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How can chronic kidney disease be treated?

Q: I am a 76 years old male suffering from chronic kidney disease. My blood urea is 68, serum creatinine – 1.7, sodium - 136.8, potassium - 3.9, chloride - 104.8, bicarbonate - 28.6 and calcium - 8.6. Urine report is normal except leukocytes 2.3/HPF epithelial calls 1.2/HPF. My Hb level has reduced from 9.9 to 9.40, blood urea from 84 mg/dl to 69 mg/dl. I am at present taking Rocaltrol dytor (5 mg) twice, Methyl cobal (500 mcg), Folvite 500, Phostat (twice), Orofer Xt 1, Ketosteril 6 tablets. I am suffering from restless leg syndrome and also experiencing burning sensation when I lie down to sleep. During day time I am alright with no burning sensation. I feel drowsy during day time.

A:Assuming that your baseline serum creatinine level is between 1.6-2.0 mg/dL, you have around less than 35% of normal kidney function at your age. This obviously reflects advanced chronic kidney disease (CKD), involving various complications like bone disease, anaemia and metabolic acidosis, for which you seem to being treated adequately. The focus should remain on strict blood pressure control (target BP<130/80 mmHg), strict blood sugar control if diabetic, continued avoidance of exposure to potential kidney toxic medications like daily continuous intake of voveran and brufen, and restricting your daily intake of protein to under 50 grams. As far as restless leg syndrome (RLS) is considered, you may benefit from iron supplements if noted to be iron deficient, avoiding excessive caffeine products and intervention with medications like Ropinirole at 0.25mg or Pramipexole (0.125mg) a hour before the expected time of symptom onset. You should consult your physician for orderly treatment of RLS.

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