I have only one kidney (donation, not illness). Do I face increased risk of serious side effects from radiation/chemo treatment of cancer than a person with two kidneys?

I am not aware that any studies have examined this particular issue.  Your estimated glomerular filtration rate (eGFR) will be lower than someone with two kidneys, so the doing of your medication (chemotherapy) may have to be adjusted based on the deceased clearance of these drugs.  A nephrologist may have to consult with your oncologist for proper dosing.  There should not be any increased risks from radiation as far as I am aware.

Posted in Ask the Doctor, GFR, Living Donation, Nephrectomy / One kidney

What is the typical amount of time are you on a transplant list before you get a kidney. I am going on four years?

Each transplant center is different.  Each center maintains a list.  The average wait time for most center is between 3 and 4 years, but some are longer and some are shorter.  It is also dependent on your blood type.  Type A’s have the shortest wait time and B’s and AB’s have the longest.  You should ask your coordinator at the transplant center, “What is the average wait time for my blood type?”.  Remember that this is an average and that there are shorter and longer waits in each center.  For general information about transplantation please click here.

Posted in Ask the Doctor, Transplantation

Sir,my wife is about 40 years and her kft is in normal range but the Creatinine is 1.2mg. Is this dangerous?

No.  This may be normal for your wife.  I suggest you go to our web site and use your wife’s vital information to calculate her estimated glomerular filtration rate (eGFR).  You can access the eGFR equation at:  http://www.kidney.org/professionals/KDOQI/gfr_calculator

Posted in Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine

I have been diagnosed with Stage 3, Chronic Kidney Disease. My eGFR has been stable at 47, my serum creatinine is 1.2. I have thinning of the Renal Cortex up to 7 mm and fatty liver on abdominal Ultrasound. Since I also have Leukocytoclastic Vasculitis, could this cause the thinning of the Renal Cortex and fatty liver? I also have white flakes on my skin of arms and legs. I have family history of kidney problems, with female cousin on dialysis.

I am unable to provide a specific diagnosis based on the information that you provide.  Leukocytoclastic vasculitis is an allergic reaction to something and usually does not cause thinning of the kidney cortex or fatty liver.  The vasculitis can cause kidney injury and skin disease.  It can also cause abdominal pain and bleeding from the bowel.  I am unable to offer any other observations about the information that you provide.

Posted in Ask the Doctor, Chronic Kidney Disease, Symptoms and Side Effects

I am very confused on fluid restriction orders and machine prescriptions for dialysis patients. I have been on dialysis twice, first when i was 35 and again at 44. I have a AV fistula using fifteen gauge needles for treatment. I have been active running, lifting weights and working. How do I have the same machine pump speed of 450 (it has since been changed to 500, which helped my labs tremendously, but that seems to be the norm) and the same fluid restrictions of a 90 year old man and a 75 year old woman that are obviously not as active? It makes no sense to me. Why is this one size fits all for dialysis patients?

Dialysis prescriptions are based on body size, any residual kidney function that you may have, and the specifications of the particular dialysis machine that you may be using.  With each dialysis session, your blood must be cleaned during the session and this is measured by a blood test that is done before and after a dialysis session.  Time and blood flow are prescribed based on these cleaning numbers (known as a Kt/V).  Time is also needed to remove fluid that has accumulated between each dialysis session, hence the weight that is taken after and before each dialysis session is critical.  It is important to restrict salt and fluid intake to keep those weight gains between dialysis sessions to something that the machine and you can tolerate.  Time is often added in order to remove all the fluid and to do so in a safe manner.  Your dietitian and your nephrologist should be able to review your particular numbers and prescription with you.

