Seeking Urgent Guidance on Kidney Issues for My Wife
Hello everyone, My wife has been grappling with stage 3B chronic kidney disease (CKD) for approximately two months. Recently, she began treatment with a combination of Ramipril at 5MG and Amlodipine at 5MG for blood pressure management. While these medications have successfully controlled her blood pressure and reduced the protein levels in her urine, we've encountered some troubling news regarding her kidney function. Here’s a summary of her recent lab results: - **Creatinine**: Elevated from 134 to 151. Her eGFR has declined from 46 to 40, having previously been at 50 before starting the medications. - **Urate**: High levels at 432. - **PTH**: Increased to 29.6. - **Potassium**: Also on the rise, climbing from 4.2 to 4.8, despite her efforts to maintain a low-potassium diet. While it remains within safe boundaries, the upward trend is concerning. - **Symptoms**: She has been feeling exceptionally fatigued, experiencing dizziness and a general sense of disorientation. Recently, she's begun to suffer from new bone pain, particularly in her heels, along with mild discomfort vaginally and some lower back pain, which is unusual for her. This series of developments has left me anxious, prompting several questions: - Will her eGFR continue to decline, or is there a possibility it might stabilize or improve? - Should we consider discussing a change in her Ramipril dosage or possibly switching to another medication with her doctor? - What might be causing the elevated PTH levels and associated bone pain? Are there solutions available for this? - Could the new pains she’s experiencing be linked to her current medications? - What are the reasons behind her increasing potassium levels, and how can we effectively lower them? - Has anyone experienced similar issues? Any advice would be greatly appreciated. - We’re currently awaiting results from an ultrasound and a 24-hour urine analysis. Essentially, I’m desperate for guidance and perhaps a bit of comfort during this stressful time. Thank you for your support!
Answers (1)
3/23/2025, 11:50:40 PM
OpenHealth AI
I understand this is a challenging time for both you and your wife, particularly with the new symptoms and recent lab results, and it's completely natural to seek comfort and clarity. Let's break down the key concerns and actionable steps here.
Key Points
- Kidney Function Decline: There is a possibility that, with proper management, her eGFR could stabilize or even improve, but ongoing monitoring is crucial.
- Medication Review: Discuss the current medications with her doctor, especially considering her elevated creatinine and potassium levels as well as new symptoms.
- PTH and Bone Pain: Increased PTH can result from kidney disease and may contribute to bone pain; exploring management options with her healthcare team is essential.
- Potassium Management: Changes in kidney function can lead to potassium retention; dietary and possibly medical adjustments may be needed.
Explanation
- Chronic Kidney Disease (CKD): In CKD, kidney function gradually declines. Changes in eGFR and creatinine levels might indicate worsening kidney function, but this isn't always the case. With appropriate lifestyle and medication management, stability is possible.
- Medication Impact: Ramipril and Amlodipine can affect kidney function. It's worth discussing any potential adjustments with her doctor.
- Elevated PTH & Bone Pain: High PTH (parathyroid hormone) levels can lead to bone density issues and associated pain as the body struggles to balance calcium and phosphorus, which are critical during kidney disease.
- Potassium Levels: Elevated potassium can stem from the kidneys' reduced ability to excrete it; dietary restrictions and close monitoring are important.
Next Steps
- Consult with Her Doctor:
- Schedule an appointment soon to review her medications in light of the increasing creatinine and potassium levels, as well as her symptoms. Discuss the potential need for dosage adjustments or alternative medications.
- Dietary Considerations:
- Continue restricting high-potassium foods (like bananas, potatoes, and tomatoes). Consider consulting a dietitian specialized in kidney disease for tailored dietary advice.
- Monitor Symptoms:
- Keep a log of her symptoms, including fatigue, dizziness, and pain. This information can be helpful for her healthcare team. If symptoms worsen, especially if she experiences severe dizziness or new pain, seek medical advice promptly.
- Follow Up on Tests:
- Wait for the ultrasound and urine results, as they may provide more insight into her kidney function. Discuss these findings with her doctor when available.
- Manage Fatigue and Pain:
- Gentle exercises, hydration (if not restricted), and discussing pain management strategies with her doctor may help improve her quality of life.
Reassurance
You're not alone in this, and many people navigate similar challenges. Ongoing communication with her healthcare provider is essential for tailoring treatment to her specific needs. Keep taking one step at a time, and prioritize her comfort and well-being during this process. If you have more questions or need further information, feel free to ask.
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