I started prednisone 70mg daily 17 days ago. I am getting the swelling in neck, worse in am but last 2 days have a firm sore lump on left side under jaw. Is this an infection or just one of the many side effects? The right side is soft.

I am unable to make a diagnosis without performing a complete history and physical examination.  Prednisone can cause swelling in the neck, but the swelling in your jaw, I cannot explain on the basis of prednisone therapy.  I suggest that you visit your physician.

Posted in Ask the Doctor, Symptoms and Side Effects

During a 4 hour dialysis treatment, when is the best time to introduce EPO into the machine before the end of the session.

Erythropoietin (EPO) can be administered into the dialysis machine at anytime during the dialysis procedure.  It is most commonly done during the rinse of blood back from the machine.  Hence, the drug is given into the venous needle during the rinse back of blood and saline from the machine in my dialysis unit.

Posted in Anemia, Dialysis, Kidney Failure, Kidney-Related Health Questions

I am a 73 year old female that was recently diagnosed with stage 3 kidney disease. I also have CHF. While in the hospital, I was given a very strict diet and upon discharge the dietitian couldn’t give me any guidelines to follow except for diabetics (I have type 2, treated with pills). I want to know if I can have tomatoes, pinto beans, fresh ham, cabbage, there are some other foods. I want to take care of my kidneys as long as I can without going on dialysis. I need a diet or some plan of what to eat and not to eat. At the present, I eat lean meat, white rice, noodles, carrots, green beans and other other leafy vegetables. My family want to go out and eat but because of the sodium and preparation of foods, we don’t go out. I also need a guideline in choosing a restaurant and food to eat.

If you have Stage 3 chronic kidney disease (CKD), and your potassium levels are normal, then I recommend the DASH diet.  You should limit the salt in the diet as well.  You can review the DASH diet at:  http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

Posted in Chronic Kidney Disease, Diabetes, Diet/Nutrition, Kidney-Related Health Questions

I have one kidney. My GFR is 60. I am taking Ranolazine (Ranexa) 1000 mg once a day, for chest pains. After having open heart surgery, is this good or unhealthy for my kidney?

Ranolazine (Ranexa) is used to treat angina pectoris (chest pain from heart disease).  If you have a normal solitary kidney the dose does not have to be changed.  This medication has many interactions with other drugs.  You should discuss this with your physician.  It does not commonly cause kidney problems.

Posted in Kidney-Related Health Questions, Medication and Kidney Function, One Kidney, Symptoms and Side Effects

My son passed away suddenly in Jamaica in February. He collapsed as he left the sea after snorkeling. The autopsy reported the cause of death as acute renal failure secondary to poly cystic kidneys. He was known to have high blood pressure, but knew nothing of kidney disease. He was a very active 43 year old who hiked , swam, played tennis and always kept going. It seems strange to me that such a person would just collapse dead with no warning. Is this possible? We have no known family history of PCKD.

Polycystic kidney disease (PCKD) does not always have a family history.  There are cases of spontaneous mutations that cause this genetic kidney disease and can be transmitted into any of your son’s offspring.  PCKD is also associated with brain aneurysms that can lead to sudden death.

Posted in Kidney Failure, Kidney-Related Health Questions, Polycystic Kidney Disease

 I would like to know if  kidney donors can safely take contraceptive pills or injections to prevent pregnancy?

Birth control pills and other forms of contraception have been safely used in patients who have been kidney donors, but blood pressure should be carefully monitored.  There is also a slight increase in risk for blood clots, strokes and heart disease in patients who take birth control pills, regardless if they have one or two kidneys.

For information about living with one kidney please click here

Posted in Donation, Kidney-Related Health Questions, Medication and Kidney Function, One Kidney, Symptoms and Side Effects

My father, age 64, has been suffering from coronary artery disease since 1995.  Recently, he was admitted hospital with severe chest pain.  After coronary angiogram, the cardiologist suggested a bypass. His kidney function is not good and because of this, the surgeon is now reluctant to do bypass surgery and referred him to a kidney doctor.  He also has diabetes. His latest kidney report shows:  Serum Creatinine 168 micromol/L, Serum Potassium 5 mmol/L.  Now my father is taking the medication, Ketosterin for 1 month, as prescribed by the kidney doctor.  Kindly advise if he can safely undergo bypass surgery with a serum creatinine 168 micromol/L.  Also, please suggest foods that would be beneficial to his kidney. 

I cannot offer a prognosis or medical advice without examining your father and performing a complete history and physical examination.  Kidney disease will increase the risk of death and kidney failure, requiring dialysis in patients with diabetes and heart disease requiring bypass surgery.  I believe you should consult with your primary care physician and a nephrologist to determine the risks and then let your father make a decision as to how much risk he is willing to accept.


For information about diet and kidney disease please click here

Posted in Chronic Kidney Disease, Diabetes, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Symptoms and Side Effects

Recently, I found out I was born with a solitary kidney; I am 26 years old and I have a 5 year old, and I lost my daughter after a natural birth 3 years ago. Which, now that I’ve found out about my lost kidney, makes sense.  What I’d like to know is what complications other women with the same condition as mine have had while pregnant?  What steps could I take to be sure neither baby or I are harmed?  Also if possible, could you refer me to a support network, so I could hear others experiences.

Having a single kidney at birth does not increase the risk of adverse outcomes as a result of pregnancy, as long as your remaining kidney is functioning normally.  If you have normal kidney function in your remaining solitary kidney, there should not be any risk to you or your fetus.  You should also be sure to check that you have a normal uterus and birth canal, particularly if your were born with a single kidney.  I do not know of any support network regarding single kidneys and pregnancy.

Posted in Kidney-Related Health Questions, One Kidney, Pregnancy / Kids

I have 1.3 creatinine.  The doctor says I have 55 percent function of kidneys.  I am 62.  I don’t have diabetes or high blood pressure and I am not over weight.  I don’t have any symptoms.  I feel great. I am going to have a ultrasound and renal scan. My last blood work in August of 2012 was normal.  What other problems could be causing me this problem?  I think my GFR is 54.  

I am unable to provide a diagnosis without performing a complete history and physical examination.  Your doctor is trying to come to a diagnosis by doing an ultrasound and renal scan.  I suggest you ask your physician once all of the testing is complete.  If your previous blood work was normal, you may need to repeat the blood tests to see if perhaps this was just a temporary problem that is reversed with time.  You do not mention any urine testing.  You should also have urine testing.  If you have persistently abnormal testing, a kidney biopsy could be necessary.


Posted in GFR, Kidney-Related Health Questions, Laboratory Testing

I have a pre-owned (brother) kidney. The transplant was done at UCLA, 7-30-97. My creatinine has been perfect. 4 years ago, blood pressure was either 140/90 or 90/69 or 120/80. I have been taking BP & Beta Blockers but has been a juggling act. I am worried that high BP will destroy pre-owned kidney as it did my two original birth defective kidneys. Any suggestions you can give to me or the specialists I see?

It sounds like you are being very careful with your health.  This is a good thing.  I suggest that you continue to monitor your blood pressure carefully.  An average blood pressure of 130/80 is desirable.  You should also have annual urine testing for blood, protein and infection to monitor your transplant function.  I also recommend a low salt diet.  If you are exercising regularly and maintaining a healthy weight, then you are doing all you can to preserve the function in your “pre-owned” kidney.  Keep up the effort!  You should be seeing your primary care physician annually and your transplant nephrologist annually as well.


Posted in Hypertension/High Blood Pressure, Kidney-Related Health Questions, Nephrologist, One Kidney, Symptoms and Side Effects, Transplantation