Jordan Weinstein

Hello,

Kidney replacement (dialysis or transplant) is indicated with any or all of the following:

• intractable symptoms of end-stage renal failure (usually loss of appetite, severe fatigue, confusion or nausea/vomiting)
  
• intractable high potassium, acidosis and to a lesser extend phosphate
  
• inability to control your fluid balance (resulting in fluid accumulation in the lungs) and/or severe hypertension
  
• pericarditis
  

Until such time, patients can continue with their daily activities (with modification as required) without kidney replacement.

Dr. Jordan Weinstein

Hello,

From a kidney point of view, that frequency and dose of ibuprofen is safe provided you don't have significant loss of kidney function or protein in the urine. Even then, very sparing use of ibuprofen can used in certain circumstances. But in the later case, you would have to consider your own individual history first before deciding.

Dr. Jordan Weinstein

Hello,

Proteinuria can be minimized and in some cases are reversed by maintaining excellent blood sugar control, blood pressure control and by the use of ACE inhibitors - of which Coversy is an example - or else angiotensin receptor blockers. Newer data also supports the use of the SGLT2 inhibitor class not only for treatment of diabetes but in particular to improve kidney outcomes like proteinuria, progressive loss of kidney function with improvement in the rate at which patients end up with end-stage renal failure requiring dialysis or a kidney transplant.

Dr. Jordan Weinstein

Hello,

How old are you?

To clarify, your urinary albumin protein is zero (normal) and your eGFR is within the normal range (except the two creatinine levels have changed slightly in the interim. Do you have creatinine levels from past years? Urinary creatinine concentration is not a useful lab test and is used only to calculate the albumin to creatinine ratio; a rising level is of no concern. While you may have chronic UTIs, that does not mean you have kidney damage per se.

Dr. Jordan Weinstein

My father is on dialysis, three times a week for last 9 months. He used to urinate 3-5 times I
24 hours earlier. Since last one day, he is feeling of urination and going to washroom at an interval of 5/10/15 minutes, though the actual urination is negligible.

How this can be explained?

Urinary infection and prostatitis can still occur on dialysis and should be excluded as a first step.

Dr. Jordan Weinstein