Conversation: The conversation between human and AI assistant.
[|Human|] Dear Sir,I am from Dhaka, Bangladesh. Age 45years. I am a patient of CKD and my doctor is asking to do kidney Biopsy for further treatment. Would you please advise me as per following info what I need to do exactly and if I need to do biopsy of kidney then who will be the best Doctor at CMC vellore and how would I can get an appointment asap ?Urine examine report shows :Albumin : +++Pus cell : Numerous 24hrs. Creatinine Clerance Rate (CCR) : 35.0 ml/min/1.73m224hrs. Urine Protein : 6.7 gms/24hrs.24hrs total urine volume : 2.5 Liters/24hrsHematological Test shows:ESR : 105mm.1st hr.Biochemical Analysis report shows:Plasma Glucose (Fasting) : 8.4 mmol/LS. Urea : 16.4 mmol/LS.Creatinine : 261umol/LHB A1C : 6.8%S.Triglyceride : 786mg/dlSonographic Findings on KUB :Kidneys : Both kidneys are normal in size, shape and position withh ill-defined cortex, medulla. Cortical echogeniicity of both kidneys are increased. size of right kidney is 10.2 X 4.2 cm and the Left kidney is 10.9 X 4.2 cm. There is no calculus or any sign of ureteric obstruction in the pelvicalyceal system of both kidneys.Ureters : Ureters are not dilated.Urinary Bladder : well filled and uniform and normal in contour. There is no evidence of stone or growth.  comment : Increased echogenicity of cortex and medulla.
[|AI|]  My dear friend, your report says that you are having diabetes and dyslipidemia (lipid disorders).Hence, there is possibility that you are having diabetes related kidney disease. In most of the CDs kidney size decreases, diabetes is an exception to this rule.The same is your report. Look, for diabetic kidney disease, renal biopsy is not at all recommended nowadays, unless any other type of renal disease is suspected in a diabetic patient. You are prone to have urinary tract infection because of diabetes. So the first thing you must do is to do a culture sensitivity of your urine and if it comes positive then take antibiotic as per the report(after consultation with a reliable doctor because for your renal problem dose adjustment is necessary). Urinary tract infection is a very common cause to decompensate the stable status of diabetic kidney disease.In the meanwhile have an eye check up-FUNDOSCOPY to rule out diabetic retinopathy. Have your blood sugar, pressure and lipid tightly controlled. There are some Chat Doctor. Consult a nephrologist or good internist for detailed follow up. You can get them in your country or if you wish you can come to India. Good luck. By the way, your problem is very common among plentiful diabetic patients so don't panic.