Dr. Manzoor Ahmad Parry
Nephrology
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
Hi doctor,
A 56-year-old female patient was diagnosed with kidney failure. The last dialysis was almost two months ago. The patient said she wanted to stop dialysis because it did not help her, and the catheter caused her pain. Therefore, it was removed (despite the doctor’s protestations) about three weeks ago. She again went back into the hospital a week ago. She could not move before going to the hospital, so doctors have investigated why she could not move. They said MRI (magnetic resonance imaging) shows a problem with her spine. Current medications are BP (blood pressure) medication and IV (intravenous) pain relievers. Her present symptoms are neck, upper back, shoulder to arm pains, numbness in arms and legs, itchy skin, tiredness, stomach feeling full, and no bowel movement since she has been in the hospital. She is not undergoing any treatment for kidney problems. Concentration is trying to figure out why she cannot move. Her urine is very yellow, and she fills about two bags daily.
Hello,
Welcome to icliniq.com.
I saw your query,
The patient has kidney failure with very high urea and creatinine. She needs dialysis for the same.
Regarding her weakness, kindly show me her MRI (magnetic resonance imaging) report.
Patient's Query
Hi doctor,
Thank you for your reply.
Here are some more of her blood work (attachment removed to protect patient identity). I will get the MRI report from the hospital.
Hi,
Welcome back to icliniq.com.
I checked the report (attachment removed to protect patient identity).
I need the MRI report of the patient.
I would also need other investigations (which have been done).
Patient's Query
Hi doctor,
Thank you for your reply.
They have given her two transfusions. She is on BP medication, IV pain relievers, and sodium chloride, and her BP is 127/96.
Hi,
Welcome back to icliniq.com.
I have reviewed all reports (attachment removed to protect patient identity) of the patient. Her MRI shows infection in the spine, leading to weakness in limbs (legs and arms). She needs to be treated for this infection, for which a neurosurgery opinion and orthopedic opinion are needed. Regarding her kidney function, she needs to be counseled about the need for dialysis. An AV (atrioventricular) fistula needs to be made in her. Although urgently, she does not require dialysis, she definitely would need dialysis in the long run. I hope this answers your query.
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Nephrology
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