I recently had a microalbumin creat ratio urine test with a new doctor. The results were creatinine, urine = 74.50 mg/dL, microalbumin, urine random = 3.1 mg/dL and micro alb creat. ratio = 42 mg/g. A simulation test was done in 2010 with the results as follows : micro alb urine random = 0.3 mg/dL and a micro alb creat. ratio = 6 mg/g. I am diabetic with my A1C around 7.1 on average. My A1C during this time period was 12.2 after a prescription change. I asked my doctor about a retest to confirm and he told me again in a year after putting me back on my old original diabetes medication. My question is, should I be concerned about these new numbers? Should I get a second opinion? Do these numbers represent stage 2 kidney disease. My new doctor is young and seems overwhelmed with a new patient overload and I don’t want to offend him by requesting a second opinion or additional tests. I’m just concerned. Thank you.

A normal microalbumin to creatinine ratio is less than 30 milligrams per gram of creatinine (mg/g). Hence, your result that you mention of 42 mg/g is mildly elevated and has increased from the prior result that you mention of 6. In order to qualify as Stage 2 chronic kidney disease (CKD) and diabetic kidney disease, this must be present for at least three months. Your result, while high, may just be a temporary change. If your diabetes is now under better control, your blood pressure is controlled and you are otherwise caring for yourself, then a follow up in 3 to 6 months might be appropriate. If the microalbumin result continues to increase, then the addition of an ACE-inhibitor or an ARB agent may be indicated. Poor diabetic control is a risk factor for the development of diabetic kidney disease. You should target your Hemoglobin A1c (HgbA1c) between 6.5-7.5%.

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Serum Creatinine

Hi, I’m a 60 year old woman with CKD IIIa (I only have one kidney); I noticed on my most recent test results that the random urine was 49.06 mg/dl, which is higher than usual. That kind of scared me, although all the other tests look okay. The last random urine was 10; time before that, 27. I have an appt, but am worrying myself to death.

I am not sure what urine test you are inquiring about. If this is a random urine creatinine test, it is of no significance. Random urine creatinine tests are not used to diagnose chronic kidney disease (CKD). In order to consider any other possibilities I would have to know what was tested in the random urine test.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

Hi Doctor, My mom is 48 years old. She has a creatinine of 4.33 and potassium 5.7. She was continuously taking medicines for creatinine. But still it is not reducing. Previously she had high WBC. Could you please let me know what to do?

I am unable to make a specific diagnosis of kidney disease based on the information that you present. Your mother appears to have significant kidney disease, but I cannot tell you why without performing a complete history and physical examination. I suggest that you visit with your mother’s physician and ask for a specific diagnosis as to the cause of her kidney disease and this will lead to appropriate treatment.

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions

Hi! My mother is undergoing dialysis since last year, however instead of getting better after the dialysis, she’s more often got exhausted. Her current ultrasound has a remark of nephrolithiasis right – small stone measuring 4.19mm and mild hydronephrosis grade 2 left. These are medical terms which I want to understand more. Can you please simplify and explain her condition in English or common languages that we could easily understand? Further, is dialysis only remedy for her or other means of medication will do? Your reply would be highly appreciated. Thank you.

The ultrasound report that you mention suggests that there is a kidney stone in your mother’s right kidney that measures 4.19 millimeters in diameter. There is also changes in the left kidney that suggest a mild obstruction. This does not explain the cause of her kidney failure.

If your mother has kidney failure, then dialysis or transplantation would be the only considerations. Dialysis can also be done at home with either peritoneal or hemodialysis done in her home. If your mother is not getting significant improvement in her symptoms, another form of dialysis or kidney transplantation should be explored with her nephrologist.

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

Hi Dr. Spry. I am 20 years and diagnosed with juvenile hypertension. I use Lisinopril daily. I once did a renal ultrasound, but I am not sure as to whether I needed to do a proper renal scan so as to be sure that my kidneys are in place. Also, do I need to check my kidney state regularly while using the drugs. I am not sure if there are long term effects of using Lisinopril tablets. Thanks.

