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Old 09-09-2010, 09:33 AM   #1
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Stage 5 Kidney disease

Looking for help. A friend that I help take care of has be diagnosed with stge 5 kidney disease in July 2010. He is refusing diaylsis, our last visit to the neprhologist was yesterday and his BUN level went from 71 in August to 98 now. I dont think this is good and am confused on if there is a cut off number for BUN level (Is 100 the highest?) What can happen to him with the BUN level being that high? Reading online I can not find a straight answer on what happens when the level is at these numbers. His creatnine is 4.35 (was 5.8 in August)

I know the best thing for him is dialysis but he is being very stubborn, any info would be helpful. Thanks

 
Old 09-09-2010, 01:51 PM   #2
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Re: Stage 5 Kidney disease

Hello and welcome. Kidney failure can be such a complex issue. First off, the BUN in and of itself doesn't really say much and also doesn't have an upper limit. What it tells is partly how well the kidneys are functioning, and also how much protein the individual is eating. Other typically done tests are creatinine (which also tells roughly what stage you are at and also how well the kidneys are functioning) and electrolytes. The most important of these is potassium, and this level being too high can be dangerous. I'm sure you have heard that if you have a cramp in your lower leg you should eat a banana? Well often that cramp is due to low potassium and bananas are very high in it. However, that same sort of cramping can occur if the potassium is too high, and it can happen in the heart muscle. So an overall look at the labwork is important and seeing a renal dietitian is also very important so that the diet can be balanced with the lack of kidney filtering.

I know how scary dialysis can be. I was on for a year. You don't say how old your friend is. It does happen that folks who are older decide to not take treatment. Your friend should find out more about the various treatment options and also keep in mind that if he doesn't like it and/or feel better (you do need to give it a chance because it takes some time to get the prescription right) he can always stop. Most folks that start dialysis feel immensely better, although sometimes it does take a month or two to get used to.

Sorry I can't be more help, but feel free to ask lots of questions. I have done both hemo and peritoneal dialysis and have had a transplant now for almost 8 years.
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Dxd T1 1966, 2001 dialysis, 2002 kidney transplant, 2003 insulin pump, 2008 pancreas transplant

 
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Old 09-13-2010, 09:07 AM   #3
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Re: Stage 5 Kidney disease

Thank you for getting back to me. I appreciate any information that I can get.

My friend is 74 years old, and he has had critically high pottassium levels three times in the last two months. The doctors each time gave him a one time dose of keyltrom (?) a liquid that he had to drink to help lower his pottasium level. It did bring his potassium level back down to 5.5.

He also gets the "shakes" (cant hold a newspaper to read), the nephrologist informed me that it could be from the uremia level rising but informed us to speak to his primary doctor.

In the last 3 weeks he has had 2 car accidents (yes he is still driving, have tried to convice him that it is not a good idea). He called me on Saturday afternoon and informed me that he could not remember anything from Friday night on and that someone put peaches on his kitchen counter. (He lives alone and no one except for myself comes to see him, and I did not bring him peaches). He also informed me that he thought that he was in the bathroom when he got out of bed in the middle of the night and relized in the morning that he went to the bathroom on his bedroom wall.

I tried again to convince him to do diaylsis and he is still refusing.

From what I am reading I believe that toxins are building in his body and the only thing that will help him at this point is dialysis. But it is like his body is contradicting itself, he has uncontrolable shaking and confusion and a few hours later he is back to "normal". It is like a roller coaster I am not sure which way to turn next.

I am sorry if I am venting and I do appreciate you taking the time to help me. I am just trying to do everything I can for him but still respect what he wants. I just feel like I dont know what is going to come next.

 
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