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Q. Please explain the test results of diabetic and renal tubular acidosis patient.

Answered by
Dr. Prathish Kumar
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on May 25, 2020

Hi doctor,

My father was previosuly diagnosed with renal tubular acidosis and diabetes mellitus, was maintained on Potassium citrate and Gliclazide OD. Currently he had an infected insect bite on the left anterior lateral aspect of the leg. He was started on CO-Amoxiclav BID. Currently on its 4th day, I had his labs taken which revealed HbA1c: 8.5, FBS: 7.57, Crea: 2.79 mg/dl, BUN: 3.67 mg/dl, Hgb:195, Hct: .58 wbc:13.2, plt: 157 with normal lipid profile and uric acid. Should I start CKD medicines already? Should I step up with the DM medicines? Thank you.

#

Hi,

Welcome to icliniq.com.

High creatinine suggests a CKD picture for a long term diabetes particularly uncontrolled DM. Your fathers HbA1c is high which shows his diabetic status is not under control. High potassium levels is one of the complications of CKD, in this picture taking Potassium citrate is not advisable as it may increase its levels. And diabetic drugs also need to be modified when a person lands up in CKD, most oral medicines cannot be given. It is safe to shift the treatment with Insulin. You need to visit a Nephrologist for alterations in your medications and appropriate advice for CKD.


Investigations to be done:

serum potassium, sodium, phosphorus
urine routine
USG abdomen

Probable diagnosis:

DM, CKD


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