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How can my father's health be improved?

Q: My father is 72 years old and has diabetes for the last 18 years. He also has hypertension. His heart blood pumping reading is 26 out of 80. He also has mild renal failure due to his heart problem. He is under control of doctors for the past 18 years. He is restricted for 2 mg salt, 1.2 L of liquids. What kind of diet should he take to regain his health? Can I give him threptin? His nephrologist said that he should not take a lot of protein, since his creatinine is 1.7 (Normal is from = 0.7 to 1.6). His cardiologist told him to take Threptin, but I don't know whether he considered his renal problem or creatinine readings. How can his creatinine be reduced? I want to give him good food so that he does not suffer any vitamin loss. What vitamins does he need? He is stable now and the doctors are happy for his improvement. He can walk now, but doctors have restricted it to 10 minutes at a stretch. Any weakness can arise due to this minimal activity. What should I do to avoid that?

A:To begin with, elevated blood creatinine level points towards an abnormal kidney function. Based on the serum creatinine of 1.7 mg/dl, your father has chronic kidney disease with 40-45% of normal kidney function at his age. Type of diet recommended will be based upon your father’s underlying medical conditions. Based on the information provided, he has been advised a low salt diet and daily fluid restriction in view of his underlying heart disease (heart failure) and hypertension, in addition to daily protein restriction intended to delay the progression of kidney disease. However, due to multiple medical conditions in your father, there is always a risk of poor nutrition. Hence, I would advise moderate intake of protein (50-60gms/day) since the typical Indian diet, namely a vegetarian one, is not abundant in protein. Dal, milk and cereals are rich in protein. Threptin nutritional supplements are the milk- protein based, high efficiency protein supplements available in different forms often with low fat, and multiple vitamins along with minerals. You can certainly have it as a supplement in addition to a well balanced nutritional diet as needed. One doesn't have to shop around for vitamin supplements in addition to what has been recommended by the doctor, since many of these minerals and vitamins can be obtained from a healthy daily diet (namely, moderate protein, low fat and carbohydrates). Finally, an outdoor activity/exercise regimen as advised by his cardiologist based on the state of his cardiac illness is crucial to the maintenance of his optimum health.

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