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Old 08-23-2010, 11:05 AM   #1
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creatinine level 3 to 4? please advice

Hi,

My sister is suffering in kidney disease,she has the results like

Urea : 40 mg/dl range(10-50)
Creatinine: 3.4
Sodium and potassium are normal

hemoglobin is 12.5 G/dl

these results are by the pakistani lab.
But when she was in Uk the doctor's of Uk said that go for the transplant after observing these parameters...

when she was in uk her results was like...

urea : 13.1
Creatinine: 340

but here in pakistan we met the doctor he said that she doesn't need transplant or dialysis now immediately her kidneys are still working good like 30 to 40% when she'll really need then go for the transplant even he said there is still no apparently symptoms of failure kidney's disease no doubt she has a kidney disease but now in the mean while she really doesn't need dialysis or transplant even he said if she cares her self and take proper diet she can survive like 5 to 10 Years (GOD 'll do better) with her own kidneys so we are confused here at one side Uk doctors says that go for transplant immediately and pakistani doctors says that don't go for transplant immediately as she can survive more few years or might be GOD knows better she would survive more than 15 years with her own kidneys so guyzz please advice us what should we do either we go for transplant or wait and observe the parameters after each 1 or 2 months. as we are in big tension she is my very lovable sister ... I'll wait for your suggestions even im going tomorrow to another doctor for advice ..

Thank you ..

 
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Old 08-23-2010, 11:49 AM   #2
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Re: creatinine level 3 to 4? please advice

I can tell you what guidelines are here in Canada. At her level of creatinine, they begin the teaching process to prepare you for dialysis. In these sessions they talk about diet: -low potassium foods if required by labwork, but since her level is normal it is not anything to worry about currently but may be in the future
-low phosphorus (things like dairy and lentils are high in ph.) but again not required until the levels begin to rise
-low animal protein (important to help maintain kidney function as too much of it is hard on the kidney)

They also teach about the different forms of dialysis like hemo and peritoneal (my personal preference is peritoneal as it allows more flexibility in many areas) and may then suggest the person start to contemplate the small surgery required for either form to begin dialysis when needed.

Exactly when you start dialysis is a very personal decision. Some folks feel absolutely horrible at the cr. level your sister is at and ask to start treatment right away. I felt fine and was still working - for several more years in fact). To be perfectly honest, I didn't start dialysis until I hit about 8 or 9 creatinine (yes, I did leave it a bit too long, but not by too much in my case). The other issues to consider when starting is things like potassium levels and fluid balance. If she were to have very high potassium (dangerous) or had high levels of swelling, dialysis again might be considered to alleviate this.

Some areas will push to get a preemptive transplant, but to me (I'm not a doc, just a patient with a lot of experience) there is early and then there is too early. Your Pakistani doctor is correct that it could be 5 or 10 years before she required dialysis. Different hospitals have different standards. Of course, pre-emptive transplants are often preferred as the recipient is still a bit more healthy than a person on dialysis, but dialysis patients get transplants every day and do well.

In the meantime, I would wait at least a bit. The most important issue is to watch for trends. If her function seems to be declining, then start thinking about what action to take. Are there family members or friends who might be willing to donate? It is often easier if another family member or friend approaches them so that the potential recipient isn't forced to ask for a body part and then face rejection. And the potential donor will be able to look your sister in the face knowing that she will never know that they did not wish to donate (and there is absolutely nothing wrong with not being comfortable with the process).

I know how hard it is to wait, but sometimes it is the best course of action.

Feel free to ask me any questions about the entire process. I was pre-dialysis for over 20 years, on hemodialysis for 1 year (tried peritoneal for a while) and then had my kidney transplant from my cousin in 2002. I am currently doing quite well.
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Dxd T1 1966, 2001 dialysis, 2002 kidney transplant, 2003 insulin pump, 2008 pancreas transplant

 
Old 08-23-2010, 01:04 PM   #3
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Re: creatinine level 3 to 4? please advice

hi
Thank you Cora.
so you suggest us we should wait and observe the values until it goes high?
according to you can you tell me how long it can take the time(Approximately) to go the values like creatinine 3.4 TO 8 or 9 ??

 
Old 08-23-2010, 01:32 PM   #4
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Re: creatinine level 3 to 4? please advice

Quote:
Originally Posted by Muhammad zaryab View Post
hi
Thank you Cora.
so you suggest us we should wait and observe the values until it goes high?
according to you can you tell me how long it can take the time(Approximately) to go the values like creatinine 3.4 TO 8 or 9 ??
That question is the most difficult to answer. In fact, almost impossible. If everything goes well, depending on her type of kidney disease, and all sort of other things, it could take a decade. Or, if she were to get very ill (something like pneumonia, or the flu, or all sorts of other serious things) her kidney function might take a serious dip. The good news is that the doctors will increase the frequency of lab work as things begin to decline. So there shouldn't be any sudden surprises.

In my case it took 17 years to get from 2.5 to 9. But I may not be average. I won't tell you not to worry. She is your sister and so of course you will. But from what you have described, the doctor does the appropriate labs and has a suitable conservative approach. Not too pushy for significant procedures, just a wait and see attitude.

I wish your family the best and feel free to keep asking questions.
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Old 08-23-2010, 02:07 PM   #5
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Re: creatinine level 3 to 4? please advice

thank you thank you so much cora..
it is very kind of you.

if i'll have any query then i'll come back to you its big relief for me after reading your reply..thank you once again.



i'm gonna visit another doctor tommorrow for advice i'll tell you whtever he'll say. thank you so much see you tommorrow.

