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Nephrology/Regarding CKD of my mother


my mother, 48y, with CKD-5, was having heavy menstrual bleeding and got UTI and her Hb level came down to 4.9, and creatinine/urea to 7.0/162. So, first she had blood-transfusion with 2 units of blood and levofloxacin treatment for UTI. But, now she is feeling very tired, unable to walk, with pain all-over body. 2 months ago her Hb was 6.5 and creatinine/urea= 4.0/72. Please tell  what to do. Doctor treating her at Hospital in Delhi are not giving her dialysis (not willing to give). Please help...

Good afternoon, Mohit,

Your Mother is a complicated patient.

The first question that I would ask is why is she in kidney failure? Is her kidney failure chronic? Are her kidneys obstructed so the urine cannot be excreted?  These are questions that must be answered in order to approach her kidney failure properly.  To do so, we need to know her kidney size, how long she has had kidney failure, whether has any other complicating diseases like diabetes, cancer, chronic infection of the kidneys.
If you have any of this information it would be very useful.

It is common for women with chronic kidney failure to stop menstruating. I wonder if she has some gynecological disease that is complicating her kidney disease.

One does become anemic as a consequence of chronic kidney disease but a hemoglobin of 5 or 6.5 is lower than what one would expect with kidney disease.  It suggests another complicating disease or possible blood loss into the intestines which can occur in advanced kidney failure.

Normally, there is a 10 to 15 to 1 ratio between the BUN and the CREATININE.  Your Mother's is higher.  This is seen in patients who are dehydrated, or who are in heart failure, or those who have an obstruction to the flow of urine, or those who have bleeding into the intestinal tract.  I wonder if the later is the case with your Mother.

It would be helpful to know WHY the Doctor in unwilling to give her dialysis.  Do you know?

See if you can get me more information, specifically the things that I mentioned above and any other information you have and I will try to be a little more helpful.

I'm sorry your Mother is have such difficulties.

Very sincerely,

Dr Falkinburg  


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Newell R. Falkinburg, M.D., FACP


I am a board certified nephrologist and emeritus professor of medicine at a major medical school and past Director of Nephrology & Hypertension at a university affiliated hospital. I have expertise in all areas of clinical nephrology, dialysis, transplantation and plasmapheresis.


Professor of medicine Director of Nephrology


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