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Will urethral catheter solve my wife's kidney problem?

Q: My 25 years old wife was undergoing treatment for her back pain for the last one year. Recently, when we got her admitted to the hospital, we came to know that her creatinine level had reached 7.01 but her Sodium and Potassium levels are normal. The nephrologist, after examining the blood reports and the MCU report, told us that it is due to her urine reflux and that there is no specific medication to get the creatinine down to normal level. Both her kidneys are damaged and she would have to go in for dialysis or a kidney transplant. Another urologist had suggested that we could surgically divert the urine, which was going back to the kidney, by connecting a tube to the ureter and diverting it to the urethra so that the urine passes off without affecting the kidneys. My wife has a urine bag attached to her body now and after a week of having the bag attached, her creatinine level has come down to 6.01. Is there a possibility that her kidneys got damaged only because of the high creatinine level? Will the surgery, which the urologist has suggested, provide a permanent solution to my wife’s kidney problem or will she have to go for dialysis or a kidney transplant?

A:It seems your wife has sustained significant kidney damage on account of congenital vesicoureteral reflux and placement of catheter is unlikely to make any major change in her condition. On the contrary, placement of urethral catheter in the cases of vesicoureteral reflux enhances the chances of severe urinary infection. In case of fever, you should immediately take her to the urologist. The rise in creatinine is the result of kidney damage and not its cause. In all probabilities she will ultimately need renal replacement therapy i.e. dialysis and or transplant. Any surgery for reflux at this stage may not be justifiable.

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