God Bless you.

 
Old 08-25-2010, 07:26 AM   #6
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Re: creatinine level 3 to 4? please advice

In the US she wouild be getting the same info as in the UK, dialysis and then transplant waiting list. In Canada they will not put you on the list unitl you very sick. Here and in the UK they know it can take time. I will need a new kidney eventually in ckd now, not in need of dialysis yet. I just got an email from the UNOS people here that coordinate all that stuff.

I would go with the UK drs. I just got this link today from UNOS www.transplantliving.org.
i am posting a link for anyone else for cost breakdown of other transplants here in the US.

http://www.transplantliving.org/beforethetransplant/finance/costs.aspx

This is why Cora they do not put you on the list to the very end i was living there and came back to the US for the care.

god bless both of you.

Last edited by moderator2; 08-25-2010 at 07:57 AM.

 
Old 08-25-2010, 08:32 AM   #7
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Re: creatinine level 3 to 4? please advice

Caring, that wasn't my point. This had nothing to do with when to be put on the list, versus when to actually get the transplant. For many people, getting the transplant or going on dialysis at this point is unnecessary. Especially if you go on hemo. In many cases, hemodialysis will stop the functioning of the native kidney entirely within a year or two. So if the sister is still producing adequate amounts of urine and feeling well, then dialysis could, in fact, decrease her quality of life. As I said before, I had 10 years before I actually needed dialysis and was still working for quite some time during those 10 years. I would not have been able to do so on dialysis.

Each center is different and some places will try to push extremely early intervention while others take a more wait and see attitude. There is no really definitive answer as to which works better. You have to do what feels right for you.
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Old 08-27-2010, 04:41 AM   #8
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Re: creatinine level 3 to 4? please advice

I have kidney disease. Here is my story in a nut shell. I was born with one kidney and didnt know about it till I was 35 when they thought I had kidney stones and did some testing.
Everything was fine with the one kidney I had for years. But the last few years things have changed.
First of all I am diabetic and it was thought that I had diabetic nephopathy. My right kidney is only functioning at 30%.
My creatine level is running between 2.0 and 2.4. And it has been in that range for the past 5 years or so.
But it was recently determined that my problem is not diabetic nephropathy. The damage was done to hypertension over the years. My BP is under control now and even on the low side at points.
My diabetes in years to come may eventually affect the kidney.
But as to when the creatine level should become a major concern is at a higher level.
This rabbi I know went thru a kdiney transplant. I think his creatine level was about 5 or so when things became an issue for him.

 
Old 08-27-2010, 05:44 PM   #9
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Re: creatinine level 3 to 4? please advice

Cora they do not push here. It depends on who needs it.
To the gentlemen who posted. Dialsyis can begin depending on what your stage is. The lower the stage they will put you on dialsyis. See GFR calculator. Generally here they do not put you on dialsysis until you are in stage 4 and you go on the kidney waiting list here. When CKD has progressed to Stage 4, it is time to begin preparing for dialysis and/or a kidney transplant . The patient should discuss the two types of dialysis—hemodialysis and peritoneal dialysis—with the doctor to determine which is best. If the patient will undergo hemodialysis, a fistula or graft vascular access can be put in to give it time to mature before dialysis begins. A catheter also needs to be put in place for peritoneal dialysis.

There are many variables here they take a look at.

 
Old 08-27-2010, 05:54 PM   #10
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Re: creatinine level 3 to 4? please advice

My last reply on this. < edited > gfr calculator. input her age and creatinine. that will tell you what your sisters stage of kidney failure she is. i do not know here age. I put in 35 and it was in stage 4 at dialysis level.
that is just using the creatinine from Pakistan. 4 is when they begin dialsysis here in preparation for transplant. It goes 1 through 5.

Last edited by hb-mod; 08-28-2010 at 12:03 AM. Reason: Please don't post unapproved websites, per Posting Policy. Thanks!

 
Old 08-29-2010, 10:19 AM   #11
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Re: creatinine level 3 to 4? please advice

Thank you Everyone,

Cora i went to the doctor with my sister he said that her creatinine level is 3 so im not going to do a transplant so early unless her creatinine level become 6 then i'll go for pre-amptive transplant.Because my sister doesn't want to go on dialysis.he advice to maintain her BP and control her diet then she might doesn't need transplant for many years ... Doctor adviced the same thing what you told me on your early posts..

so what do you have to say now?

 
Old 09-16-2010, 06:00 PM   #12
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Smile Re: creatinine level 3 to 4? please advice

Muhammad, in the meantime, have your sister do a naturopathic detox or body cleanse. If you can find two products by Metagenics online or in a health food store, please add them to your sister's diet. They are Metagenics Ultra Clear PH, Metagenics Avaclear, and Metagenics Renagen DTX. They detox the liver and kidneys. My creatinine was at one time 4.4 before taking them and now it is 2.0. My GFR went from 14 to 50 just in a couple of bottles. In the US the three supplemts cost about $150. Meanwhile no protein except light half portions of non-processed turkey, chicken without skin, fish preferably salmon or cod, and egg whites in small quantities. Drink lots of high PH alkaline water. Stay away from culprits like foods high in sodium and potassium and have her do moderate exercise so the body will make use of as much protein as possible especially lifting weights. Most of all, a geen diet dodging all the potassium hidden fruits and vegetables.

Last edited by moderator2; 09-17-2010 at 05:40 AM. Reason: you don't really need the quote in there

 
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