Q: My 66 years old diabetic father has high blood pressure and is a cardiac patient too. His creatinine levels have had variations in the last couple of years; the lowest he had was 2.1 mg/dl. It went up till 4.9 mg/dl and came back at 3 mg/dl after a strict diet, however his uric acid has always remained between 3.4 mg/dl and 6 mg/dl and the urea level has remained between 50 mg/dl and 65 mg/dl. Now his creatinine is 5.0 mg/dl and urea is 64 mg/dl. His sugar and blood pressure is under control. For how long can we avoid dialysis? Can the creatinine level be controlled? If yes, how?

A:Your father's kidney function as estimated from serum creatinine value of 5 mg/dl is 15 ml /mt, which puts him into stage 5 of chronic kidney disease (CKD). This means he is close to requiring dialysis. In fact he should get his A V fistula made as soon as possible, the fistula takes 4 to 6 weeks to develop. This makes the veins in the forearm to be accessible for needle insertions for haemodialysis. There is no medicine available anywhere to improve kidney function. He should continue BP medicines and keep his blood sugar under good control.