Q: My 61 years old father is a diabetic for the last 22 years. His creatinine was 1.9 when he started treatment for this last year. The very next month, it rose to 3.9 then came to 3.5 over period of 2 months. Initially he had oedema in his legs but it disappeared slowly. Again his creatinine shot to 6.1 then 6.8 last month, came down to 5.6 in 2 weeks and after another week it is 5.0. His blood urea level is 114 and haemoglobin level is 9.6. He is taking injection for low haemoglobin. Sodium is 127 and potassium 5.1. His blood pressure usually ranges between 148/88 and 160/80 mmHg. Now he is taking Tor20 and Metlar to control blood pressure. Ever since he has stared the medicine, he vomits at night. Are my father’s kidneys degrading day by day?

A:Your father suffers from progressive chronic kidney disease characterised by loss of greater than 85% of kidney function at his age. Further, he does have the complications of advanced kidney disease including severe anemia, swelling over the body parts, poorly controlled blood pressure and abnormal electrolytes including elevated serum potassium level. I would advise him to have a complete and thorough evaluation and follow up care plan by a qualified Nephrologist if not done so. Unfortunately, he is fast reaching the stage of End Stage Renal Disease(ESRD) where he would need the dialysis support or preferably kidney transplant.