new here / daughter

[hopeful28]

my father, 50, was diagnosed with diabetes induced ckd-5 in the first week of january. the nephrologist he went to recommended immediate treatment (dialysis or more preferably tranplant)
His blood creatinine was 6.62 mg/dL at that time. (from 2 labs)

2 weeks later he got tested again from the same center, blood creatinine was 7.2mg/dL
he's been on a strict diet since, and 3 days ago he got a gamma - ray test done, from another center. It says his total GFR is 23. with the Rt kidney's being 9.7 and lt. kidney's is 14.
This other nephrologist says it is ckd-4 and if the GFR is maintained, he does not need immediate dialysis.

Tomorrow he'll be giving his 24 hour urine sample for analysis.

I have been very very worried all January, but the gamma-ray test (is it ultrasound?) result has given me some relief. however my father physically doesn't feel very well , he has kidney pain, chills, cramps, fatigue, and i guess from what i have gathered from his talks his urination output has decreased significantly.

I would appreciate some comments from people out there, what should he be doing (as in treatment etc. )
Thanks and wishing good health to all the kidney patients....
I feel for you all! God Bless.


(As for my introduction, I am a 20 year old girl from Pakistan, and a first year medical student - so much moved by the effects of kidney disease on people's lives now that i am facing it first hand, that i wish i would play a part in finding a revolutionized way of treating it and finding its ultimate cure...the stories of patients and their caretakers touch my heart.)

[paul.karen]

Hello Hopeful and welcome to IHD.

It sounds like your father is ready to start Dialysis with the sypmtons you posted.  Maybe you should look at his bloodwork and see if he needs meds for high phosphorate and there is also meds for bone pain i take (hectoral) for bone pain and Renvela to help lower my phosphorous.  If he is cold his iron and hemoglobin could be low.  All these are things we learn over time or for me learned from this site.

I see your from Pakistan are you and your father there or elsewhere?

Your father will have to decide what kind of dialysis method he would like HD or PD.

Im sure others will have helpful information for you. 

[RichardMEL]

On the surface, a eGFR of 23 is too high to warrant immediate dialysis, despite the relatively high creatanine value. I would say that high amount of creat (ie: toxins) in his system is contributing to the effects he is experiencing, though I would also investigate if the chills etc are the result of some sort of infection or something else going on. I would also not go off the one lab value as they can change and what you want to see is a trend.

The bottom line is how HE feels. Just because 23 is an unusually high eGFR value to start dialysis doesn't mean he shouldn't if doing it will clear some of those nasties out and relieve his symptoms so he feels generally better. In this case he should be guided by his nephrologist as to the best course of action I think.

This is all very sudden it seems and clearly a great shock to your entire family - I can definitely understand the fears and worries you would all be experencing.

[billmoria]

An Indian doctor, working with Cal Tech and Stamford, is determined to attack the high numbers of dialysis patients in India. (of course any solution for India is a solution for everyone) His work involves and artificial kidney which wil not be rejected by the body. It shows great promise and trials on animals are now under way. Don't know if any of this work will benefit many of us as these trials take a long time.

[Rerun]

Hi Hopeful and welcome to IHD.  It sounds like you have a tiny window of time before he has to start dialysis.  Now is the time to take advantage of all there is to learn about the different types of dialysis so you and your father know what questions to ask.

He will need an access soon.  Dialysis depends on a good access to either his blood or his peritoneum cavity (tummy).

Rerun, Moderator      

[rsudock]

An Indian doctor, working with Cal Tech and Stamford, is determined to attack the high numbers of dialysis patients in India. (of course any solution for India is a solution for everyone) His work involves and artificial kidney which wil not be rejected by the body. It shows great promise and trials on animals are now under way. Don't know if any of this work will benefit many of us as these trials take a long time.

human trials are projected to begin around 6 years.

[peleroja]

Welcome to the group.  You will find lots of information here for your father.  Glad you joined!

[hopeful28]

@paul.karen, Thank you for the reply. yes he is taking medicines for bone pain and also for binding phosphorus. he does experience chills, also kidney chilling specifically. 
we live in pakistan.

@RichardMEL: Thank you for the reply. He got bloodworks done from 3 labs, all are almost in the same range. I am quite worried, because the latest blood results, and the 24 hour urine analysis test say that the GFR is 10.6%. I am also confused about the difference in the gamma x-ray (that says 23% eGFR) and urine analysis result. (GFR10.6%)

@Rerun: Thank you for the reply. Yes, he got his wrist surgery done today for an AV fistula.

@peleroja: Thank you .. =)

[galvo]

G'day, Hopeful, and  .

[paris]

Welcome, Hopeful.  That is something we all have to live with -- HOPE.   Your father is fortunate to have a daughter who cares so much for him.  All of this is very confusing.  It seems like the doctors are getting him ready to start dialysis and that is good.  He will feel better when he does start.   This site is great for information and also for support.  There is always someone here to talk to or ask questions of.  Post often and let us know how your Dad is doing.   So glad you joined us.  Welcome to IHD


paris, Moderator

[RichardMEL]

I'm not sure about the gamma scan. I've had one of those and I don't recall anything about figuring out a GFR from it. I'd trust the serium GFR over that. Remember though that it is an estimate and not a concerete number and can change from lab to lab based on various factors.