instruction: hello doctor I am on dialysis for kidney failure and I have noticed a fluctuation in my monthly blood work for the creatinine and bun levels at the beginning of the year my creatinine was and it has decreased every month to I was also making more urine as I went along all of a sudden last month my creatinine jumped back up to 10 I have not changed anything in my routine or treatments does anyone have any ideas
output: hello I have worked as a chief in a hemodialysis center for 20 months once the kidneys have failed and the patient is hooked up on dialysis the creatinine value is always high at this time we do not care about the creatinine values because once we start dialysis on a patient it is assumed that his kidneys have incurred permanent damage and he cannot come back to normalcy at this juncture we use the patient creatinine value as a measure of protein intake if a dialyzing patient creatinine value is high it is assumed that he is having good protein intake through diet and high creatinine value is desirable in dialysis patients since intake of much proteins gives them a long life when creatinine value drops we start worrying that the patient is not taking much proteins so the drop in your creatinine value may be because you have started taking less proteins than usual in this situation we advise you to take more protein containing foods for a dialyzing patient the most important parameter is blood urea see what is your blood urea level before and after a single dialysis session ideally there should be a 60 reduction then it can be comfortably assumed that dialysis is effective if you do not achieve this reduction complain to the dialysis technician he will do the needful adjustments with the machine the big factor we have to afraid of is potassium it should never cross I hope this helps