Brief Answer:
please upload the reports here ..

Detailed Answer:
Hello XXXXXXX Welcome to HCM,

I've gone through your query and understand your concern for your brother-in-law..

Please attach the reports here as i couldn't find any attached reports..

I believe he's 50/M as mentioned here or is it your details, please clarify..

Some further details will help me to advice more specifically in this regard, i.e.

What made you get him tested for the kidney functions ? In other words, briefly explain what were his health problems which let you get him examined for this ?

Is this the first time this has been detected ?

Any other tests done apart from the kidney functions, if yes, please upload them here too..

You've mentioned he's diabetic, please let me know since when he's diabetic/ how are his blood sugar trends in general/ what all medications is he taking for this/ any recent changes in body weights ?

Is there any other problems like hypertension/cardiac/gastro-related problems etc., please let me know in details ?

Is he on any particular medications for any other reasons, if yes please provide details ?

You haven't mentioned your location here, so in order to let me provide you with the relevant specialist details, please mention your location details..

I'll be waiting for these necessary details to guide you specifically on this..

Take Care
Kind Regards

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Brief Answer:
Follow the Advises..

Detailed Answer:
Hello XXXXXXX thanks for providing these necessary details,
I've gone through all the attachments,

Although the current list of medications looking good, but still there may be a need to optimize some of them.. yes, it's always better to keep a check on the cardiological profiles since he's diabetic for so such a long time.. as per this reports and his symptoms, it seems like diabetic nephropathy has set in.. well the creatinine is just borderline deranged, however there's some reduction in the eGFR..

Well compared to the 27th Dec reports, there's a bit of derangement in the blood sugar control, and there's an element of hematuria(blood in urine), as I can see he's on dual antiplatelet (Ceruvin-A), so you should contact and inform his prescribing doctor/Cardiologist about this at the earliest (as I can see that there's also a drop in the hemoglobin 11.7 to 9.8, which is significant in such a short period of time).. do not stop it on your own, as there must be significant reason for putting him on to dual antiplatelet therapy, and since he's already on other cardiac medications for heart rate control (Lanoxin), yes a Cardiologist consultation is definitely needed..

You should also get the urine culture sensitivity done if there's any fever, burning sensation, difficulty in urination like symptoms.. as he's also on Tamsulosin (Uriment), so there may be an underlying prostate issue (for which it's been prescribed)..

Yes, this is a chronic ailment, thus he needs to be under continuous follow-up of a Nephrologist as well as Cardiologist (for lifelong).. along with it, very good diet control for diabetes and kidney disease, daily activities, yearly eye check-up, good foot-care and hygiene maintenance all are equally important..

You can take him to any multispeciality hospital there like Pace hospital, Asian Institute of Nephrology and Urology where you'll find the nephrologists, urologists all under one roof only, and all sort of investigations (which ever is necessary accordingly)..

You can also contact XXXXXXX Kidney Centre & Super Speciality Hospitals (at Himayath XXXXXXX Telangana) and schedule an appointment with Dr XXXXXXX Deshpande or Dr Sree XXXXXXX XXXXXXX at Nizam's Institute of Medical Sciences..

Just decide as per your convenience and schedule the appointment with any of them (you can simply pre-book the dates online only)..

I've tried to make it as simple as possible for you, please let me know if anything's not clear..


Take Care
Kind Regards

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

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