Posted in Dialysis, Kidney-Related Health Questions

Male 62, diabetic since 2007, blood sugar is well maintained, A1c is 6.2, blood pressure is 120/80 (have some hypo tension lately 80/50), cholesterol is at the low end of the scale. In the last 6 months, start having some number issues with my kidney performance the creatinine serum jumped from 99 to 110 and my estimated GFR dropped from 70 to 62 also my microalbumin/creatinine ratio, urine is up and down like a yo yo, the sequence is 1.1, 3.8, 1.2, 4.1, 1.9, but my 24 hours urine microalbumin/creatinine ratio is 0.7 Due to my lack of knowledge about renal disease, I really do not know what that meant. All I know I am still within the “limit”. But looking at the trend, if it continues, it might get me into trouble very soon. Since I am still within the “limit”, my GP will do nothing. Took some clinic sponsor workshop on living with kidney disease, not able to get any appropriate information only comment I got is I “don’t have kidney disease” I understand at my age, 1 or 2 percentage up and down of my GFR is expected, but I sure would like to know why the big slide in 6 months (confirmed with 3 tests), and is there anything I can do to stop the slide, or even reverse the current performance

The equations that are used to estimate the glomerular filtration rate (eGFR) are not very accurate with eGFR above 60 milliliters per minute per 1.73 meters squared.  Hence, based on these estimating equations, we designate any eGFR above 60 as normal.  Normal urinary microalbumin excretion is less than 30 micrograms of albumin per milligram (mcg/mg) of creatinine.  Hence, all of the information that you provide suggests that your kidney function is normal.  I believe that you are trying to use tests that are subject to normal laboratory variation in measurement, but are nonetheless normal.  I would follow your physicians advice and continue regular testing.  It sounds like you are otherwise doing all of the important things you need to do to preserve your kidney function with diabetes.

Posted in Ask the Doctor, Diabetes, Laboratory Testing, Risk factors

I have CKD do I what medicine have to avoid: Advil or Telenoid? I am mixed up between the two.

Advil, also known as Ibuprofen, should be avoided in patients with chronic kidney disease (CKD).  I am not familiar with “Telenoid”.  You may be referring to “Tylenol” also known as acetaminophen, which recommended dosage is safe for patients with CKD.

FOr general information you may find helpful please click here.

Posted in Ask the Doctor, Chronic Kidney Disease, Medication and Kidney Disease

I have frequent bladder infections. My last CT scan showed 1 stone in my left kidney and several stones in my right. I also had surgery April 1 to remove ovarian cysts & the doctor removed my Fallopian tubes (which turned out to be full of cysts as well). My menstrual cycle has been extremely heavy and clotting. My bladder always feels full and I always have an urge to urinate. Sometimes it feels like I empty it only to have to go back and pee again 10 mins later. I’m up and down all night. My lower back seems to stay in pain.

The problem that you describe is a urological problem and best handled by a urologist who deals with bladder issues.  I am a nephrologist and have no expertise in this area.  I suggest you consult with your primary care physician (PCP) about referral to a urologist.

Posted in Ask the Doctor, Urological Issues

I am 72 years old, creatinine level is 1.8, up from 1.6 three months ago. My GP is monitoring. I excercise to include weight lifting and eat foods with moderate levels of protein in order to improve muscle rebuilding. What amount of protein from food will best help me halt the decline of kidney function? The

Protein restriction in the diet does not lead to any meaningful changes in kidney function.  I generally recommend a diet that has 0.8 to 1.2 grams of protein intake per kilogram of body weight.  I do not recommend protein restriction for patients with chronic kidney disease (CKD).  For patients with Stage 1, 2 or 3 CKD, I generally advocate for a low salt diet and I am very fond of the DASH diet which you can review at:  https://www.nhlbi.nih.gov/health/health-topics/topics/dash

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition

I am experiencing some flank pain consistently for a week now. Is it a warning sign?

Pain is not a common presenting symptom of chronic kidney disease (CKD).  It can be experienced with kidney stones.  I suggest you consult with your primary care physician (PCP) for evaluation and recommendations.

Posted in Ask the Doctor, Symptoms and Side Effects