My sister who is a serious diabetic called today and told me that her doctor told her that the diabetic medication she was taking had damaged her kidneys and that they were now functioning at 18%. Her doctor told her to stop taking a pain medication and her gabapentin and just take tylenol. He then sent her home. What can she expect with 18% kidney function. Will she have to wear a catheter with a bag? With she have to do dialysis? What can she expect? She is a serious diabetic who has had one leg amputated high above the knee and is going blind. She would not be a good candidate for a kidney transplant. She is also a little slow and may not have understood what her doctor was telling her. I want to know what she can expect next and for the long term.
Many pain relievers do, over the long term. damage renal function. But so does diabetes itself and the high blood pressure that often comes with it. So this has probably been slowly coming on for years.
Catheters are more a urinary management issue than a renal function issue, so that's really a separate question.
Dialysis may be in her future, but the judgement on "when" has to be made by a nephrologist familiar with her case. It's different for every patient.
As a general rule, non-diabetic patients with renal disease need to plan on dialysis at about 15% residual renal function; diabetics often need to start a bit sooner, roughly 20% renal function. But again, it varies with each patient.
I can tell you from personal experience, starting sooner rather than later is easier; it's better to get started when the patient has some health remaining, rather than waiting until the patient is very sick or in the hospital.
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