pre renal failure

[chuckt67]

My mom is in pretty bad shape and leaving peritoneal dialysis and going on hemo. I believe she has what's known as pre-renal failure. The arteries leading to her kidneys are thin walled and collapsing. Doctors placed a stent in each kidney artery entrance 5 years ago but have never brought it up. After we just now asked we were told they didn't work. So does this mean they are still there possibly causing a bigger blockage. should they be removed? and why cant they take one of my arteries and switch it with her failing one? Does this type of procedure exist? Just seems wrong to die of kidney failure with good kidneys.

Thanks in advance

Chuckt

[jeannea]

I'm not sure what you mean by good kidneys. If she's on PD, she has renal failure. ESRD never goes away. I don't know of any procedure where they would transplant an artery or what good that would do. I'm sorry your mom is in bad shape. I think you need to make sure your mom puts you on the HIPPA paper and then you can have a thorough and honest conversation with the doctor. Also, hard as it is, please discuss end of life issues with your mom and make sure she has a will, financial power of attorney, health care power of attorney, and living will. With proper care and good dialysis she may live many years yet. But you need to know what she wants.

[cariad]

They cannot transplant just an artery because it would not fit her kidney. Apparently, they transplant the artery with the kidney, so that each transplanted kidney has a perfectly matched artery. That is what I was told at UCSF. However, if you want to be a donor for your mother, you could donate an artery with a kidney attached. Is your mother a candidate for transplant?

[jbeany]

Sorry Chuck, but if she's already on dialysis, no matter what kind, she's way past the Pre-anything stage.  They don't put you on D unless you have ESRD - End Stage Renal Disease.  I doubt the stents would cause any more blockage than what the original problem was that the stents attempted to fix.  If the stents didn't work, the damage to the kidney would not be reparable with a new artery.  Restored blood flow won't undo what's already happened to her kidney function.

You might want to check out www.kidneyschool.org.   It will explain pretty much everything about ESRD in basic terms.  The more you know, the more sense you can make out of what the docs tell you - and figure out what questions to ask them.

[chuckt67]

Thank you all for the replies. I had to cliarify the term i used with the pd nurse. The 'pre' is an indication of not what stage the kidney failure is in. It is an indication of where the failure lies in the whole kidney processing function. The failure begins before the blood to be cleaned even reaches the kidney (or in her case, most of the blood cannot get into the kidney. They can't truly judge the kidney's health or full remaining potential on it's processing of the trickle of blood it is slowlly, decreasingly receiving. On top of that, she has mysteriously swung a 30 bp points average to the Hypotension side, even after taking away all her BP lowering meds and her water pill for the last 2 months. They gave her midodrine which helps to an extent. She is now in her second week of hemo, but the week previous, when we were waiting for the emergency hemo catheter placement, her diastolic was droping to as low as 34 (which is as low as my machine will register) and trending down. I started her on liquid flavinoid supplements which have worked wonders to raise and stabilize her bp.