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Please Refer My Previous Questions And Answers To Better Understand

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Posted on Fri, 29 Jan 2021
Question: Please refer my previous questions and answers to better understand the situation. I spoke to my father doctor this morning. The doctor said my father kidneys are failing, his potassium is very high and and he is still in septic shock ( 10 days in shock). But his respiration is a little better. Please advise me what need to be done and what is this all mean ? FYI : he is not receiving IV fluids I don’t know why , what is your opinion about IV fluids?
Thank you !
doctor
Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Hello again.

I have read your new question.

About kidney failure, it is caused by sepsis or infection.

In such cases, giving i.v fluids may result in fluids accumulation and worsening of the heart and lungs function, diuretics are generally used in such cases.

Potassium levels should be love red by using drugs such as calcium, glucose, or Kionex.

If there is not sufficient urine output, hemodialysis may be necessary periodically in order to remove the toxins from the blood.

Please discuss with your father’s Doctor these issues.

Hope this helps.

Feel free to ask if you have further questions.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Erion Spaho (11 hours later)


GCS is 6T still

Vent support is also not high

Renal: k+ is 5.1 , metabolic acidosis with concomitant resp acidosis

Urine output 800ml/24hrs
NaHCO3 is not available in the country and contraindicated for him since his Na is 160 and on hypernatraemic management.

Anyway,I will evaluate him and see what we can do more

What I am saying is Adrenaline requirement is coming down (from 0.5 to 0.2 mcg/kg/min)


Any advice?
doctor
Answered by Dr. Dr. Erion Spaho (13 hours later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

The aim is to maintain near normal values of the electrolytes in the blood, since there is a kidney insufficiency, the toxic metabolites also should be removed.

Furosemide in high doses may increase the urine output and lower the Na levels.

Hemodialysis if accessible should be considered as well.

This GCS coma level should be investigated by a brain CT scan as well.

Hope this helps.

In good health.
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. Raju A.T
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4494 Questions

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Please Refer My Previous Questions And Answers To Better Understand

Brief Answer: I would explain as follows. Detailed Answer: Hello again. I have read your new question. About kidney failure, it is caused by sepsis or infection. In such cases, giving i.v fluids may result in fluids accumulation and worsening of the heart and lungs function, diuretics are generally used in such cases. Potassium levels should be love red by using drugs such as calcium, glucose, or Kionex. If there is not sufficient urine output, hemodialysis may be necessary periodically in order to remove the toxins from the blood. Please discuss with your father’s Doctor these issues. Hope this helps. Feel free to ask if you have further questions.