High Creatinine 442 due to Diabetes and Hypertension

Illness description: I have diabetes and high blood pressure for years and now my creatinine is higher, about 442, any advice?
The following is the report of my Renal Function Test
Sodium 127V mmoi/L
Potassiun 5.2 mmol/L
Chloride 99 mmol/L
Creatinine 433 umol/L
Urea 31.6 mmol/L
Uric Acid 676V umol/L
Illness analysis: For your condition, I don’t think it is late for you. So, please don’t worry. There are many patients in our hospital have gotten rid of dialysis, some of them had been keep dialysis for three years. So, please don’t worry.There is high possibility to get ride of dialysis for you
As you know, long term diabetes and hypertension can make kidney damaged. In your case, you have both hypertension and diabetes for a long time. That is why your kidney get damaged and creatinine increases.
For diabetes, people keep high blood glucose . Long term high blood glucose can make superabundant saccharification final products deposite in glomerular endothelial cells and mesangial cell . This process will make extracellular matrix have
pathological changes . Thus, extracellular matrix will produce excessive fiber cells and finally lead to glomerula fibrosis and necrosis. Generally, 10-15 years diabetes can lead to obvious kidney damage.
For hypertension, long term hypertension can make renal artery atherosclerosis. The artery atherosclerosis can lead renal tubular capillary hypoxic-ischemic, which will lead tubular necrosis generally. Generally 5-10 years hypertension can lead to the damage
I believe your have given you diet suggestion.So , I ‘d like to offer you some tip on daily life. Please try your best to keep your blood sugar and blood pressure well, it will reduce the burden of your kidney. And please take shower with warm water(40 degrees Celsius) . And do not have your breath and overexertwhen you are defecating.
From your last letter I can tell your helpless feelings. I am afraid that you now have already started dialysis. I remember your last time creatinine level was 433umol/L. Generally, this level does not require dialysis, but you have Diabetes. I think your doctor also take your diabetic history into consideration, so he suggested starting dialysis earlier.
By the way, dialysis is not a standard to judge renal damage level. What matters is the pathological changes within kidneys and whether certain portaion of these changes can still be reversed. Sclerotic cells are died cells, but in most cases there are still large portion of damaged but still reversible cells. This is also why some end stage patients can still stop dialysis. Hope you will also have a thorough evaluation for your condition to avoid any possible chance for improvement.