Hi I have wanted to donate a kidney for years. I was diagnosed with stage 1B squamous cell lung cancer in 2012. The left upper lobe was removed and I had one dose of chemo which almost killed me. It will be 5 years on Aug 20 2017. Can I donate a kidney or is it to risky? My age is 58 yr old female otherwise in decent health.

It is unlikely that you could be a kidney donor with a history of lung cancer.  It is your right to offer to donate, and each and every transplant center determines who can and cannot be a kidney donor.  There are no nationwide guidelines that are accepted by all transplant centers.  Hence, you could offer to donate, but with a history of lung cancer, I do not think most centers would be interested in offering you the chance to be a kidney donor.

 

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Living Donation, Symptoms and Side Effects, Transplantation, Treatments

My brother is awaiting a second kidney transplant. His first transplant was 7 years back. Dr’s are saying his PRA levels are very high. He has HLA Class I PRA -7% and HLA Class II PRA -91% (tests done in Feb 2017) What are options to reduce PRA and can continuous dialysis for some more time reduce PRA? He started dialysis again in Feb this year and he had few blood transfusions in Jan & feb this year.

Panel reactive antibodies (PRA’s) are immune proteins in the blood that are non-specifically directed against potential kidney donors.  In some cases, the exact Human Lymphocyte Antigen (HLA) type can be detected, but in some cases, we do not know the exact antigen that is reacting with the antibody.  The antibodies are generally caused by prior blood transfusion and prior transplantation.  This appears to be the case for your brother.  Reducing the PRA’s is not an easy task.  There have been many attempts using apheresis separation techniques, immunoabsorption, intravenous immune gamma globulin infusion and very sophisticated techniques of immunosuppression, but most reports are mixed results.   Conventional hemodialysis does not remove or reduce PRA’s.  In most cases, it is necessary to just wait for the right kidney to come along that is matched to your brother, but this can take some time.  I suggest that your brother discuss the PRA testing with his transplant nephrologist.

 

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Living Donation, Symptoms and Side Effects, Treatments

Hello Dr. Kindly, I have a question about “men’s multivitamins”, especially (One A Day Men’s Health Formula).? I have a kidney transplant in 2010, a good creatinine rate at 1.3 and stable. Is it safe to use One A Day® Men’s Health Formula?

A multiple vitamin sold over-the-counter is safe for a kidney transplant patient to take.  This particular vitamin is common and should be safe for you.

 

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

I started home hemodialysis about 10 months ago and I’m concerned about shortness of breath that I’m having recently. I am trying to figure out a number for the amount of fluid I can safely remove in a run of dialysis. I found a formula that says under 10mL/kg/hour is safest but I tend to break medical formulas. I am 7 feet tall and my dry weight is approximately 173kg; I am about 25% overweight (my ideal weight as far as anyone can tell me would be about 135kg). Using this formula I calculate I can remove almost 7L of fluid in a 4 hour run and still be in the safest range for CV complications. I am currently removing a maximum of 4L in a 4 hour run but recently this doesn’t seem adequate as I have had to have several “catch-up” dialysis sessions to keep my fluid weight down. Does this formula work for me? If needed can I safely remove more than 4L during a run? I should add that I have high blood pressure that never goes low after HD.

Very large individuals, such as yourself, have a very hard time maintaining fluid balance with dialysis only three times per week.  While the formula that you mention is one that I also use, it may not be appropriate for large people.  For very large individuals, increasing the number of dialysis sessions per week may be necessary.  This can be accomplished with home hemodialysis.  I suggest that you discuss more frequent dialysis with your nephrologist.  With more frequent dialysis, it may be possible to bring your blood pressure down into the normal range.   In general, hourly fluid removal rates of less than 13 milliliters per kilogram of body weight per hour is safe from a heart point of view, but some individuals can tolerate more than this and others are unable to tolerate, leading to increases in the number of weekly dialysis sessions.

