CKD stage 4

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CKD stage 4

Postby footyfan » Sun Jun 12, 2016 6:39 am

My mum has type 2 diabetes, with a longstanding decline in Kidney function, it has decreased from 40% to 20% over the past 10 years. The GP has asked us to stop for the 5mg dose of ramapril for the time being and retest in 2 weeks. Also blood glucose levels for many years on metformin, gliclizide and pioglitazone were in the region of 6.9-9.5. Now these are reducing and she no longer takes Gliclizide, Metformin stopped in recent weeks too. Her glucose levels now seem to be settling at about 4.8-5.5.

Has anyone else experienced this?
One of the major problems is due to other health issues it is sometimes imposssible to attend any hospital appointments so a clear diagnosis other than the assumption of diabetic kidney disease is difficult to make.

She is 74 years old, has suffered more than 40 years of that time with one problem or another with varying degrees of both physical and mental well being, we thought we'd lost her 10 years ago when she went into multi organ failure due to Beta Blocker toxicity so sadly we know that her organs have been damaged it is just a shock to have to realise that she will probably decline as opposed to suddenly leaving us.

No really sure what I would prefer! The only good thing is that I am able to provide much of her care alongside a team of 3 other carers thanks due to a great Social Worker and Pyschiatric team who have supported and fought for us to receive Direct Payments rather than have the Local Authority provide the care. We can be as flexible as her needs are, some days more care when things are bad sometimes less when things are good.
W are now worried as to prognosis as she is not a candidate for dialysis due to other health issues.

Any support or info gratefully appreciated.
footyfan
 
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Re: CKD stage 4

Postby wagolynn » Sun Jun 12, 2016 4:12 pm

Hi footyfan,

Sorry to read about mum.

Kidney function at present sounds to be adequate, dialysis would start (on average) around 8%. I am surprised that some sort of compromise cannot be arranged about visiting a consultant, and diagnosis, things like ultra sound scans can be done at home.

In general, if her kidneys have been permanently damaged, their decline will be progressive but no one will be able to say how long it will take.

If you find your way to the home page of this site there is lots of basic information available on kidneys.

Have a look at that. If this raises more questions try again here.

Best wishes.
wagolynn
 
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Re: CKD stage 4

Postby footyfan » Wed Jul 06, 2016 6:28 am

Update- Following a period of very poor health we visited GP who referred Mun to FAB at Ipswich Hospital- a unit that operates an appt only assessment for fragile patients. The aim to avoid admission to hospital. They conducted full set of blood tests and heart scans. They also have Physio assessment and Occupational Health assessment as well as a Dietician, all overseen by a Consultant. A bit ike a clinical assessment unit but primary aim to avoid hospital admission. I understand they had an 80% success rate in first 6 months of existing.
It was so refreshing to speak with medcial people who tried to look at the individual rather than the condition. Blood tests showed increase to 27% to kidney function , reduction in creatinine but severe anemia. Treatment normally would result in admission to hospital to undergo blood transfusion, however, the Consultant arranged for appoitment at day clinic for transfusion . Appointment took place within 48 hours and a second apointment to take place within the week.
The consultant did speak about the possible causes of the anemia but also understood the difficulties for mum to undergo theses investigations - endoscopy and colonoscopy to name 2. Due to other health conditions the likelyhood that course of treatment would not be tolerated and certainly surgey highly unlikelt to result in good outcome. The decision therefore is to look to give mum quality of life not quantity and to treat all health problems symptomatically.

Mun seems to have improved slightly after first transfusion so we hope that she will feel better again after todays transfusion.
footyfan
 
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Re: CKD stage 4

Postby wagolynn » Wed Jul 06, 2016 3:20 pm

Hi footyfan,
Looks as though, with regards to mum, things are looking up.

Best wishes.
wagolynn
 
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Re: CKD stage 4

Postby chrisb » Thu Jul 07, 2016 4:30 pm

During the period of reducing kidney function (PKD) I was diagnosed with Type 2 diabetes and was on medication. About 5 years later and after I had had my kidneys removed and was on dialysis I was told that I am no longer diabetic! That's good but try explaining that to staff EVERY TIME I go into hospital. Their computer says I'm diabetic so therefore I must be diabetic :roll:
chrisb
 
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