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Advanced kidney failure

Q: My aunt, who is a fifty year old lady, is having very poor health from the recent past. She is a non-diabetic, non-smoker and has undergone hysterectomy (15 years) and cholecystectomy (9 years) ago. The patient is suffering from bilateral renal dysfunction. Three months ago the creatinine level was 16.6 mg which dropped to 7.8 mg as a result of hemodialysis. Now the level has again gone high and she also has acidosis alongwith gastropathy as a result of bilateral renal failure. Presently the patient has oedema of feet and hands and also painful joints (especially metacarpo-phalyngeal joints). She is partially anorexic. Please guide immediately regarding what should be done and if she is a good surgical bet.

A:Your aunt seems to have advanced kidney failure requiring dialysis. Dialysis only removes the waste products from the body and cleanses the blood. It does not do anything to the basic kidney disease. From the limited history you have provided, I can't tell you the cause of her kidney failure. From the description my guess is that she has chronic kidney disease and would require to be on dialysis three times a week and eat well. Her treating nephrologist may have discussed about the options of kidney transplantation/dialyis/CAPD.

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