How to control high creatinine levels in an 81-year-old heart patient with leg swelling?

Question #29310

45 days ago

114

How to control high creatinine levels in an 81-year-old heart patient with leg swelling? - #29310

Client_23fc4d

My father aged 81 years is a heart patient. His creatinine is increasing and now it is 7. He is admitted in the hospital. There is swelling on the legs. There is no shortness of breath. He is doing find overall. We need to understand the course of action to control the creatinine level please.

How long has your father had high creatinine levels?:

- More than 6 months

Has your father experienced any changes in his urine output?:

- Decreased urination

What other symptoms has he experienced besides leg swelling?:

- Fatigue

Has he had any recent changes in medications or treatments?:

- No changes

What is his current diet like?:

- Low in protein

Does he have any other medical conditions besides heart disease?:

- Diabetes

How is his fluid intake managed in the hospital?:

- Restricted fluid intake

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

44 days ago

Hello
Thank you for sharing these details. I understand how worrying this must be for your family.
### What Does a Creatinine of 7 Mean?
A creatinine level of 7 is quite high, especially for an elderly person with a heart condition. This usually means the kidneys are not working well (advanced chronic kidney disease or possibly acute-on-chronic kidney injury). The swelling in his legs (edema) and decreased urination are signs that his kidneys are struggling to remove excess fluid and waste from his body.
### What Happens Next in the Hospital?
Here’s what doctors typically focus on in this situation:
1. Identify and Treat the Cause: They’ll look for any reversible causes (like dehydration, medication side effects, infections, or heart issues) and treat those.
2. Manage Fluid Balance: Since he has swelling but no shortness of breath, they’ll carefully monitor his fluids to avoid overload, which can affect the heart and lungs.
3. Adjust Medications: Some medicines can worsen kidney function, so doctors may stop or adjust these.
4. Monitor Electrolytes: High creatinine can cause dangerous changes in potassium, sodium, and acid levels, so these are checked and managed closely.
5. Consider Dialysis: If his kidney function doesn’t improve, or if he develops symptoms like severe swelling, breathing difficulty, confusion, or very high potassium, dialysis may be needed to remove waste and fluid.
### What Can Be Done to Lower Creatinine?
- Treat underlying causes (infections, heart failure, dehydration, medication side effects)
- Control blood pressure and blood sugar (if diabetic)
- Dietary changes (low salt, low potassium, low protein—guided by a dietitian)
- Dialysis (if kidneys can’t recover or symptoms worsen)
### What Should You Ask the Doctors?
- What do they think is causing the kidney problem?
- Are there any reversible factors?
- Is dialysis being considered, and if so, when?
- What is the plan for fluid and medication management?
- What dietary changes should be followed?
### Key Points
- At this stage, close hospital monitoring is essential.
- The main goal is to support his kidneys, manage symptoms, and prevent complications.
- Recovery depends on whether the cause is reversible and his overall health.
Thank you

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

44 days ago

Hello dear
See definitely creatinine levels are high
But this itself doesn’t is a concern only
You need to have urine analysis and kidney function test to see
Urine output
Filtering
Urea level
Sugar
Potassium level
Please share the below tests for confirmation with urologist
Cbc
Esr
Serum ferritin
Serum tsh
Serum hb
Rft
Lft
Gfr
Serum creatinine
Serum bilirubin
Hemogram
Kidney USG
Hopefully you recover soon
Regards

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

When dealing with elevated creatinine levels, especially at a level of 7, it’s important to consider the underlying causes and the need for immediate medical management. Given your father’s age, heart condition, and hospitalization, it’s likely that his kidney function is significantly impaired. This could be due to acute kidney injury (AKI), which is sometimes reversible depending on the cause, or chronic kidney disease (CKD) which tends to be progressive. The leg swelling suggests fluid retention, possibly linked to heart failure exacerbations or renal impairment. The immediate focus should be on ensuring proper fluid management and avoiding further damage to the kidneys.
In the hospital setting, the medical team will likely address potential reversible factors: optimizing heart function, ensuring appropriate blood pressure control, reviewing medications that might harm the kidneys, and looking for any signs of dehydration or infection. Diuretics may help with the swelling, but careful monitoring is necessary, given their potential impact on kidney function. If creatinine continues to rise or if there’s significant fluid overload, hemodialysis might become necessary to take over the kidney’s filtering role.
Monitoring electrolytes, acid-base balance, and adjusting the diet to lower protein intake could also help in stabilizing kidney function, along with any necessary, heart-specific treatments. It’s crucial to have regular discussions with the treating cardiologist and nephrologist to be updated on his treatment plan, potential interventions, and further steps including outpatient follow-up once stabilized.

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