Doctors' Answers to "Frequently Asked Questions" - Renal Problems

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Codeine in Renal Insufficiency [posted 1/11/99]
Question: I need to know how I should dose codeine in renal insufficiency. Would you have any references on that?

Answer: Goodman and Gilmans Pharmacological Basis of Therapeutics. ed. Hardman.

Chronic Renal Failure [posted 7/27/98]
Question: My father is 72 years old. He was told that he is in chronic renal failure. The doctors stated that he would be on dialysis in about two years. He is very unhappy about this and so is the rest of the family. He has a history of high blood pressure. What can we do to salvage what he has left and not have to go on dialysis? I read where amino acids could help and also limiting your protein intake. We live in Lawton, Oklahoma and resources are very limited. Money and travel is not an issue in the care of my father. We would make it some how. I just need some input into this chronic problem and maybe a solution.

Answer: Well as luck would have it, I spent a lot of time in Lawton growing up. My grandparents lived over by the old Vaska Theatre. Anyway, first ensure that there are no reversible components. That is, no back up from his prostate, no medications enhancing the problem and no blockage of the arteries supplying blood (a simple nuclear scan will do). If these are normal, there is little to be done except dialysis. You might get a second opinion from the Renal Department at the University of Oklahoma in Oklahoma City. They have an excellent department and at least you would know that there are no alternatives. Your doctor can arrange this very easily.

Renal Disease [posted 7/27/98]
Question: My mother has been diagnosed with renal failure. She has abnormally high levels of BUN and Creatine: 72 and 4.3 respectively. For several years she has been taking Procardia (30 mg) and Normodine (200 mg) to control her high blood pressure. Given the kidney problem she now has, should she continue to take those medications? I've read Pfizer's Procardia XL information sheet which describes rare cases of reversible elevations in BUN and serum creatine in patients with chronic renal insufficiency.

Answer: Usually neither of these would be an initiating factor in renal failure, but hypertension certainly can be. Also, renal artery stenosis can give this picture. She needs very good control of her blood pressure although she could stop one at a time if other drugs are substituted. I doubt you will see any difference.


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