Dr. Tarek Algamal
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
Hello doctor,
My father-in-law is aged 77 years. He has diabetes and blood pressure. His creatinine level is between 3.6 and 3.8. Has high levels of albumin in the urine and high levels of urea (129). He is admitted to the hospital following less to nil urine output. They have placed a catheter and are observing the urine output. However, it is still less. Around 600 ml for 24 hours. For now, the doctors are running an infusion to reduce acidosis. Does he need a dialysis? Is this a case of CKD? If yes, what could his stage of CKD be? What would be the further line of treatment?
Hi,
Welcome to icliniq.com.
Yes, unfortunately this is chronic kidney disease stage 4 to 5. May be the late stages of CKD (chronic kidney disease) is rapidly progressive especially in diabetics. If urine output has not been improved after treating the infection and achieving good water balance, I am afraid he might need dialysis.
Patient's Query
Hello doctor,
Thank you for your reply. Unfortunately, my father-in-law had necrosis in his left leg and they have done above-the-knee leg amputation. Doctors are doing hemodialysis and are giving albumin injections to reduce fluid retention in the entire body. I want to know if there is any relation between kidney disease and foot ulcerations, which can lead to an amputation.
Hello,
Welcome back to icliniq.com.
Foot ulcers and leg infections are most probably due to diabetes and not kidney disease. Because there is narrowing in the arteries supplying every part of the body and lower limbs will be most affected by this problem. Any ulcer or infection will not have a good blood supply for rapid healing. That is why these ulcers and wounds are getting infected more and more and it may cause sepsis if untreated well.
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