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Why isn't my friend's leg pain getting better?

Q: My 32 years old friend is having severe pain in his legs, since the past 2 years. One of his kidneys is damaged by 80 percent. His haemoglobin count is around 6.0. The pain usually happens in the night. We have met several orthopaedic doctors. Noone has been able to diagnose the exact problem. From the last 6 months, the pain has become very acute. Earlier the pain was felt only below the knees. Now it has reached his thighs also. The pain is so severe that he cannot sleep. It isn't that severe when he walks. He has been on painkillers (like combiflam) for a long time. Now he has reached a stage, where even the pain killers have stopped working. Please suggest what should be done.

A:Ultrasound shows the structural changes of kidney and does not give information about the function of kidneys. Function of kidney is determined by blood tests of urea and creatinine and DTPA scan. Pain killers do cause damage to the kidney especially in someone who has already an underlying kidney disease. You should see a nephrologist to evaluate your kidney function. Anaemia is also because of kidney disease. Kidney produces the hormone erythropoietin, which is essential for making red blood cells. In patients with kidney disease this hormone is less and thus has to be given as a drug to improve haemoglobin. However other causes of anaemia also need to be looked into.

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