Q: My 68 years old father has been suffering from high blood pressure and sugar for past 25 years. He is on insulin injections and medicines for the last 4 years. As per his latest reports, his blood sugar is 128 mg/dl, blood urea is 76 mg/dl and creatinine amounts to 3.2 mg/dl. E.coli was grown in his urine culture and after taking antibiotics for six months, E.coli disappeared but has now appeared again. He is on strict vegetarian and low protein diet for the last one year. Can you suggest any exercise or method to reduce creatinine? My father is a retired man and of late he feels pain in right pelvic junction and also experiences difficulty in moving and getting up after sitting in a chair for a while. All his ultrasound reports of liver and neurological tests for nerves in these areas are ok. What could be the reason for this muscular difficulty?

A:Serum creatinine is used as an indirect marker of kidney function. High creatinine reflects poor kidney function. The cause for this is most likely diabetes and hypertension of long standing duration, aggravated by urine infection. There is no drug which reduces creatinine or improves kidney function. However, if there is a reversible factor, which aggravates kidney dysfunction, correction of that factor, might improve kidney function and thus creatinine might decrease. The pain and weakness in muscles and bones may be also related to kidney disease, which affects vitamin D as well as parathyroid gland, both affect muscle & bones. You should get Vitamin D levels and intact PTH levels measured in blood.