In the case of your brother, I have always found that such people need to start trusting a physician. The best place to start is with a primary care physician (PCP). Your brother should find a PCP who he can establish with and build some confidence. This may take some time, but this has to be the first step. Once this is done, then the PCP may choose to refer to a nephrologist. Direct referral to a nephrologist will likely not help the situation. The important step with your brother is to trust someone to provide medical advice to him and then get consultation if needed. The PCP is very much able to treat high blood pressure and treat early kidney disease.
For your mother, her use of non-steroidal anti-inflammatory drugs (NSAID’s) is very concerning. The combination of Meloxicam with ibuprofen and Tylenol (acetaminophen) can be particularly damaging to the kidneys. I am unable to provide a diagnosis or prognosis without performing a complete history and physical examination. I would again suggest that your mother establish with a good PCP and follow his or her advice.
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