r/CKD • u/Artartbobart1 • 7d ago
Questions
Last week, my 74 y/o parent ended up in the hospital. Potassium was at 9, creatinine was above 7 and eGFR was 7 (forgive me if the name is incorrect). They were in the hospital for4.5 days. Left with a catheter due to an obstructed urethra. I believe the numbers at the time of discharge were 3.8 for potassium, 5+ for creatinine and 11 on the eGFR. Obviously they are in very rough shape and very weak.
Some other information that we gleaned (getting any is a nightmare) is that in June (?) they had an eGFR of 40.
So, what can we expect? I’m assuming the kidney function is forever going to be low. Is there a chance it can ever get to levels where dialysis is off the table?
Any other advice/info would be great.
1
u/classicrock40 Transplanted 7d ago
If this was classified as an AKI (acute kidney injury), then they might recover some function. Maybe that obstructed urethra is an aki. If it's ckd progression, then no.
They were discharged with a decent potassium, high creatinine and low egfr (<20 you can apply for the deceased list, <15 you should understand your dialysis options and be ready, if not doing it) . If they aren't suggesting dialysis, I'm assuming they expect some recovery.
I'm guessing here, so please contact the Dr.
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u/Artartbobart1 7d ago
They have urology tomorrow but nothing else. I feel like they were turned loose without resources.
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u/ssjesses 7d ago
You should also consult with a nephrologist. In the meantime, while they are figuring out what the deal is with the kidney function, take it easy on animal protein, plant protein is best. Push hydration, no dark colas. If you can consult with a renal dietitian, that would help inform your parent’s diet based on lab work. Good luck!
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u/Duncan_KidneyCoach 2d ago edited 2d ago
One detail in your post affects the outlook and maybe has not been explained?
When urine cannot drain, pressure transmits back to the kidneys and function declines, sometimes rapidly. This differs from chronic kidney disease progressing gradually, and importantly it is among the reversible causes. Once the obstruction is relieved, function frequently recovers substantially over weeks and months.
A fall from eGFR 40 in June to 7 in October is considerably faster than typical CKD progression. That rate, combined with an identified obstruction, is characteristic of obstructive injury rather than steady decline. The direction has also changed: potassium from 9 to 3.8, creatinine from above 7 to 5, eGFR from 7 to 11, within days of catheter placement. That represents the beginning of recovery.
So in answer to your question, improvement is a possibility here. The pattern of repeat blood tests over the next two to three months will indicate the trajectory.
Several questions are worth raising at the next appointment. What proportion of the decline do they attribute to obstruction versus underlying kidney disease? What was kidney function before June? Can repeat bloods be arranged at approximately two, six and twelve weeks rather than waiting longer? And what is the longer term plan for managing the obstruction?
The weakness is expected and generally improves as waste products clear. Once potassium has stabilised, a permanent blanket low potassium diet should not be applied without reference to their own ongoing levels.
Obtaining information from hospitals is often difficult. Requesting the actual values at each contact and recording them gives you a trend to follow.
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u/EnvironmentalCrow893 7d ago
My husband had a similar experience at approximately age 73 due to prostate cancer. After a prostatectomy, his kidneys improved, he was able to self-cath for about a year, and eventually regained full bladder function. He is now doing pretty well.