Brief Answer:
you need to remain under strict medical supervision and investigated thoroughly on routine basis..

Detailed Answer:
Hello XXXX, Welcome to HCM,
I've gone through your query in details and understand your concern,

There are several causes and responsible factors for the rise in creatinine in this scenario..

Post Renal transplant hypertension is one of the bad prognosis and there's also Diabetes, and an element of obesity(as per your description, your BMI's ~35, which is quite in the obese category) so you need to be under strict medical supervision for any plausible changes..

You've also mentioned about the chronic tobacco chewing habit, you must've been well informed how bad it can be (it's severely detrimental habit damaging health of any normal healthy individual), and when considering your post renal transplant status along with these co-morbidities, you must need to quit it..

It's (Tobacco) also one of the reason for chronic kidney damage, hypertension, in fact every other medical conditions(except a few handful), please quit it at the earliest..but since it's a chronic habit, so you need to be under observation for any associated withdrawal, it's better to chew nicotine chewing gums instead, give it a try..

Recurrent UTI is another extremely bad feature which not only jeopardized the graft kidney but the overall renal system..so it has to be cured under strict medical supervision and barrier precaution, if needed.. since Meropenem started, then E.coli must be resistant bug to other lower generation antibiotics (Meropenem itself is a Nephro toxic antibiotic, but here the benefit outweighs the risk..).. Nephrocalcinosis itself is another risk factor..

Then comes the diabetes, which has to be kept under strict control (strict Renal Diabetic diet) along with the anti-diabetics..if oral anti-diabetics fail to control it over a period of time, then you should discuss with your treating Nephrologist for switching over to Insulin for long term benefits..

So please keep yourself motivated in quitting tobacco in the first place.. the first effort in this regard has to be made by you.. rest all the treatments have to taken as strictly advised by the Nephrologist..

Also there's a need to reduce some weight, start doing some physical activities- as much as possible along with the diet plan (you must follow a strict Renal Diabetic low calorie diet as modified by the Dietitian)..

The first aim is to treat the UTI in the first place, then routine follow-up with the Nephrologist has to be continued..

Meanwhile control of blood pressure, blood sugar has to be monitored stictly..

It's not 2.43 of Cr which is to be looked at right now.. it's all these associated co-morbidities and risk factors which needs to be under control as much as possible..

It's a chronic tough process but definitely achievable, so have faith in yourself and keep following all these advises..

After the completion of Meropenem, there'll be a need to do further urine culture study, along with complete Renal function study (the focus should be on the creatinine clearance and it's trend at that time and not on the serum Cr).. during that phase, please also discuss regarding the need for doing Repeat Renal Artery doppler along with Graft USG for further evaluation of the graft functioning(the infection has to settle down before doing this)..

Maintain strict hand hygiene , cannula site proper hygiene with antibacterial scrubs and washes..

I've tried to make it as simple as possible for you to understand, let me know if there's any further queries..


Take Care
Kind Regards

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Brief Answer:
Yes , please do so.... I'm glad to help you out also..

Detailed Answer:
Hello XXXX, welcome back,

Yes please start doing them, remember, it's not a single ailment/concern that we are dealing with in your case, it's a complete effect of the systematic approach by your Nephrologist, Urologist, Cardiologist, Endocrionologist, Dietitian, Infection control nurse and off course you, yourself..so things are compact, systematized, round the clock and strictly disciplined..

Dear you can get not only this query but another follow-up here which are absolutely free, your welcome to have my suggestions in future whenever you feel like..If you want any further assistance in this regard then please contact the customer care, they'll surely help you out with..

Whenever you feel like contacting, prior to typing , I'd request to please write down the complete query what all you need to ask, including the present health concern, the current medication and latest investigation reports in details, organize them thoroughly and then go ahead and post your query (you can also upload all those reports at the reports section, whichever will be relevant at that time)..

For your convenience, I'm also providing you my direct follow-up link through which you can contact me directly in future, it'll be my pleasure to help you in this journey ahead,

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Take Care
Kind Regards

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Brief Answer:
You're most welcome to have my suggestions..

Detailed Answer:
Hello B.I. VHANKORE, welcome back,

It's all your effort only, please don't thank me, I'm glad to guide you in this regard..

Yes, most importantly follow them as already described, do get back to me whenever you feel like.. you can also use the direct follow-up link for future queries, and follow those instructions prior to send your query which I've already given you, as it'll save a lot of precious time if every details remain organized while putting forward the query..

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Take Care
Kind Regards

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