Q: My 35-year-old wife suffered kidney damage due to Wegener’s Granulomatosis. She was treated with plasmapheresis last year. Now she is taking MMF 360 mg twice and omnacotril 2.5 mg. At present, her creatinine is in the range 3.5-4.0. What precautions should one take for it? She is also taking Dilzem 90 mg, Clozen and Lasix. She has gained 15 kg as a result of using these steroids. Is she on the right treatment?

A:Wegener’s Granulomatosis is a multi-system disease, autoimmune in nature. Your wife seems to have been treated adequately; however has irreversible damage of the kidneys leading to elevated serum creatinine of 3.5-4, which means a kidney function of 18 ml/min (18%). Once kidney function is irreversibly damaged, it will progress and once kidney function is less than 15% and patient has symptoms like nausea, weakness, decreased appetite, the patient will require either dialysis or kidney transplantation. Your wife should continue the medicines as advised & be on regular follow-up with a nephrologist.