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Hi doctor,
My grandfather is 82 years old. He has undergone bypass surgery before 14 years and also done angioplasty last month. He has diabetes and BP. He has a high level of blood urea and creatinine. What are the steps can be taken now? Please suggest.
Dr. Hafiz Muhammad Hassan Shoukat
Hi,
Welcome to icliniq.com.
He has a worsening kidney function secondary to hypertension and diabetes. His hemoglobin is low, (attachment removed to protect patient identity) and it is 7.6 g/dL. I believe that it is low due to kidney failure and he also has a bladder infection. Consult a urologist soon and do these blood tests such as serum iron, ferritin levels, and TIBC (total iron binding capacity).
You can also consult a nephrologist soon, and he also needs subcutaneous erythropoietin during this time. For infection, you can give him tablet Ciprofloxacin 250 mg twice daily for five days. He needs hemodialysis also, and I also recommend getting a fistula now. It would become mature in three to four months, and it helps in the future. Discuss with your cardiologist if the stents are placed, before discontinuing Brilinta (Ticagrelor) and continue taking Aspirin.
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