I’m A-. Can I donate a kidney to an A+ person?

A person with blood type A can always donate a kidney to another person with blood type A.  The Rh factor (which may be either positive or negative) does not factor in to the decision.

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Posted in Ask the Doctor, Donation, Kidney-Related Health Questions

What hypertension drugs do not raise creatinine levels? I have been diagnosed with PKD. My creatinine level is 1.71, I want to know if Ramipril could be causing it? If it is, what drug can I take that will not raise the creatinine level?

This is a complicated question and I will try to answer in a way that makes sense. The way that drugs protect the kidney and help to sustain the kidneys for longer periods of time, is to lower pressures inside of the kidneys. Drugs such as ACE-inhibitors and ARB agents help to protect the kidneys and lower pressure inside of the kidney filters (glomeruli) of the kidneys. As these drugs work in the kidneys, the initial result is to lower the glomerular filtration rate (GFR) and this will slightly bump up the serum creatinine.  However, as time goes on the kidney will be protected and kidney function will last longer.  Hence, while the initial response to ACE-inhibitor and ARB agent treatment will slightly increase the serum creatinine, the final result is to delay the loss of kidney function so the kidneys will last longer.  Ramipril is an ACE-inhibitor.

Posted in Ask the Doctor, GFR, Kidney-Related Health Questions, Medication and Kidney Disease, Serum Creatinine

Hi – I have a non-specific chronic glomerular nephritis. My creatinine and BUN are within the normal range, but I have high proteinuria. My last 24 hr count totaled around 800 mg for proteinuria. I take enalapril and losartan. I am a 30 yr old with good health otherwise. I’m a runner and have signed up for my first marathon. I’m running 30-40 miles a week for training, which is higher than ever for me. Is this a bad idea with kidney disease? Should I just limit myself to lower mileage weeks/races? I don’t want to do further damage to my already slowly diminishing kidney function.

Physical activity, including marathon running, should not pose any threat to your kidneys as long as you maintain adequate hydration. As you train, you should weigh yourself before and after running. Adequate hydration would mean that you lose a small amount of weight during the run. If you are gaining weight with each run, then you are drinking too much fluid during your exercise. If your weight is the same or less after exercise, this is the proper amount of fluid. If you are weak and dizzy after exercising and have lost more than 5% of your body weight, then this is inadequate hydration during your run.

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Proteinuria

I am a 65 yo white female. My eGFR has been consistently less than 60 for at least 4 years. It has been as low as 45 and as high as 56. My most recent result was 50 on May 1, 2017. My BP is on the low side (116/70 is typical). I have extreme GERD and have taken Protonix for more than 10 years. I also take Meloxicam for inflammatory arthritis. I have recently discontinued Plaquenil as my arthritis has improved. When I question my primary care physician, he says not to worry about the low eGFR. I can’t help but worry, though, when I see my lab results that say results in the 30-60 range indicate Stage 3 renal disease. Should I be concerned? Thank you.

The Meloxicam that you mention can decrease kidney function. I suggest that you visit with your physician about the abnormal kidney numbers. I cannot make a specific diagnosis based on the information that you present. If your estimated glomerular filtration rate (eGFR) has been less than 60 milliliters per minute per 1.73 meters squared and has been present for four years, this would qualify as Stage 3 chronic kidney disease (CKD).  I also suggest that you have urine testing for blood, protein and infection in the urine.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing

Are jaundice and kidney failure often associated? My sweetie just got out of the hospital after 30 days. His sole kidney is not working properly and he has started dialysis. I expected him to be puffy or swollen, but was completely shocked to see him yellow. I haven’t had much success googling this. Thanks for your feedback.

Jaundice is not usually associated with kidney disease, but if the original disease was liver disease and the kidney disease followed, this could be the case. Patients on dialysis are often anemic and this can have a sallow or yellow appearance. I am not able to make a specific diagnosis based on the information that you present. I suggest that you and your friend visit with his physician about the concern.

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions

My question is regarding my boyfriend, who is a type 1 diabetic and has kidney disease. In May of this year, his GFR was 80 and now today his GFR is at 18. His kidney doctor is speaking of dialysis and saying he needs to find a treatment center before his appointment in a month. He is supposed to limit potassium and phosphorus in his diet, and drink a quart and a half of fluid per day. My question is, he seems to be doing worse everyday and his face is a little swollen more and more each day. Are there any remedies that can help his kidneys function a little better such as natural remedies that he may take or drink? What do I do to help him make it until next month?

If dialysis is indicated, there are no herbal or dietary supplements that will help someone with advanced kidney disease. If he is having increasing symptoms, I suggest that your boyfriend contact his nephrologist for advice.

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, GFR, Herbal Supplements in Kidney Disease/Failure, Kidney Failure, Kidney-Related Health Questions, Nephrologist

Does a PET scan harm kidneys? I have ckd stage 3 and a PET scan is scheduled for me on 9/29. Could it be harmful or even kill my kidneys?

A Positron Emission Tomogram (PET) scan is generally done with radioactive isotopes and does not pose any problem for patients with chronic kidney disease (CKD).

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Symptoms and Side Effects

Hello doctor. I am from Pakistan. I had stones in my right kidney and was discharged before 2 weeks, but I still feel pain in my kidney. My uric acid is 6.2. My blood urea is 43 and creatinine is 2.1. Please suggest what I should do.

I am unable to make a specific diagnosis based on the information that you present. You should consult with your physician and your urologist about your pain. I am a nephrologist and not a surgeon. I do not have any experience with surgical care of kidney stones and you urologist, who is a surgeon, should be able to assess your pain and make recommendations regarding care.

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Urological Issues

Hi, My mother needs a hemodialysis access for her failing kidneys. She has been as low as 12% but the latest is 17%. She had pre-op testing to form a fistula, and scheduled surgery. At surgery, she was put under, and an ultrasound determined that her veins/arteries would not support a fistula. Now she is being advised to have a graft and has it scheduled a week from today. So my question is: If an ultrasound can determine the viability of a fistula, is it not worth having another exploratory ultrasound done to be sure there is no location that a fistula would be fabricated? And while there under the ultrasound, if it is verified that her veins are too weak, at least they could view and make a plan for the graft ? The surgeon’s decision to not do the fistula was one persons view at one point in time. Should we not seek further verification? Thanks you.

I am a nephrologist and not a surgeon. In this instance, a repeat ultrasound and Doppler examination is unlikely to show new findings. The size of the veins and arteries do not change in a short time. A graft in done with much larger veins at the elbow or in the upper arm. I suggest that you ask the surgeon for clarification of the issues regarding the planned surgery and the surgical plan.

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist

Why do I have to drink excess fluids to urinate? If I don’t drink an excessive amount of water I cannot urinate at all.

The amount of urine that you produce, if you have normal kidney function, should be about one half liter less than the liquids or fluids that you take in.  The only times this is not the case is if your have unusual sweat losses or losses of fluid by vomiting or diarrhea.  I suggest that you review your concerns with your physician.

Posted in Ask the Doctor, Kidney-Related Health Questions