Q: My mother has hypertension and piles for last 2 years. During the treatment for piles and high BP, her kidneys shrunk (left: 7.6 cm, right: 8.0 cm). Two years ago the S. creatinine and urea were 10.4 and 148, she was on haemodialysis. Then we moved on to Ayurvedic treatment and with the help of Ayurvedic treatment her creatinine level was decreased to 3.5, but suddenly piles was increased and we had to go for surgery for piles, due to operation and irregularity in medicine her creatinine level was increased to 11.4 and again she had taken two consecutive haemodialysis. After dialysis she lost her memory. Now her memory has improved a bit but she has some madness problem. Can you tell me why she has a memory problem after dialysis and how can we resolve this problem? I heard about peritoneal dialysis (home dialysis), can you suggest me what should we do, should we go for that home dialysis or the kidney transplant is the only option to save her life?

A:Your mother has remained with high levels of urea and creatinine for some years, which has affected her memory. In addition, Ayurvedic drugs also could have contributed - I hope the Ayurvedic medicine did not include any metals. I have known of patients have received such medicines in the hope of curing irreversible chronic kidney failure. In this process, I suspect your mother also must have become weak & lost her muscle mass. She should get dialyzed adequately and get good nutrition once she is physically better then may be consider kidney transplantation. Peritoneal dialysis is also good form of dialysis but patients should not be malnourished. In such patients haemodialysis would be better.