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

My wife is 51 years old. Her creatinine level was always below 0.97. On 18 April, her creatinine level rose at 1.41 and gfr was at 51. On 25 May her creatinine level was 137.6 umol/L and gfr went down to 37. In the 1st investigation period she was having fever and in the 2nd investigation period she had coughing. Now her creatinine level is 1.55 even though she is on 30gm protein level diet plan. What is the cause of quick drop of her gfr?

I am unable to make a specific diagnosis based on the information that you present.  This appears to be something that is causing acute kidney injury.  I recommend consultation with your physician and further testing as to why she is having acute kidney injury.

 

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects

My question is out of desperation. My husband has suffered kidney issues since he was 12. And at the age of 35 and after many kidney surgeries and procedures had his left kidney removed. It was not draining correctly causing severe pain and after several attempts to repair it, the doctors decided removing it was the best option. Now he is having similar problems with his other kidney. After research of my own, I went to the local urologist here and told him I thought my husband had a floating kidney. He said he had never heard of that but thought it made sense. He did all the tests and said, yes, that his kidney was moving and that was what was causing the pain and why it was not draining. He said he would look into the surgery and put in a stent for the time being. When we went to the followup, we were treated much different. We were told that floating kidney was not real and they would not do the surgery and all they would do is put in stents. I guess my question is, how can a Doctor say something he can see with a test is not real and where do I go from here for treatment. There is a surgery out there that can fix this but instead my husband is forced to suffer and live a life in pain.

I have never heard of a floating kidney.  I understand that this term used to be used years ago to describe pain moving around in the back, but the kidney only moves up and down when you breathe.  Everyone’s kidneys move up and down when we breathe.  I am not a urologist.  I am a nephrologist.  I have never heard of any surgery done for a floating kidney.  I can only suggest that you seek a second opinion from another urologist.

 

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Urological Issues

I have a family history of CAD, hypertension and kidney failure. I am 40 year old, normal weight, non-hypertensive, non-smoking, non-drinking female taking only levothyroxine for my thyroid. All of my labwork is within normal range except my GFR, which is 59. What does this mean for my kidneys?

Normal kidney function is to have an estimated glomerular filtration rate (eGFR) greater than 60 milliliters per minute per 1.73 meters squared. I am unable to make a specific diagnosis based on the information that you present.  This may be mildly abnormal.  I suggest that you discuss your concerns with your primary care physician (PCP).  I also recommend that you have urine testing for chronic kidney disease (CKD) that includes blood, protein and testing for infection.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

What is the best solution to use for a cleanse before a colon exam?

Before a colon examination, such as a colonoscopy, I recommend use of laxatives that contain polyethylene glycol plus electrolytes (such brand names as Miralax, Golytely, Nulytely and many others).  I do not recommend Magnesium Citrate or Fleets Phosphasoda.

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Treatments

I have three kidneys. I had a CT scan and they said one of the kidneys was black. What does that mean and what are the risks?

The medical term for multiple kidneys is “supernumerary kidneys”.  This is a congenital condition and means that you were born with extra kidney tissue.  This extra kidney may or may not work properly.  I do not understand the term “black kidney”.  This is not a term I use or understand.  I suggest that you discuss your concerns with your physician.

 

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I am male 82 years old. I tested today for 2.0 creatinine. I have been taking for a long period of time 3mg a day of Ativan and 400 mg of Ibuprofen. Could these medicines affect the creatinine level and if so would it raise them that much? About a year ago, it was less than 1.3 and I have only tested again this year to find the high increase.

Ibuprofen can reduce kidney function and should not be taken long term.  I suspect that the abnormalities in your kidney function may be related to the ibuprofen.  I suggest that you stop this medication and then see your primary care physician (PCP) for followup regarding your abnormal kidney function test.  You should also have testing of the urine as well looking for blood, protein and infection.

For more information on pain meds click here:

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments