Q: My 50 years old mother suffered from acute renal failure (ARF) last month. After her discharge from the hospital, she was on medication. Her latest report indicates increased creatinine levels. Her BUN is 68.65mg/dl and creatinine is 8.30mg/dl. Her haemoglobin is 7.5g/dl. Over the last 20 days, her BUN levels have decreased but blood creatinine levels have increased. The doctors have suggested that she should go for regular dialysis if the blood creatinine level doesn’t come down. She feels healthy and is very active. Is dialysis an absolute necessity in her case? Are there any alternatives to reduce creatinine in blood?

A:Your mother suffers from acute renal failure as pointed to her by her kidney physician with no signs of recovery. It seems that her kidneys have suffered damage from whatever cause more than a month ago. However, patients with acute kidney failure, like her do show signs of recovery many weeks after the initial injury and this recovery would be obvious by blood tests and improved urine output. But for now, the numbers do suggest that she may need maintenance dialysis in near future especially if she starts feeling sick, tired, having nausea and poor appetite (all resulting from accumulated toxins in the body not filtered by failed kidneys). Her anaemia is explained by her kidney failure. There is no medication or any other intervention, which can take the place of dialysis in cases of irreversible kidney damage resulting in kidney failure. In the meantime, it would certainly help to undergo kidney biopsy to ascertain the actual cause of ARF, which may help to plan the future treatment including possible kidney transplant if her kidney function doesn't improve.