### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi I am Sudha. Am living in Boston. Am from India. My parents are there in India. For the past 15 days, my daddy is hospitalized. He has varicose vein in both the legs for the past 7 years. He has only one kidney by birth. It is diagnosed that his urea and creatinine level is high in blood than normal. He is taking medications for that past 7 years. Am not sure about the name of the medication. He was doing well so far. But on Dec 23rd he got sudden fever and chills. His left leg got swollen. He got admitted in the hospital on Dec 26th. The doctors found that his creatinine level was so high. It was 7 then. So they started Dialysis. But even after dialysis it is not getting reduced. Now for the past 3 days he is not able to breathe properly. They are doing dialysis every other day.Now the creatinine level is 9. Can you help me out in this? Please let us know if you need further info.

### output:

Hi Sudra, After going through your fathers' case there is possibility of underlying chronic kidney disease (CKD) as he is on some medicines for his raised urea and creatinine level (you have not mentioned his range of urea, creatinine levels over past 7 years before current rise). As you have mentioned on 26th Dec he developed fever with chills and swelling over left leg there is possibility of left leg cellulitis (infection) which may responsible for further deterioration of kidney function called as Acute Kidney Injury (AKA) this might be due to1) Infection its self.2) Low Blood Pressure caused by infection which leads to decreased blood supply to kidney and deterioration of kidney function.3) Deny Chat Doctor. In case of AKA there might be need for hemodialysis as in you fathers case. Need for Hemodialysis depends on on-1) Amount of Urine production daily.2) Serum electrolyte mainly Potassium.3) Serum Creatinine level.4) Arterial Blood Gas (ABG) analysis which denote degree of acid accumulation in blood.5) Signs of water retention like breathing difficulty(as in your father), swelling over body, puffiness of face. In most of the cases after control of disease responsible for rapid deterioration of kidney function (left leg cellulitis as in your father case) there might be improvement in kidney function. There is persistent deterioration of kidney function in your fathers' case may be due to-1) Single kidney.2) Underlying CKD (maybe advancing).3) Delayed recovery of cellulitis.4) Persistent hypotension (low blood pressure)Presence of comorbid conditions like diabetes, high blood pressure, cholesterol problem usually associated with deterioration of kidney function.