Q. My sister has less urine output with pulmonary hypertension. Please help.

Hello,

Welcome to icliniq.com.

I am sorry to hear about your sister's health problems. She is not making urine at the moment because most likely she suffered kidney injury.

Is her body swollen? Is she on urinary catheter? How long has she been on Furosemide?

Hello,

Welcome to icliniq.com.

It saddens me to know how worried you are, but please try not to give up hope. Truly idiopathic pulmonary hypertension is a chronic illness and not easy to deal with, but do not be discouraged. Once there is life, there is hope.

Normal quantity of urine passed in a healthy individual is 800 - 2000 ml that is if you drink at least two liters of fluid a day. So her normal quantity of urine per day is supposed to be around 400- 1000 ml per day since, according to you she takes 1 liter/day of fluid.

When you say she is not passing sufficient urine, what is the quantity in ml she passes? Because her urine quantity will be proportional to the amount of water she takes in.

Hello,

Welcome back to icliniq.com.

Yes, exactly as I said earlier. I expect that she should have the symptoms she is presently exhibiting.

According to her medical report (attachment removed to protect patient identity), she has class 2 heart failure. Right-sided heart failure to be precise. So it is not strange that she is having a puffy face and swollen leg, it is due to the fact that her heart is failing.

As for the urine, she is making a good quantity of urine. For intake of 1 liter of water, 500 ml urine is fine. The medications she is presently taking are not effective. There is a need to change them.

For further management based on my clinical experience, Verapamil, Macitentan and Tadalafil will have to be withheld. She will try a monotherapy using a parenteral or inhaled prostanoid like Epoprostenol. You will need to discuss the possibility of her taking this medication with her cardiologist depending on the treatment protocol of your country. But this is the treatment protocol accepted by world health organization.

Hi,

Welcome back to icliniq.com.

Yes, of course, if she gets the right treatment her total condition will improve. But I have to inform you early, in case she does not improve on any of the medications, she will need a transplant. A transplant is a definite treatment if all medical treatment fails. If not, it could be fatal.

I am sorry I had to make you aware of the fact on time. Please be strong and hopeful. The best thing you can do for her is to show support in any way you can. Sincerely I wish her a speedy recovery.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Isaac Gana

Experience: 8 + Yrs

Cardiology

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