How to manage chronic kidney disease using medications?
Patient's Query
Hello doctor,
My mom was a CKD patient. Currently, she takes the following tablets: Lorazepam 2 mg, Sodium bicarbonate, Metoprolol Succinate 50 mg, Torasemide 10 mg, Nifedipine, and Febuxostat. But she frequently feels vomiting, headache, and so on.
I have attached the latest laboratory reports for your kind information. Please provide the prescription for tablets to be used to recover from this critical situation.
Please help.
Hello,
Welcome to icliniq.com.
I understand your concern.
I think your mom is suffering from severe renal failure, termed CKD (chronic kidney disease). Going through her reports (attachment removed to protect the patient's identity), she is having severe abnormalities in various reports. I suggest you add the following medicines along with the medicines she is already taking:
-
Tablet Vitamin D 0.25 mcg, two tablets in the morning.
-
Tablet Sevelamer thrice daily.
-
Tablet Cinacalcet 30 mg once in the morning.
-
Tablet Pantoprazole 40 mg twice in the morning and at night.
-
Tablet Domperidone 10 mg thrice daily.
-
Stop tablet Febuxostat.
Apart from renal failure, she also has tertiary hyperparathyroidism (PTH is more than 1600 pg/mL), which is an indicator of severe vomiting. She is almost on the verge of dialysis. Please explain whether she has swelling in her legs or appears dehydrated. Do not totally stop salt or liquid intake. If she is dehydrated, add a little more salt and water to her diet, but do it very carefully.
Try the above medications; she should improve in 2 days. If not, take her to a nearby kidney hospital and, if necessary, start her on dialysis so that her symptoms will improve and she will definitely be fine within two to three weeks.
Feel free to connect over a call or video consultation so I can physically assess her volume status and guide you on the fluid allowance required per day. I will send the prescription.
I hope the answer was helpful.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I request that you send the prescription with all tablet lists (inclusive of existing tablets). So that I can buy it easily. My mom has swelling in the back, upper side, and hands.
Please help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
She should be dialyzed immediately based on your statement that she is swelling all over, as medicines will not help.
I hope this helps you.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thanks again.
However, she is unwilling to undergo dialysis. Is there any possibility of recovering without dialysis?
Please help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have sent the dose of her regular medicines and the amount she takes every day. I will add those to the prescription and will send you, but start dialysis for her immediately.
No, she will not risk her life if dialysis is not done in a week. She will become worse if the situation is not corrected, and with this much edema, medicines will not help.
I hope this helps you.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you.
The dose of medicine was already shared in the first chat.
Please suggest.
Hello,
Welcome back to icliniq.com.
I will check and let you know.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you.
She takes Febuget 40 mg once at night.
Please suggest.
Hello,
Welcome back to icliniq.com.
I will send the prescription. Please go in for dialysis as advised.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you.
Do you know any specialists?
Please suggest.
Hello,
Welcome back to icliniq.com.
Sorry, I do not know.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you.
Actually, I could not buy Lorazepam 2 mg tablets, because the medical staff told me the production or supply had stopped. So, please provide the prescription with an alternative tablet.
Please suggest.
Hello,
Welcome back to icliniq.com.
Lorazepam is a sleeping pill. In her condition right now, sleeping pills are not advisable. How is she in general, and is she passing urine? If not, you need to give Furosemide 100 mg, 3 tablets, in the morning and at night for at least 3 days to reduce her swelling. What is your take on dialysis?
I hope this helps.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thank you.
She is fine now, but sleeps for only around two hours.
Please suggest.
Hello,
Welcome back to icliniq.com.
She is not able to lie down, right?
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
No, swelling is reduced.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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