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Suggest Medical Tests To Rule Out Kidney Failure
Question: My father has been admitted into hospital for an emergency with loose motions,vomitings ans stomach pain and the doctor told its due to bacterial infection and has done the treatment. On the first day they have done creatinine test and value is 1.1 before any medication started and after they have given some anti biotic injections,cylines and they have done the creatinine test again on the next day and now the value has increased to 1.6 and they have prescribed medicines for 5 days nd doctor has asked me to under go creatinine test and when we did the test the creatinine value is 1.5.My question is with in a day does the creatinine value increase suddenly or is it due to the anti biotic injections,cylines. After 5 days the report shows a decrease in creatinine from 1.6 to 1.5.So is this any thing to worry.My father is taking telma 20 mg for BP and is not diabetic.Can you suggest some tests to verify if his kidney is fine.
Brief Answer:
Acute kidney injury
Detailed Answer:
Hello
Thanks for getting back
The most likely cause for increase in creatinine is dehydration because of vomiting and loose stools. Most often it recovers with adequate fluid resuscitation with IV fluids. It is unlikely to be because of antibiotics.
I recommend that you stop Telma as it can worsen the creatinine, I recommend calcium channel blockers for hypertension at the moment until complete renal recovery.
My other suggestions would be
1. Keep him well hydrated with water and fluids
2. Avoid fruit juices including coconut water
3. Measure accurately his daily urine output with a urine measuring jar, alert your physician if it is less than a litre
Further tests would be to get ultrasound abdomen, urine routine and eye examination to see for retinopathy
There is nothing to worry as of now as the creatinine is coming back to normal. No dialysis or any such interventions will be necessary at the moment.
I hope I was of help, if you have any further queries please get back to me
Regards
Acute kidney injury
Detailed Answer:
Hello
Thanks for getting back
The most likely cause for increase in creatinine is dehydration because of vomiting and loose stools. Most often it recovers with adequate fluid resuscitation with IV fluids. It is unlikely to be because of antibiotics.
I recommend that you stop Telma as it can worsen the creatinine, I recommend calcium channel blockers for hypertension at the moment until complete renal recovery.
My other suggestions would be
1. Keep him well hydrated with water and fluids
2. Avoid fruit juices including coconut water
3. Measure accurately his daily urine output with a urine measuring jar, alert your physician if it is less than a litre
Further tests would be to get ultrasound abdomen, urine routine and eye examination to see for retinopathy
There is nothing to worry as of now as the creatinine is coming back to normal. No dialysis or any such interventions will be necessary at the moment.
I hope I was of help, if you have any further queries please get back to me
Regards
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Hi,
Thanks for getting back.I have attached the discharge summary and Ultra sound scan taken when my father was admitted and the doctor has changed the BP tablet from Telma to Amlong 2.5 mg but when Amlong was taken the BP was not controlled for 2 days and again he was taking Telma for the past 4 days.So do you mean to completely stop Telma and go for other BP tablet.
In fruits he is consuming pomegranate,pine apple and orange.Please let me know if these can be taken.His previous medical,history shows he has kidney stones when his age was 25-40 and from past 15 years he doesn't have this.
Can you also suggest some healthy food diets to lower his BP and creatinine and also to tell you his WBC count is also little higher than normal.SO does this indicate he still has some bacterial infection ot is this also due to increase in creatinine.
When would you to suggest to retest creatinine again to check if its normal.Currently his urine outflow is good but he is little weak.Can you also let us know what are the fluids you are referring to any examples
Thanks for getting back.I have attached the discharge summary and Ultra sound scan taken when my father was admitted and the doctor has changed the BP tablet from Telma to Amlong 2.5 mg but when Amlong was taken the BP was not controlled for 2 days and again he was taking Telma for the past 4 days.So do you mean to completely stop Telma and go for other BP tablet.
In fruits he is consuming pomegranate,pine apple and orange.Please let me know if these can be taken.His previous medical,history shows he has kidney stones when his age was 25-40 and from past 15 years he doesn't have this.
Can you also suggest some healthy food diets to lower his BP and creatinine and also to tell you his WBC count is also little higher than normal.SO does this indicate he still has some bacterial infection ot is this also due to increase in creatinine.
When would you to suggest to retest creatinine again to check if its normal.Currently his urine outflow is good but he is little weak.Can you also let us know what are the fluids you are referring to any examples
Brief Answer:
Acute kidney injury
Detailed Answer:
Hello
Thanks for getting back. I am sorry for the short delay in my reply.
Since there are several questions, I shall answer them one by one so that I dont miss any
1. Discharge summary does not add light to his condition and could have been more elaborate. It is a good idea to switch to Amlong in the setting of acute kidney injury ( AKI) as Telma is known to further worsen the kidney injury. Ultrasound is normal but for the fatty liver
2. I recommend that Amlong dosage be increased. I suggest you to wait for complete renal recovery before starting Telma
3. I suggest only Papaya, Guava, Pineapple and apple. Avoid all fruit juices including tender coconut water. The biggest issue with fruits is the presence of high potassium in them. Increased potassium levels in the blood can cause sudden cardiac arrest.
4. Increased WBC indicates infection, it takes about a week for it to completely settle down. If he is not spiking fever then it means that ongoing infection has settled.
5. I recommend low salt diet ( 1 teaspoon a day). I suggest avoiding red meat for now. Chicken and fish can be taken once a week. All other vegetables and dal can be taken. Please speak to your doctor regarding fluid restriction ( as this has to be clinically assessed and told) He can consume coffee/tea. Smoking and alcohol should be abstained from.
6. I usually check creat once in three days, however this is a clinical decision, in some patients I check daily. I was referring to plain water. IV fluids cannot be given as he is discharged now
Regards
Acute kidney injury
Detailed Answer:
Hello
Thanks for getting back. I am sorry for the short delay in my reply.
Since there are several questions, I shall answer them one by one so that I dont miss any
1. Discharge summary does not add light to his condition and could have been more elaborate. It is a good idea to switch to Amlong in the setting of acute kidney injury ( AKI) as Telma is known to further worsen the kidney injury. Ultrasound is normal but for the fatty liver
2. I recommend that Amlong dosage be increased. I suggest you to wait for complete renal recovery before starting Telma
3. I suggest only Papaya, Guava, Pineapple and apple. Avoid all fruit juices including tender coconut water. The biggest issue with fruits is the presence of high potassium in them. Increased potassium levels in the blood can cause sudden cardiac arrest.
4. Increased WBC indicates infection, it takes about a week for it to completely settle down. If he is not spiking fever then it means that ongoing infection has settled.
5. I recommend low salt diet ( 1 teaspoon a day). I suggest avoiding red meat for now. Chicken and fish can be taken once a week. All other vegetables and dal can be taken. Please speak to your doctor regarding fluid restriction ( as this has to be clinically assessed and told) He can consume coffee/tea. Smoking and alcohol should be abstained from.
6. I usually check creat once in three days, however this is a clinical decision, in some patients I check daily. I was referring to plain water. IV fluids cannot be given as he is discharged now
Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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