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Ken
Ken, Postgraduate doctor
Category: Medical
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Experience:  Working as a Doctor who Cares since 2001.
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I am a 52 year old type 1 (well controlled - with Hba1cs of

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I am a 52 year old type 1 (well controlled - with Hba1c's of under 6.5 over the last 10 years) diabetic. In addition to the usual developments in my Diabetes care over the last 10 years (Losartan - for Kidney function; Codeine - for Diabetic autonomic neuropathy (DAN) - chronic diabetic diarrhoea; Levothyroxine - for Thyroid; etc, etc.) - ......
I have been suffering chronic mid to lower back pain which has been treated by my GP and local NHS with a growing cocktail of pain relieving drugs (Ibuprofen, Tramadol, Gabapentin, Paracetamol, etc.
During this time my general health has deteriorated and it has become increasing more difficult to keep the blood-sugars at the right level sometimes with completely unpredictable results. I am now suffering skin rashes, muscle aches and urinary problems.
However, it is only now that my GP has sent me for an ultrasound scan of my kidneys and unfortunately these show one kidney working, the other has a blocked / restricted Ureter and the kidney is 6x its' normal volume. My GP has referred me to a specialist at our local hospital on an urgent basis - but the appointment won't be for two weeks??
Should I be booking myself into A&E or a private hospital/clinic to get this problem resolved quickly- conscious of the fact that the longer this kidney drowns in its' own juices the less of the kidney may be saved. I know humans can live on one kidney - but a Type 1 Diabetic with all the usual add-ons - I don't rate my chances of getting to 60 years. Can you please advise??? Await a response. Thank you.
Submitted: 2 years ago.
Category: Medical
Expert:  Ken replied 2 years ago.
Hello,

I am Dr Ken and I will be helping you today.

Can you give me the ultrasound report? Was renal function test obtained {blood test}? Do you have symptoms like swelling all over the body/ feeling tired/ less urine output?
Customer: replied 2 years ago.

I don't have the ultra sound report however recent blood tests were what made my GP send me for the ultra-sound. Some swelling - feet and legs when I am stood-up for a while. I have been fatigued and tired for 7-8 years - thought it was the cocktail of drugs. I dehydrate constantly - especially while having the few hours sleep I get at night and during the day - so in the morning after 4-5 hours sleep I can pass nearly 1.5 litres of urine - very painful full bladder (no signs of infection, yet??) and sometimes it feels as if I can't urinate fast enough??

Expert:  Ken replied 2 years ago.
Simon,

Thank you for additional information.

Do you mean blocked kidney which is enlarged {enlarged 6x times normal}? OR do you mean the kidney is smaller than the normal one?

Customer: replied 2 years ago.

The GP has explained that I have one normal looking kidney under ultra-sound - although the recent blood test might not agree with that.


And one kidney that has a blocked Ureter (tube to bladder) and the kidney is flooded with so much fluid (making it swell-up bigger) that the ultra-sound scan cannot detect any tissue in the kidney - only fluid??

Expert:  Ken replied 2 years ago.
Thank you Simon. That makes me easier to explain.

Kidney consists of renal tissue with central collecting duct {renal calyces and renal pelvis}. The pelvis drains in to ureter {tube connecting kidney and bladder}. Any blockage of the ureter leads to accumulation of urine in the proximal ureter and renal pelvis causing it to dilate. Chronic dilatation leads to thinning of surrounding renal tissue - leading to reduced renal function. The cause of obstruction at ureter can be varied - calculus/ stricture from infection or trauma/ congenital stricture {PUJ obstruction} or some lesion causing pressure over the ureter. In your case - I am happy that the diabetes is well controlled. This reduces the chances of infection and hence it is less likely that diabetes is the cause of ureteral blockage.

Next step - A physical evaluation along with few investigations like CT abdomen to look for exact cause of obstruction and its level are needed. The doctor will first relieve pressure over the surrounding renal tissue by putting a tube in the renal pelvis from your abdominal wall. This will relive the pressure and avoid further damage to the kidney. Complications like urinoma formation are also avoided by this.

If you have symptoms like Pain in abdomen/ fever or vomiting than I would get to ER and get the obstructed kidney drained. Two more weeks will further damage the renal tissue and also increase the risk of rupture of the dilated collecting system. If you were my close friend or a relative I would get you to the ER {Urgent care}.

Wish you well.

Best
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience: Working as a Doctor who Cares since 2001.
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