my husband have a 19 mm calculus in left renal pelvis and 5 mm calculus in left kidney. Is surgery the only remedy to remove it? Is there any other chance. Can it be cured by medicine?

The 19 millimeter (mm) stone is very large and will likely require surgery.  There are no medications that will reliably cause this large of stone to pass.  I do not perform surgery.  I am a nephrologist.  You should discuss this with a urologist who is a surgeon.

Posted in Kidney Stones, Kidney-Related Health Questions, Urological Issues

My father is suffering from CKD as per the doctor advice. He is undergoing dialysis twice a week. His creatinine level was 6. Now my father is taking a Dytor 40 tablet. If he takes the tablet twice a day he can urinate 1200ml/day. If not he urinates around 300 ml/day. Does dialysis need to be continued or is it not necessary?

I cannot give medical advice without performing a complete history and physical examination.  The amount of urine that is produced is only one consideration.  The levels of blood chemistry is also a consideration.  You should discuss this with your father’s nephrologist. Traditional dialysis is commonly performed three times weekly and not twice weekly.

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

My husband has retrigrade ejaculation. He had bladder surgery during childhood. He is having problems after an orgasm. After orgasm, he will feel the need to urinate but it will burn in his ureathra. He will continue to have the sensation of needing to urinate for around 30 minutes and it will continue to burn. He has seen a urologist, but they have not been able to treat this. He also has had his prostrate checked and it is normal. We are not sure where to go for help. IF you can provide direction, we would greatly appreciate it!

I am a nephrologist and do not deal with male fertility issues.  These issues are usually addressed by a urologist.  I suggest your husband see a urologist who commonly deals with male infertility.

Posted in Ask the Doctor, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis, Urological Issues

I’m 63. I have Stage 3 -GFR 50. What should my protein intake be? Weight is 200 lbs.

I do not advocate strict protein restriction in patients with Stage 3 chronic kidney disease (CKD).  I suggest you follow the DASH diet.  You can review the DASH diet at:  http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf   I generally suggest you take in approximately 0.8 and 1.2 grams of protein per kilogram of body weight per day.  Since you weigh 200 pounds, this is approximately 91 kilograms, so you could take between 73  and 109 grams of protein per day.

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

My husband has an GFR of 60 (non-AfricanAm). He thinks he has CKD now. The NKF website has a chart with 2 green boxes that say – if you GFR is a 60 and you “have no other markers for CKD” than you have NO CKD. Can you please tell us what the “other markers would be”? We have a full renal blood test from a few weeks ago. Our Nephrologist is not very helpful. We have scheduled a new appt at Mayo Clinic but that is not until May 6.

According to our recommendations at the National Kidney Foundation, in order to qualify as chronic kidney disease (CKD), you must have an estimated glomerular filtration rate (eGFR) of less than 60 milliliters per minute per 1.73 meters squared and it must be present for greater than 3 months.  If the eGFR is 60 or greater, then you must show that there are abnormalities in the urine such as blood, protein, or infection cells.  You could also qualify for CKD if you have an abnormal image of the kidney on radiological examination or with tissue examination such with a kidney biopsy.  The removal of one kidney can also qualify as CKD because of the decrease in kidney function that occurs.  These are the other markers for CKD.

Posted in Chronic Kidney Disease, Kidney-Related Health Questions

I have a kidney that the function is 15% , would there be any ways to get it to function more?

There are no medications that increase the estimated glomerular filtration rate (eGFR).  The eGFR can vary from day to day.  The eGFR may increase to 20 or decrease to 10 milliliters per minute per 1.73 meters squared, but on average the eGFR remains stable.

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

Four years ago, my husband had one kidney removed due to renal cell cancer. Just yesterday, his annual blood test came back with an GFR estimate of 56. His primary care isn’t too worried about it. He is only 42, so we are trying to keep on top of things and don’t want anything to happen to his remaining kidney.

A single kidney has an estimated glomerular filtration rate (eGFR) between 50 and 70 milliliters per minute per 1.73 meters squared.  Hence, your husband’s eGFR at 56 is likely normal.  I do suggest that your husband also get a urine test for blood, protein, and infection.  If this is normal, then your husband’s remaining kidney may be normal.

Posted in Kidney-Related Health Questions, Nephrectomy / One kidney

What are some ways to prevent or lessen the side effects of hemodialysis such as heart palpitations, shortness of breath, and dizziness?

It is important to dialyze for the full time, you should limit the amount of weight that you gain between dialysis sessions, you should follow the diet that has been recommended for you, and you should take your blood pressure at home on the days between your dialysis sessions.  You should inform your physician of your weight gains and your blood pressures that you record at home.  If symptoms persist, you may need further testing for heart disease.

Posted in Dialysis, Kidney-Related Health Questions, Symptoms and Side Effects

My gastroenterologist just suggested I take 1500 mg of Calcium daily, along with 400 mcg of Folate – because I form many polyps each year and need frequent Colonoscopies. He said these two supplements would help to prevent forming so many polyps. What I’m worried about is that I’ve had several bouts with kidney stones as an adult, and I’m worried these two supplements might cause more kidney stones? Needless to say, since they’re SO painful, I don’t want to take anything that may cause kidney stones. What is your opinion as a kidney doctor?

Taking extra calcium supplements can increase the risk of kidney stones, if you are passing calcium oxalate stones.  The most important aspect of preventing kidney stones is drinking extra water to keep your urine clear and dilute.  You should drink enough water so that you get up at least once at night to pass urine and then your drink a glass of water in the night.  The second most important thing to do to prevent kidney stones is to follow a DASH diet.  You can review the DASH diet at:  http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

The calcium supplements would be a minor factor is causing kidney stones.  This may be a good subject to discuss with your primary care physician and see what he or she may advise in this situation.

Posted in Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions

I am a female 80 years old. For the past three years I have been steady with GFR at 34. I follow the kidney diet and watch my diet very carefully. For my age, I feel great and no one believes that I am 80 years old. I am very active and stay busy most of the time. I have very little arthritis. I have HBP and take medication for it. I have been taking Synthroid 100mcg for the past five years. About six months ago, my primary doctor reduced my Synthroid to 88mcg. At my next visit to my kidney doctor my GFR had dropped to 31. I now do not feel as well as I have felt for the past three years. I feel more sluggish all the time now. I am very frustrated with my feelings. Could the decrease in the Synthroid have anything to do with the decrease in my GFR and the way that I am feeling now? I would like to go back to the 100mcg Synthroid, since I felt so much better on it than on the 88mcg. Would it be damaging in any way for me to go back to the higher dose of Synthroid.

A change in your thyroid dose should not cause a change in your estimated glomerular filtration rate (eGFR).  I suggest you continue to follow your physician’s advice.

Posted in Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Function