A renal scan in not warranted unless your blood pressure fails to control. If your blood pressure is well controlled on Lisinopril, then no further testing should be required. I do recommend that you have blood and urine testing for your kidney function at least annually to follow up on your high blood pressure (hypertension). If you decide to become pregnant, the Lisinopril would have to be stopped and another drug substituted.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions

Hello! I’ve been concerned about my health for a long time already but unfortunately I live in 2 countries and the doctors can’t see my medical records from both countries. I’ve been having constant UTI’s, hematuria and anemia since I was little (I’m currently 19 years old). They even took a kidney biopsy when I was around 10 years old. When I was 16, I got into a hospital due to back pains and heavy shaking and they thought I may have Nutcracker’s syndrome but they couldn’t put the diagnosis since I wasn’t in a country I was currently living in so they asked me to visit a doctor in the other country. They didn’t find anything in the other country. Over the years I’ve had a lot of UTI’s and visited a lot of doctors in the country I now live in and I’ve also always had blood in my urine but they just always write it down as “periods” even though I didn’t have my periods on any of the times I gave a urine sample. My concern now is that I’ve been feeling dizzy, had lower back pressure and even fainted a few times over the past year and it seems to worsen with even short periods of running or even regular walking. I also yawn every time I walk faster or run (eg. physical exercise). So should I be concerned or what should I do? I’d also love to exercise but I’m afraid it’d just worsen my health. And is it possible that I have Nutcracker’s syndrome? I’ve done a lot of research on that and the symptoms are there. Thank you beforehand.

The Nutcraker syndrome is usually diagnosed when someone has the left renal vein overlapping the upper part of the superior mesenteric artery in the left abdomen. It is commonly associated with blood in the urine but pain is not as common. The diagnosis is commonly made with ultrasound examination or contrasted computerized tomograms (CT scans) or contrasted magnetic resonance imaging (MRI).

I am not able to explain most of your symptoms. I suggest that you continue to visit with your physician and see if you have had any clear evidence of this particular abnormality. I would also suggest that you continue to exercise and maintain a healthy lifestyle.

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

My Mother is 72 and has 1 kidney. She lost the other to cancer. She is now suffering from severe vertigo. Her crystals need to be realigned. She has a complete loss of appetite and barely drinks a full glass of water a day. She has lost over 60 lbs in 3 months. We are extremely concerned about her kidney function. The audiologist says she needs therapy but she has just given up and I am desperately afraid she will have kidney failure. I am telling my father to get her to the hospital for hydration but the DR office is saying it wil not help her and get her to therapy.

I agree with you that your mother needs to be seen and evaluated by her physician. I do not believe that vertigo alone should be responsible for 60 pounds of weight loss. I suggest evaluation by her primary care physician (PCP).

Posted in Ask the Doctor, Kidney-Related Health Questions

I have had nephritis in the late 80’s, swelling etc…checked for cancer none indicated. They gave me an antibiotic and it went away. In 2014, thought I may have problems, but negative results. A few months ago I had blood work done included kidney, it flagged a little high .90. Had another one done last week, it said .92, The last several days I have had very painful right side going across the lower abdomen, down the leg (outer thigh). The past month I’ve had dry eyes, mouth, exhaustion (also with fibromyalgia), and on and off nausea with some burning and pain in the upper part of the stomach. Could this be indications of a kidney disease with a number in the 90s or even kidney infection? I have had these problems for quite some time, worrying that it has been a kidney problem and went unknown. Doctors give me test results, one says this and that is a little high, the last one just showing on my chart without any explanations and I don’t understand any of the results. I also had 2 positive test many years ago for RA. Which can affect the kidney, but I never took the medication. I went to a specialist last week, one of the results showed no sign of RA. I don’t know yet for sure until all the test come back. Need to call to see if last test had come back, not showing on the chart if it has. My question is, should I have concern and see a kidney specialist with this number and pain in the area, soon?

I am unable to make a diagnosis of kidney disease based on the information that you present. I do suggest that you also have a urine test for blood, protein and infection. I suggest you see your primary care physician (PCP) for further testing. I do not see an indication for you to see a nephrologist at this time.

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

My sister is having chronic kidney disease and her age is 27. Creatinine is 5.3, eGFR is 10ml, urea is 88. She has an issue in her heart vein as well. Is kidney transplantation a must? Is there any way to cure? If at all kidney transplantation is required, which surgery should take place first. Kidney or Heart?

I am unable to provide medical advice without performing a complete history and physical examination. Your sister appears to have advanced kidney disease, but I cannot tell if this is acute kidney injury or chronic kidney disease (CKD). Your sister needs further testing that might include an ultrasound examination of her kidneys. If kidney transplantation is to occur, the heart issues must be dealt with first. I suggest that your sister continue to work with the physicians who are caring for her.

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Transplantation

I recently had a test and the proteinuria was 947. Is this anything to be worried about?

I am unable to make a specific diagnosis based on the information that you present. The normals for protein in the urine are either less than 0.2 milligrams per milligram of creatinine or less than 200 milligrams per gram of creatinine. I suggest that you review this with your physician.

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