Your mother’s condition with chronic kidney disease (CKD), small kidney size, decreasing hemoglobin, and rising creatinine levels requires specialized care from a nephrologist, a doctor who focuses on kidney health.

1. Consulting the Right Specialist

   • A nephrologist manages CKD by monitoring kidney function, controlling complications, and adjusting treatments as the disease progresses.
   • Regular follow-up is essential to track hemoglobin and creatinine levels and to prevent further kidney damage.

2. Understanding Kidney Size and Its Implications

   • A kidney size of 5 cm is smaller than normal, indicating advanced CKD with likely irreversible damage.
   • This affects treatment options and prognosis, emphasizing the need for close medical supervision.

3. Managing Decreasing Hemoglobin and Rising Creatinine

   • Anemia in CKD is common due to reduced erythropoietin production; it often requires treatment with supplements or medications prescribed by the nephrologist.
   • Rising creatinine signals worsening kidney function, so ongoing monitoring and possible treatment adjustments are critical.

4. Use of Patanjali Divya Punarnavadi Mandoor in CKD

   • This Ayurvedic herbal formulation is traditionally used to support kidney health and manage related symptoms like anemia and edema.
   • However, there is limited scientific evidence on its safety and effectiveness in advanced CKD, especially with significant kidney shrinkage and lab abnormalities.
   • It is important to consult the nephrologist before starting this or any herbal medicine to avoid interactions or harm.

5. General Recommendations

   • Avoid self-medicating with herbal or alternative treatments without medical advice.
   • A multidisciplinary approach including diet modification, prescribed medications, and regular lab tests is key to managing CKD effectively.

6. When to Seek Immediate Medical Attention

   • If your mother develops severe shortness of breath, chest pain, confusion, or swelling that worsens rapidly, seek emergency care promptly.

Please arrange an appointment with a nephrologist as soon as possible to ensure your mother receives appropriate and safe management tailored to her condition. If you want, I can explain more about CKD management or anemia treatment.