How to manage pneumococcal disease in a CKD patient?

Question

Hello doctor,

My 65-year-old mother has been living with kidney disease and was diagnosed with a pneumococcal infection recently. She had a kidney infection last year and was hospitalized for a week. She feels tired all the time, has a persistent cough, and has lost some weight. I understand that patients with chronic kidney disease (CKD) are at higher risk for serious infections.

We have been focusing on keeping her hydrated, but she experiences stomach pain after drinking water.

Should she start antibiotics, or are there other treatments to help boost her immunity while managing CKD?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Chronic kidney disease (CKD) can be quite challenging to manage as it causes fluid retention in the body, which increases the risk for severe infection and chest congestion, which manifests initially as a cough.

While it is recommended to start her on antibiotics, I strongly suggest she also do a renal (kidney) function test, a chest radiograph (X-rays), and measure her blood pressure. This would help to differentiate if the cough results from a chest infection or chest congestion, and also help to direct management and advice to prevent subsequent similar health challenges in her. For now, start her on antibiotics (check treatment), raise the head of her bed, or she should use multiple pillows when lying down; it will help with the cough.

The probable causes:

Pneumonia.
Pulmonary edema.
Early stages of heart failure.

Investigations to be done:

Chest radiograph (PA).
Renal function test (RFT).
Blood pressure measurement.

Regarding follow up let me know when you have the results.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.