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Stage Three Kidney Patient. Underwent Urology Operation. Having Swelling In Feet And Legs. Suggestions?

Posted on Mon, 23 Sep 2013

Question: I am a Stage3 kidney patient now , having underwent Urology operation for Augmentation Cystoplsty about five years back.I am able to release very little urine normally and hence, doing CIC(self catherisation) 4- 5 times a day.My Blood&urine reports are as follows: BLOOD: Creatinine-- 4.0, Blood urea - 80 , Uric acid - 4.8 , Sodium- 144. Potassium- 5.1, Phosphorous- 5.9 URINE: Protein(++), Leucocytes(+++), Amorphous Phosphates present, Pus?HPS cells- 25-30. What do the above reports indicate and what can be done to decrease Blood Urea and Creatinine levels in my case? My BP is around 150/90 and I am using Medicines: DYTOR,LOSAR,ProlometXL50 nd CINOD(clinidipine) for control of Blood pressure., as suggested by local nephrologist. I am also having some mild swelling in feet and legs also Whether swelling is due to any of the BP medicines mentioned above?

Answered by Dr. Avinash Ignatius (8 hours later)

Brief Answer:
Dear XXXXX

Detailed Answer:
Dear XXXXX

It appears you are gradually progressing from CKD 3 to CKD 4.

You will need to have a moderate restriction in dietary protein and phosphorous.
A good idea to avoid non-veg foods, nuts and dry fruits and take veg proteins in moderation. A dietician would be able to prescribe a diet appropriate to your weight and taste.

If your 24hr urinary protein is less than 1000mg/day, Changing losartan to an alternative BP medications might help in reducing the creatinine

Keeping salt intake to below 3g per day(1/2 a teaspoon/day) and limiting fluid intake will help reducing swelling.

Cilnidipine may rarely be responsible for swelling, but it is lesser than similar other drugs in the same class.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Avinash Ignatius (1 hour later)

Hello doctor, What about Dytor(Torsemide) and ProlometXL50 (Metaprolol)tablets with respect to water retention (swelling) of the body? Also, you have mentioned that Clinidipine is lesser(less effective?) than similar other drugs ; Example of other similar same class drug may be given please Losartan's Alternative drug may also be indicated pl.

Answered by Dr. Avinash Ignatius (14 hours later)

Brief Answer:
Dear XXXXX

Detailed Answer:
Dear XXXXX

Toresamide actually makes the kidneys produce more urine and reduce swelling, Metoprolol is not associated with water retention
Cilnidipine is effective BP medicine but oedema is lesser than other medicines like amlodipine.

Other alternative BP medicines are
Prazosin, clonidine, moxonidine
(However if your urinary protein is more than 1000mg/day losartan is still a reasonable option, as it helps reduce protein in the urine)

Change of medications should only be done by your nephrologist after assessing your condition. Do not attempt to change medications on your own.

Warm Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Avinash Ignatius (53 minutes later)

Hi doctor again, Can I do away with Losartan tablets by increase of alternative tablet Prolomet XL50 dosage increase to twice a day, instead of once daily as at present?

Answered by Dr. Avinash Ignatius (37 minutes later)

Brief Answer:
It is an alternative provided your heart rate is

Detailed Answer:
normal and is monitored, as prolomet can sometimes reduce heart rate.

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar