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Q. My mom has high creatinine and GFR values with high BP. Kindly suggest treatment options.

Answered by
Dr. Manzoor Ahmad Parry
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 04, 2020

Hi doctor,

I want to consult a nephrologist for my 54-year-old mother. She has high creatinine at 164 and eGFR at 31. She also has high blood pressure for the past 15 years, for which she takes Amlodipine 5 mg once a day. No other medicines and she does not have diabetes. We got her blood tests done and renal ultrasound with Doppler too. I have those reports to show to the doctor as I do not understand what is written in the ultrasound result and discuss my next step. Please help.

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Hello,

Welcome to icliniq.com.

I checked the reports of your mother (attachment removed to protect patient identity). It shows features of CKD (chronic kidney disease) with the possibility of renovascular disease. CT (computed tomography) angiography will be a good choice to rule out any renovascular disease. If that is normal then kidney biopsy can be contemplated. Rest, she should have good blood pressure control to prevent any further kidney function loss.

Thank you doctor,

Is this a severe condition? Because my mother does not have insurance, and if it is serious, we will have to go back to our home country for further treatment. Is there medicine to continue staying abroad or urgently needs to go to our home country?

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Hello,

Welcome back to icliniq.com.

Your mother has kidney disease with low kidney function. She needs to be evaluated for this. One important cause of this is most likely due to renovascular disease, for which you would need CT angiography. I do not know how much it would cost in your country, if it costs too much, you should prefer to return to the home country. Also, she needs further investigation, which again can be cumbersome without insurance. But I would suggest you check out with the local hospital to get an idea of how much it will cost to make decisions accordingly.

Thank you doctor,

She does not have any symptoms right now and is behaving normal. It will be very costly here. From her ultrasound reports, does it look very urgent for which I need to take her immediately? Or can I take her after one or two months? I know you said you cannot judge without further tests but I wanted to know your best guess based on ultrasound report and her having no symptoms? Why do we need to do biopsy? Is it related to cancer?

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Hello,

Welcome back to icliniq.com.

If it is this much costly, you can come back to your country. Since it is not that serious, you can take one or two months, but it is better to evaluate soon. A kidney biopsy is not for cancer but to see why kidney functions are low, especially if CT angiography is normal.

Thank you doctor,

Did you mean it is not that serious instead of it is that serious? She is walking 10,000 steps / 90 minutes daily and has cut down very much on salt. She has stopped consuming processed foods, proteins, and turmeric for 40 days. What precautions does she need to take? Can she drink a lot of water? And she can walk 90 minutes, right? And what other dietary restrictions should she take?

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Hello,

Welcome back to icliniq.com.

I meant it is not that serious in terms of life. But if we delay the investigation, the treatment will be delayed, and kidney function may not improve later.

She needs to have a low salt and low protein diet (especially avoid animal protein). She can take fluids as per urine output (urine should be around 1.5 to 2 liters). Also, avoid processed food. Rest, she can do normal work.


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