Nephrology


        

Case Discussion

Re :Chronic kidney failure   Posted By Anil Kumar Saxena, MD; FRCP    Date : 05-May-10   07:14 AM     Reply

It seems this gentlman had acute infective insult of the kideys due to leptosirosis on the underlying Chrnic kidney disease - possibly hypertensive nephrosclerosis or Chronic GN. However, it is not known whether the genleman had proteiuria / hematuria or renal insufficiency earlier to development of ARF and Hypertension may be secondary to chronic glomerulonephritis. Is he oliguric or aneuric? How catabolic is he? What is the size of kidneys on Ultrasound abdomen. Is there any histoty of family history of renal disease/deafness? My advice is to continue him on hemodialysis atleast 3 times per week through permacath;watch urine output and renal biochemistry; repeat renal biopsy if the recovery does not occur in 6-8 weeks. There are chances that he would need longterm hemodialysis and possibly renal transplant if renal function does not retun to baseline in 6-8 weeks.

Best wishes,





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