Q:My dad, aged 72 years, is a CKD patient (on account of high BP) and has been on dialysis since March 2013. While he manages to lead as normal a life as possible (i.e. he drives his car, manages his finances, etc), we require your guidance on the following issues: • Hemoglobin continues to be high (15+ even when blood is released twice a month) • BP is always low (in the 90 by 60 range) • Very tired especially on the day of dialysis • All other parameters like potassium /calcium /sodium/phosphorous /BUN are within permissible range • Of late, his muscles are getting weak and there is joint pain He has been on STARVOS 10 mg for cholesterol and this appears to be under control.Arati
Patients on chronic dialysis often have such symptoms like fatigue, electrolyte disturbances, anaemia, etc. In addition, atorvastatin therapy can also contribute to muscle weakness.
I am a little surprised with his haemoglobin level of 15 though. Usually, patients suffering from Chronic Kidney Failure have low Haemoglobin. Is your father taking erythropoietin injections?
You also mentioned the underlying cause of CKD as hypertension. But, at same time you say his BP is always low (in the range of 90/60 mm Hg). Does this mean he is on some anti-hypertensive drugs?
You can get a thyroid profile done to rule out hypothyroidism. I would also advise you to get his calcium levels investigated. You can consult a haematologist and your nephrologist with the reports.
On the whole, however, your father's condition seems stable.- Dr. Abhijit Dam, MD (AIIMS), FCCP, FPM, M.Sc.Pall.Med. (Cardiff)
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