Patient: HUSSAIN ALI, Male, 20-year old, Unmarried, from Oman
Illness condition: High serum creatinine for 3 years and becomes serious in last month.
He was in hospitalization in Shijiazhuang Kidney Disease Hospital on 27th, June, 2015, 3:55 pm.
1. Test report of 6/28/2015: serum creatinine level is 879umol/L
2. Test report on 7/2/2015: serum creatinine level is 932 umol/L
3. Test report on 7/7/2015: serum creatinine level is 826umol/L
4. Test report on 7/12/2015:serum creatinine is 479 umol/L.
Diagnosis and Our treatment
Symptoms: High creatinine level remains for 3 years and elevates in last month.
Test in local hospital in 2012:
· Urinalysis: protein ++, occult blood –
· Serum creatinine: 500umol/L
· Ultrasound of kidney: both kidneys are smaller than normal range
Test result in May, 2015:
· RBC: 3.26×1012/L
· Hemogloblin: 70g/L
· Serum creatinine: 1200umol/L
· Blood urea:500umol/L。
End stage of chronic glomeruloneohritis, renal anemia and secondary hyperuricemia.
Test result when he was addmitted in Shijiazhuang Kidney Disease Hospital：
· RBC: 4.04×1012/L
· Hemoglobin: 107g/L
· Urinalysis：protein +, occult blood -,
· Microscopic examination: leukocyte 20-30/HPF
· Electrolyte：leukocyte 93.4mmol/L, calcium 1.79mmol/L, total carbon dioxide 14.2mmol/L, potassium 4.22mmol/L
· Seven readings of kidney function：BUN 43mmol/L, serum creatinine 879umol/L, uric acid 483umol/L
· Blood coagulation：D-Dimer 16.15mg/L FEU, fibrinogen 3.34g/L, PTH 1463pg/ml
· Iron metabolism：TIBC (Total Iron Binding Capacity ) 39.3umol/L，ferritin 251.7ug/L、erythrocyte sedimentation rate (ESR) 50mm/h
·Urine protein components：24-hour urine protein 239mg/L, microalbuminuria 120mg/L、microalbuminuria/urine creatinine 198mg/g cr,TRF 5.9mg/L, TRU G 21.9mg/L, urinary α1 -microglobulin 64.5mg/L, rinary α1 -microglobulin/urine creatinine 106.29mg/g cr，urinaryβ2 microglobulin23.9mg/L，RBP 16.96mg/L, NAG/creatinine 24.72U/g cr，NGAL 419ng/ml
· Immunity: immunoglobulin M0.21g/L,complementC1q108mg/L, complementC3 0.83g/L24-hour urinary protein quantity0.44g,Ccr6.74ml/min
· Abdominal ultrasonography：right kidney is 70×37×33mm,left kidney is71×40×31mm,thick ，bilateral renal parenchymal echo enhancement, diffuse damage
· CDFI：reduced blood flow signals on bilateral kidneys
Diagnosis: Bilateral diffuse renal damage, both kidneys shrink.
Added diagnosis: metabolic acidosis, secondary hyperparathyroidism
· For acidosis: 100ml 5% Sodium Bicarbonate injection a drip each day;
Sodium Bicarbonate Tablets 1.03/day
· Adjust calcium-phosphorus metabolism: Calcium Carbonate Chewable Tablets 1.25 3/day
· For Anemia: Folic Acid Tablets 5mg1/day, Iron sucrose Injection 100mg 2/week, Recombinant Human Erythropoietin Injection 3000IU 2/week
· Reduce urea: Febuxostat Tablets 40mg 1/two days
· Necessary amino acid supplement: Compound keto acid Tablets 1.89 3/day
Traditional Chinese Medicine Treatment
· Danshen Chuanxiongqin injection 10 ml for a drip/day to improve mirco blood circulation
· Shenshuanning Tablets 1.08 3/day
· Oral Chinese medicine to reduce blood clots and remove toxins
· Hemodialysis with catheterization on right femoral vein
Duration of hospitalization is 18 days, a short time due to finiancial issue.
Time of addimission of hospital: 6/27/2015, 3:55 pm
Time of discharge from hospital: 7/15/2015, 8:00 am
Hope you can get better like him. Any questions, add me on Whatsapp 008615512139310.
Director of International Department：Dr.John