CKD stage 5 survival with comorbidity - #11415
My mother is 77 years old with ckd stage 5. She is bed ridden and on conservative therapy. But last few days there is blood in stool. Gastroenterologist have given trenexa inj. But no improvement. She can't eat solid food. She is very frail with multiple episode of unconsciousness. Surgeon suspect gi bleeding. At this point she won't be able to do Colonoscopy or endoscopy which is ruled out by the gastroenterologist earlier due to her frailty. I just wanted to know any possible medicine or support which we can give to her so that she can have some quality of life for the remaining few days of her life.
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Doctors’ responses
Hello dear See stage 5 of chronic kidney stage is a very dreadful stage with severe edema and restless ness. Surgery could be very difficult without any advanced recovery I can suggest some dietary modification for improvement Take light dust like Dalia and Poha Avoid high protein and fat diet Take water accordingly Take zincovit multivitamin Avoid alcohol Avi d raisins Kindly follow this diet. In case of no improvement, Please contact the concerned doctor for better clarification Hopefully improvement should occur Regards
As i can see ckd 5 stage disease which is the reason for hypertension and if there is gi bleed and your doctor already administered inj trenexa which is not subsiding the bleeding please prove some additional info on the bleeding is it visible or occult type and drop me a msg i will provide you some additional medicines
Your mother is in CKD stage 5 with frailty, GI bleeding, and multiple health issues, so treatment should now focus on comfort and quality of life rather than curative options. Continue supportive medicines such as tranexamic acid (if advised), a proton pump inhibitor like pantoprazole, and sucralfate syrup to help reduce bleeding and protect the stomach. Provide small, frequent soft or liquid renal-safe meals (e.g., Nepro HP, rice water, thin dal, blended khichdi) to maintain nutrition. Avoid NSAIDs, and if she has pain or discomfort, only low-dose opioids under medical supervision should be considered. Ensure good nursing care hydration in moderation, frequent position changes, skin and oral care, and an air/soft mattress to prevent bedsores. Oxygen may be used for breathlessness. At this stage, avoid aggressive interventions like colonoscopy or surgery and instead focus on palliative care at home to keep her comfortable, pain-free, and supported in her remaining days.
Your mother’s bleeding with CKD stage 5 and frailty is best managed with supportive/palliative care since invasive procedures are not safe. Options include transfusions, liquid nutrition, and medicines for comfort under close supervision. Please consult a palliative care physician or gastroenterologist for tailored symptom control.
Your mother’s bleeding with CKD stage 5 and frailty is best managed with supportive/palliative care since invasive procedures are not safe. Options include transfusions, liquid nutrition, and medicines for comfort under close supervision. Please consult a palliative care physician or gastroenterologist for tailored symptom control.
Considering your mother’s condition is quite complex, especially with CKD stage 5, and being frail and bedridden, prioritizing comfort and symptom management is of utmost importance. In cases like this, palliative care comes into focus—it’s about ensuring the best possible quality of life given the circumstances. For her, addressing the bleeding without invasive procedures can be challenging. Since tranexamic acid hasn’t been effective, sometimes switching tactics may include other non-invasive interventions like optimizing iron levels or using blood transfusions to manage anemia if indicated by her latest lab values, but given kidney impairment, all therapies should be considered cautiously and ideally tailored by the treating nephrologist to avoid further complications.
A softer, easily digestible diet, such as pureed foods or nutritional shakes, could help maintain some nutrient intake without overwhelming her digestive system. It’s important to keep her comfortable, monitor for any signs of severe blood loss, like rapid heart rate or further drops in consciousness, which would need prompt medical attention. Managing pain and any discomfort should be a priority, possibly through adjusted medication that considers kidney function. Keeping her adequately hydrated is key too, while balancing it with any fluid restrictions due to her renal condition. Communication with her healthcare team is essential—she may potentially benefit from hospice services which specialize in maintaining quality of life even in the toughest of situations.
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