scoops with warm water at night. Hemoglobin (Hb) is low. So, check his iron profile, serum ferritin, and intact parathyroid hormone (iPTH), after which we can start some injections to increase Hb.
I hope this helps you.
Thank you.
Probable diagnosis
Treatment plan
Preventive measures
Patient's Query
Hello doctor,
Thank you for the reply.
He is 58 years old. He has been losing weight for two months. His weight was 165 lbs two months ago, but now he is 125 lbs, a drastic change in two months. He eats well. Morning, he takes tea and biscuits for breakfast, oatmeal and milk, or brown bread and milk.
For lunch, he will have boiled rice along with a vegetable (gourd). In the evening again tea and biscuits. Then after an hour, he will usually take a fox nut seeds pudding, and for breakfast, he will usually take porridge and a vegetable curry. His milk intake is only 200 mL per day. No nausea or vomiting as such except severe constipation. He is having a backache and shoulder pain.
Please guide.
Hello,
Welcome back to icliniq.com.
This weight loss is quite significant. I suggest making an arteriovenous fistula (AV) at the earliest, if not done. Get a chest X-ray done.
Visit a dietician to follow this diet formula:
You can give him tablet Dulcolax (Bisacodyl) two tablets for relieving constipation.
For further information, consult a nephrologist online.
I hope this helps you.
Thank you.
Was this conversation helpful?
Answered byDr. Krishna Somani
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
Related Questions
Weight Loss Drugs in Individuals With Pre-Existing Medical Conditions
Constipation in Chronic Kidney Disease
Weight Loss Drugs Vs Weight Loss Methods - Weighing the Pros and Cons
Surgery for Soft Tissue Sarcomas - A Detailed Review
Constipation With Multiple Sclerosis and Its Remedies
Surgery for Perfect Nails - Techniques, and Indications
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.