Wednesday, 16 January 2013
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Dear expert,  My question is about a patient diabetic  on hemodialysis with creatinine of 3 mg/dl and serum urea = 160 mg/dl despite being overloaded, dyspneic  and orthopnic and usually need ultrafilteration of about 4 L every session.
more than a month ago
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#245
Hello,

Are you asking why this patient requires so much ultrafiltration with each dialysis?

Please clarify.

Dr. Jordan Weinstein
more than a month ago
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#246
Dear Dr.Jordan

I am asking about your explanation for her relatively low creatinine compared to her urea level . the patient weight is 90 kg and she is ESRD and has a history of rhabdomyolysis.

thanks .
more than a month ago
·
#248
Hello,

I personally don't place much stock in urea to creatinine ratios. Depending on the patient's age and weight, a creatinine in this range could still be associated with severe renal dysfunction and could be reason enough for dialysis dependence. Though I suppose you can screen for the usual causes of high urea to creatinine ratios: volume contraction (assuming some residual renal function), catabolism, GI bleed.

Jordan
more than a month ago
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#250
My questions I would like an answer too, regarding the question posed on the 16/1/2013 so as to partake in the discussion is: History is scanty. As a diabetic patient, how controlled is her Random blood glucose level? What type of antidiabetic medication is she taking. Secondly, how is the appetite of the patient? What was her history for a diagnosis of rhabdomyolysis?
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