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Dr. Saha
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 15843
Experience:  35 years of experience
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This patient creatinine is 4.5, his BUN is 55, all other blood

Customer Question

This patient creatinine is 4.5, his BUN is 55, all other blood work is abnormal. 89 yowm. He stays tired, losing wt, weak. My question is his physician has already told him he is in renal failure, his physician does not recommend dialysis due to his age and health condition. but he will not tell him he cannot go on dialysis. How long will a person last without dialysis, and how high does his creatinine and BUN have to go before he is bed fast? Thank you
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Saha replied 5 years ago.
Hello,

Does he have any swelling of the body?

Is there any shortness of breath?

How is his blood pressure?
Customer: replied 5 years ago.
He does not have swelling anywhere's on his body. His blood pressure was high but now it is low 90/64 and yes he does have shortness of breath. He gives out very easily, he can only walk or work for 15 minutes and he is tired. He gets trembly all over.....
Expert:  Dr. Saha replied 5 years ago.
Thank you for the information.

His urea & creatinine levels indicate that he is in renal failure.

Dialysis is not carried out in mild cases when the rise of urea & creatinine can be checked by diet , restriction of fluid & monitoring urine output.

Usual indications for dialysis in chronic cases creatinine level above 6.7 , in some cases 9 depending on the clinical condition or sometimes with lower level also, rise of potassium level which can not be controlled by diet alone, collection of fluid causing heart failure & accumulation in lungs, inflammation of the covering membrane of the heart or pericarditis.

Blood pressure level is also important as dialysis can cause fall of blood pressure. In low blood pressure hemodialysis can not be done.

If his shortness of breath is increasing , he should have a review of his condition.

I hope this information will be helpful.

Please ask if you need any clarification.

Best wishes.


Customer: replied 5 years ago.
His physician said, he is in chronic renal failure. If his creatinine keeps increasing, and blood pressure keeps falling this will be grave correct. He does not have fluid build up in his lungs, heart, or legs, feet or anywhere's we can tell. He will continue to get weaker and weaker, correct?
Expert:  Dr. Saha replied 5 years ago.
In such cases where the rise of blood creatinine can not be checked by dietary measures he can need dialysis.

Sometimes peritoneal dialysis is done if blood pressure is low.
Customer: replied 5 years ago.
<p>The lab can check his creatinine by drawing blood, they keep a check on his BUN, creainine, potassium, etc, his filtration rate, what I am asking you once again, is:</p><p> </p><p>1. If his creatinine keeps increasing it is already up to 4.5 or higher, his bun increased from 45 to 55 within one month. He itch alot, I realize this is complicated to answer but ALL I need to know if you can give an estimate on how much longer his creatinine, bun, and If his labs keeps going up due to his age and health since everything is creeping up slowly I am going to assume by end of summer he will be bed fast. All I wanted to know is a time frame of how long it will take for him to become bedfast, so I can get someone to be with him. Thank you</p>
Expert:  Dr. Saha replied 5 years ago.
It is difficult to calculate the rate of progression as it is influenced by so many factors.

But if it increases at this rate as has been in a month he can be bed ridden without treatment in 2-3 months.

Again the prognosis is extremely variable in elderly , a sudden fluid & electrolyte imbalance or an infection can lead to rapid deterioration, & maintaining protein & fluid intake can lead a long way to keep him going.
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 15843
Experience: 35 years of experience
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Dr. Saha
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