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Suggest Treatment For Acute Kidney Injury

Posted on Mon, 4 May 2015

Question: Attached reports of my mother in law aged 75 years. Recently suffered cold and cough with mild fever occasionally. Is it a kidney problem?

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer:
Acute kidney injury

Detailed Answer:
Hello

Thanks for the query

I have gone throught the reports furnished by you, it looks like she is suffering from acute kidney injury because of an infection. To know about the reversibility of the kidney injury I would like to know a few more details

1. Is she hypertensive or diabetic ?
2. has anytime serum creatinine checked before this ?
3. did she complain for any burning micturartion
4. was any urine test done?
5 has the fever settled down

please get back to me , I am awaiting your reply

regards

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

Follow up: Dr. Rakesh Madhyastha (3 hours later)

1. Yes, she is hypertensive.
2. Serum Creatinine was never checked.
3. During the recent illness under consideration she complaint regarding burning sensation while urination.
4. Urine test was never performed before.
5. She is admitted to hospital for past three days and under treatment. There is no instance of fever ever since admitted to hospital except one with a very mild nature.

In today's report, WBC level came to the acceptable range as understood from the hospital staff.

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer:
Please send urine routine

Detailed Answer:
Hello

Thanks for getting back

The fact that she has burning micturation tells us that there could be a urine infection which could have caused acute kidney injury. Please ask the staff to send for urine routine as soon as possible and also a urine culture.

I recommend serum creatinine to be checked atleast once in 48 hours to check for recovery. Dosage of the drugs, especially antibiotics should be modified according to creatinine.

Regards

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

Follow up: Dr. Rakesh Madhyastha (38 hours later)

Attached herewith report

Answered by Dr. Rakesh Madhyastha (15 hours later)

Brief Answer:
Urosepsis with acute kidney injury

Detailed Answer:
Hello

Thanks for getting back

Yhe attached reports, suggests that there is a urine infection which needs to be treated with antibiotics.
I recommend admission and treatment with IV antiobiotics like meropenem for 7 days. There are plenty of pus cells in urine and also serum creatinine is rising indicating an ongoing infection.

If admission is not possible then I usually start my patients on Tab Farapenem twice daily for 14 days, please repeat Complete blood count and Serum creat again. Watch out for fever and drop in urine output.

Please do not ignore this any further, seek treatment with antibiotics as soon as possible

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