Q: I am suffering from chronic renal failure (CRF). I am 44 years old and my blood chemistry is as follows: Hb = 13.4; Creatinine = 4.4; Blood urea = 99; Uric acid = normal; Sugar = nil; BP = 110/70 (using irovel tab) also using injection espogen. How can I live a normal life? What diet should I take? What quantity of milk should I take? What medicine should I take? At what stage dialysis/transplant is needed? Will yoga/exercise be helpful?

A:It is evident that with serum creatinine level of 4.4 mg/dl, your kidneys are irreparably damaged and functioning at 16% or so. Your blood pressure appears to be controlled. It is not mentioned whether you are a diabetic or not. Under usual circumstances, dialysis is started when kidney function reaches 10% or lower level. Many centres may perform a preemptive kidney transplant even before dialysis is started but once kidney function is at 20% or lower level. It has been shown that individuals who receive kidney transplant before being initiated on dialysis may have improved outcome as compared to individuals who receive a kidney after having been started on dialysis. But different transplant centres may have their own policy in this matter. It looks like your haemoglobin is appropriately maintained on epogen injections. If your phosphorus levels are elevated, you will need to restrict dairy products and other phosphorus rich foods. I do not have enough information to comment on your nutritional status which cannot be ignored. You also may need to avoid food products rich in potassium such as bananas and oranges. For a detailed dietary advice, you may want to consult your local nutritionist who will assist you in customising the dietary menu according to dietary requirements.