My mother has diabetes, how can her kidney problem be controlled?

Q: My mother has some kidney problem from the past 3-4 months. She is under the treatment of a nephrologist currently. Her creatinine level is 5.3, her sugar PP is 173 (which is controlled by taking insulin as per doctor's prescription). Will my mother recover from the disease by medication completely? How will it affect her future health? What precautions do we need to take to avoid any complications in future? Does she require dialysis in future? My mother is taking wysolone 7.5 mg; endoxan 50 mg; lasix 1/2 40 mg; fefol; becosules; pentadox 40 mg; nicardia 10 mg; shelcal; fortum – 1gm (for 10 days - given 1 week back only); Eprex 400 - for haemoglobin (4 injections -1 week back only). My mother is feeling a lot better nowadays. She does not have any symptoms. Her personal details are as follows: weight - 67 kg, height - 145 cm. She had high blood pressure for which she was taking atenelol - 50 tablets.

A:Based on the limited information provided it appears that your mother's kidneys are performing perhaps less than 18% (depending on her age as well). Even though you have not provided how long has she suffered from diabetes mellitus (DM), I am assuming that she has diabetes for a long duration. Based on this assumption I believe that her kidneys are failing (irreversibly) secondary to diabetes. If diabetes is of recent onset, other causes will need to be investigated. Unfortunately, she will soon get to the point where she may require dialysis. It is recommended that for a diabetic when kidneys work less than 15% dialysis should be initiated. Diabetes is the number one cause of kidney failure in USA and Europe. In India, it is fast becoming amongst the top causes of kidney disease. First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can also cause kidney damage. To prevent further kidney damage and make kidneys will work better and last longer:

• Control diabetes
• Control high blood pressure
• Get treatment for urinary tract infections
• Correct any problems in urinary system
• Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)

If no other problems are found, your doctor will try to keep the kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function. Three types of treatment can be used once the kidneys have failed: kidney transplantation, haemodialysis and peritoneal dialysis.