Chronicle Kidney Disease

Question
Hi,



My mother having kidney disease, that we get know from past 3-4 month.



I will give you brief case detail about my mother, she is suffering from diabetes since 1995-96.



However she is able to maintain her sugar level with the help of some medicine and fully control of diet.

Her Blood pressure level is always normal.

In the February 2008, she was admitted to hospital due to low hemoglobin which was level around 6, after that she recover fast and life become normal.

During the same period she also suffering from TB and she took course of TB tablets for 9 month(Jan,2008-Sept,2008).



In the month of July 2009 she again admitted in hospital due to CKD diagnosis, she suffering from suddenly hypertension and serum creatinine level increase to 4.2 as well as water swelling in whole body and it effect the  heart also and heart is working just 18.1% , so doctor suggest as to go for dialysis treatment .



Now my mothers serum creatinine level is increase to 8.5 after 10-12 dialysis and doctor said us this is normal because she is started eating food and due to that the level is increase, this is right indication or not?



After last dialysis which was made on 12th September 2009 , will see a sudden reduce in serum creatinine level from 8.5 to 5.5, is this a normal and right indication of kidney working again?



Apart from this, I need few clarification:



1.   Is this disease in incurable?

2.   For how many months/years we need to continue dialysis?

3.   Is there any way to overcome from this disease and stop the dialysis permanently?

4.   The kidney got fail to this much amount due to TB tablets course?

5.   Is there any way of control our serum creatinine?

6.   Why mother filling weakness after every dialysis and struggling to get urine and stole properly, is this normal?



Looking forward for your response.



Warm Regard,

Jaydeep.




Answer
Hi Jaydeep,



Thanks for asking my opinion on "Allexperts".



It is important to know what caused kidney failure in the first place. A careful history, physical examination, review of older investigations and imaging of the urinary tract are required to diagnose your mother's condition. Unfortunately, I cannot do that over the internet. What is the size of her kidneys on ultrasound? Was a kidney biopsy done?



Now on to your question series:

1. End-stage renal disease is not "incurable". Renal replacement in the form of hemodialysis, CAPD or transplantation will help the patient. However, the kidneys will not start functioning again.



2. As long as your mother lives



3. No



4. Refer to the second paragraph of this answer above.



5. No



6. There can be many reasons - beyond the scope of this forum to discuss all of them.



Sincerely,



Dr. Shah