Mother Facing Kidney Challenges
Age: 75 Gender: Female Height: 5 feet 3 inches Weight: 265 pounds Ethnicity: Caucasian Duration of Symptoms: 24 hours Location: United States Relevant Health Background: Stage 3 Chronic Kidney Disease, hypertension, elevated cholesterol levels, obesity, Chronic Obstructive Pulmonary Disease (COPD), Gastroesophageal Reflux Disease (GERD), diabetes. Current Medications: 2 liters of supplemental oxygen, enteric-coated aspirin 81 MG, Bevespi Aerosphere (9-4.8 MCG/ACT), budesonide 3 MG, buPROPion 150 MG sustained release, clotrimazole-betamethasone cream (1-0.05 %), dapagliflozin 10 MG, famotidine 40 MG, ferrous sulfate (325 MG with 65 MG of iron), fluoxetine 40 MG, gabapentin 300 MG, nystatin powder (100,000 units/GM), olmesartan 5 MG, pantoprazole delayed-release 40 MG, primidone 50 MG, rosuvastatin 10 MG, and a semaglutide injection (8 MG/3 ML). Yesterday, my mother experienced significant dizziness. At home, her oxygen levels dropped to 74, and her heart rate soared to 211 beats per minute. My father promptly took her to the emergency room where she was admitted overnight. Fortunately, her heart rate and oxygen levels stabilized, however, her Glomerular Filtration Rate (GFR) had decreased to 20 (down from 35 just a month ago), and her creatinine level was recorded at 2.45. During her stay, they administered 0.5 liters of fluid for rehydration and monitored her condition. This morning, new blood tests revealed the following concerning results: - Blood Urea Nitrogen (BUN): 30 - Creatinine: 2.18 - GFR: 23 - Red Blood Cell count: 3.29 - Hemoglobin: 10.3 - Hematocrit: 32.5 Urinalysis results showed: - Protein: 30 - Glucose: 500 - White Blood Cells: 14 - Bacteria: Moderate presence - Mucus: Present Living in a small town, it appears they may discharge her without any further action. She hasn’t yet met with a specialist or received significant guidance beyond being labeled as dehydrated. I am increasingly worried that her blood test results indicate serious kidney issues or potential failure, warranting additional follow-up care. What more can I do to advocate for her health, or is this situation not as critical as I fear? Thank you for your assistance.
Answers (1)
3/17/2025, 2:10:45 PM
OpenHealth AI
Your concerns about your mother's condition are completely valid, especially given her significant medical history and the recent, concerning lab results. It's essential to address her health comprehensively, considering her stage 3 Chronic Kidney Disease (CKD) and other existing conditions.
Key Points:
- Your mother's recent hospitalization and the deterioration of her kidney function (with a GFR decreasing to 23) are critical concerns that warrant further evaluation and management.
- The presence of protein in her urine, along with elevated BUN and creatinine levels, suggests worsening kidney function, possibly due to dehydration, infection, or other factors.
- Advocating for a specialist’s insight is crucial to ensure she receives appropriate care.
Explanation:
Chronic kidney disease is managed based on the underlying causes and the stage. In her case, the drop in GFR indicates need for immediate attention, especially considering her history of diabetes, hypertension, and COPD. The elevated glucose in her urine may indicate poorly controlled diabetes, and moderate bacteria could suggest a urinary tract infection (UTI), which can exacerbate kidney issues.
Next Steps:
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Request a Nephrology Consultation: Advocate for your mother to see a kidney specialist (nephrologist) before discharge. Given her rapid decline, this is essential to evaluate treatment options and potential adjustments to her current medications, particularly the diabetes management and blood pressure medications.
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Monitor Symptoms Post-Discharge: If she is discharged, closely monitor for signs of worsening condition, such as increased dizziness, fatigue, or changes in urination. Report any new symptoms immediately.
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Assess Fluid Intake: Ensure she maintains proper hydration at home, as dehydration can worsen kidney function. A fluid intake discussion with healthcare providers can clarify ideal hydration levels, focusing on balance considering her kidney status.
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Follow-Up Appointments: Schedule follow-up blood tests and doctor visits soon after discharge to track her kidney function and manage her other health conditions actively.
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Manage Infections: If a urinary tract infection is suspected, discuss with the healthcare team the need for appropriate antibiotic treatment, as infections can complicate kidney issues.
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Support Nutritional Needs: Consider discussing dietary recommendations with a healthcare provider or nutritionist specializing in renal diets to help maintain kidney health.
By taking these actions, you can significantly support your mother's health and ensure she receives the necessary care. Remember to approach her healthcare team with specific concerns and questions to facilitate clear communication about her needs.
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