Ask the Doctor

I am 17 years old. At times my urine is cloudy. When I checked it in a laboratory it was found that my urine contains albumin (1+) and amorphous phosphate crystals present. I am a non vegetarian. My renal function test report (blood) was normal including creatinine and blood urea. Is it a major issue?

The National Kidney Foundation — Mon, 30 Jan 2012 21:28:45 +0000

I am not able to interpret a laboratory test without knowing the characteristics of the laboratory performing the test and your history. You mention that you have albumin in your urine, which should not be present, but again, without knowing the laboratory, it is difficult to estimate the significance of this result.

My son, aged 7 years, has a bed wetting problem. Normally three times a week he wets his bed. I have read the literature regarding this issue. By giving him medicines prescribed by the doctors, do they have long term side effects?

The National Kidney Foundation — Mon, 30 Jan 2012 21:26:30 +0000

I am an adult nephrologist. I do not deal with children. Bed wetting is a problem commonly addressed by pediatricians and urologists.

How high can creatinine go?

The National Kidney Foundation — Mon, 30 Jan 2012 21:24:15 +0000

This is dependent on sex (men will have higher than women), age, race, muscle mass, diet and kidney function. The serum creatinine is a function of all of the variables noted. I have seen muscular men with severe kidney failure with creatinines more than 30 milligram per deciliter.

I have one healthy functioning kidney. What is the normal creatinine range? My creatinine is usually between 1.37-1.45.

The National Kidney Foundation — Mon, 30 Jan 2012 21:23:26 +0000

You can go to our web site and determine your estimated glomerular filtration rate (eGFR) for yourself. The estimating equation can be found at: http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm

A normal eGFR for you would be between 50 and 70 milliliters per minute per 1.73 meters squared for a single functioning kidney.

I am undergoing chemotherapy for recurrent germ cell tumor. I unfortunately contracted cellulitis while undergoing treatment. I have had my daughter’s kidney for 6 years now. I was given Zyvox for a week and since then my creatinine has risen from 1.8 to 2.5. I am worried my kidney has been damaged by the Zyvox. I am also retaining water and have swollen legs and ankles. I inceased my LASIX but not urinating like I usually do. My penis is also swollen. Can this be kidney rejection?

The National Kidney Foundation — Mon, 30 Jan 2012 21:22:08 +0000

Your symptoms are very concerning to me. I would clearly recommend that you speak with both your cancer specialist and your transplant physician. There are many drug interactions that can occur with chemotherapy agents used for cancer therapy and drugs used in transplantation. Zyvox (linezolid) also has many possible drug interactions. I recommend further testing.

My mom has been recently diagnosed with Stage 3 CKD. It was through a blood test and not her doctor. From what I’ve been able to gather, it seems like the key things to do are: 1)eating a lower level of food with phosphorus 2)consume 48 grams of protein per day (calculation based on weight and .7 gr per kg body weight) 3)See a doctor about vitamins that she may want to take. 4)Get 30 min. of walking or exercise daily, and 5)though not totally necessary, lower the amount of potassium. Do I seem to have a grasp on everything we need to do, or am I missing anything? Also, she is worried about her daily cup of coffee. What’s your personal take on that?

The National Kidney Foundation — Mon, 30 Jan 2012 21:16:47 +0000

You have listed a very complete list of important things to consider for a patient with chronic kidney disease (CKD). I am not a big fan of protein restriction. If I recommend protein restriction, I usually recommend 0.8 grams per kilogram of body weight, but most studies have not shown a benefit to such a diet. I do recommend salt restriction and would recommend that sodium intake be kept less than 2500 milligrams per day. I also recommend that blood pressure be checked regularly and kept to less than 130/80. If she has protein in her urine, she might benefit from treatment with an ACE-inhibitor or an ARB agent. This latter point needs to be evaluated and recommended by her physician. Coffee does not concern me if kept to less than 6 cups per day. She does need to find a physician who will be willing to evaluate her on a regular basis. I do not give medical advice without a complete history and physical examination.

My brother was diagnosed with chronic kidney disease and they have been treating it with chemotherapy treatments. Is this a normal treatment for chronic kidney disease?

The National Kidney Foundation — Mon, 30 Jan 2012 21:13:25 +0000

I would need to know what is causing his kidney disease, whether he had a kidney biopsy and the results of the biopsy. We do use some chemotherapy agents in the treatment of acute glomerulonephritis. We treat based on the results of a kidney biopsy.

Why is my husband vomiting after dialysis? He has a severe burning sensation in his chest along with the vomiting.

The National Kidney Foundation — Mon, 30 Jan 2012 21:10:18 +0000

Nausea and vomiting are common symptoms on dialysis. Some people react to dialysis in very different ways. I am not able to make a diagnosis based on the information presented. I recommend that you and your husband discuss your concerns with the nephrologist caring for him at the dialysis unit.

My 8 year old son had strep last February and was diagnosed with post streptococcal glomerulonephritis. Since the diagnosis, he has had blood in his urine on and off (almost every month). For the past three weeks, he has had blood in the urine almost every day. The pediatrician said his ASO levels were elevated so he probably had strep again. I was under the impression once treated for this the blood in the urine usually stops and doesn’t keep reappearing. Is it possible that the strep infection from last year is still causing him to have blood in his urine? I fear that something else may really be going on. We have seen numerous doctors. His BUN and creatinine levels are normal.

The National Kidney Foundation — Mon, 30 Jan 2012 21:08:16 +0000

I am an adult nephrologist. I do not see children. I am aware that blood in the urine (hematuria) may be present for years after an episode of post streptococcal glomerulonephritis in adults. This is a question for a pediatric nephrologist.

I donated a kidney about 4 years ago on my left side. Recently, I have had bad pain on my left side towards my spine. Its been painful for a few months?

The National Kidney Foundation — Mon, 30 Jan 2012 21:03:58 +0000

I am not able to make a diagnosis based on the information presented. If you have persistent pain, you should discuss this with your primary care physician or the surgeon who performed your donor surgery.