Dr. Yash Kathuria
Family Physician
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 88-year-old grandfather's creatinine levels have risen significantly. He recently recovered from an ulcer with medication, but he is now experiencing severe low back pain, slurred speech, and episodes of aggressive and anxious behavior. The doctor has recommended a treatment plan that involves medication, fluids, and, ultimately, dialysis.
What are the potential risks associated with this treatment and what is the estimated survival rate? Please clarify.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern regarding your grandfather's illness.
Based on his medical history and the symptoms you have described, it does seem like he may be suffering from acute kidney injury, potentially leading to uremic encephalopathy. The recommendation for dialysis is often made in such cases. Dialysis can indeed have its own set of complications, particularly if the patient already has high or low blood pressure. It is important to monitor his blood pressure closely during dialysis. If his blood pressure remains stable and there are no other complications, there is a good chance that your grandfather's condition, including his altered behavior, may improve with dialysis.
It is also essential to acknowledge that at his age, there can be uncertainties, and the outcome may not always be predictable. Nonetheless, given the circumstances, it appears that dialysis is a reasonable course of action, especially if his kidney function does not improve with fluids and other medications.
I hope this information is helpful, and I encourage you to reach out if you have any more questions or concerns.
Thank you.
Patient's Query
Hello doctor,
Thank you for your guidance.
My final question is regarding the unusual fluctuations in my grandfather's creatinine levels during his hospitalization. His creatinine levels have ranged from 3.1 to 5.8, showing erratic changes within a relatively short span. Could you clarify if, after undergoing dialysis sessions, there is a likelihood that his creatinine level and GFR can return to a more manageable or normal range, enabling his discharge from the hospital?
The reason behind this rapid spike in creatinine remains unexplained. While I understand you may not have access to his complete medical records, could you provide insights into the major factors contributing to elevated creatinine levels and their potential prevention, considering his age and medical history including a hernia operation a decade ago, recent ulcer treatment, and multiple blood transfusions? Please help.
Thank you
Hello,
Welcome back to icliniq.com.
The sudden increase in creatinine levels can have several potential causes, including dehydration, infections (such as urinary tract or respiratory infections), or medication effects (like antibiotics or diuretics). It is likely that your treating doctor is considering these possibilities and tailoring the treatment accordingly. Dialysis is effective in lowering creatinine levels, but the return to normal or near-normal levels will depend on the extent of residual kidney function. There is also the possibility that your grandfather had pre-existing chronic kidney disease, and the recent spike in creatinine represents an acute insult on top of a chronic condition. It may be necessary to wait and monitor whether his kidney function improves to a stable level or if ongoing dialysis support is required.
I hope this information provides some clarity.
Thank you.
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Family Physician
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