My 92 year old father is level 3 based on his eGFR of 37. BUN is 25, Cr 1.60. MD did not check albumin. He has hx of heart failure, respiratory problems, elevated PSA and recently his glucose has been elevated. Was 85 in Oct., was 145 in Jan….is being rechecked (he loves candy). BUN/Cr ratio was 16. Realistically, what would be a reasonable action?

I am unable to recommend treatment or medical management without performing a complete history and physical examination.  Your father has a number of complex medical problems and this is best managed by his primary care physician (PCP) in consultation with other specialists including a cardiologist and nephrologist.  You should also visit with your father to see what his desires and preferences would be.  I would suggest that you attend one of the visits of your father with his PCP and ask what treatments are recommended and then discuss your father’s wishes in regards to his treatment.

For general information about CKD please click here. 

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

I recently had 2 PCNL’s. First one in April, 2nd one in August. I had a staghorn that was a 3CM stone with horns filling th pelvis of the kidney, and another horn 2.1 CM in the anterior of the kidney. They could only get the stone and horns in the pelvis in the first surgery. Second surgery they went in and got the rest of the staghorn out. Unlike the 1st surgery, I did not get out of the hospital the next day. I spent 3 days in SICU and 2 more in the hospital and missed a month of work. I had a temp of 103, and an infection. I had allergic reactions to 3 of the antibiotics, and was given antibiotics non stop the entire 5 days and an oral on to take at home, that I also had an allergic reaction to. My GFR had been close to 60 most of the time before the 2nd surgery. Since then it had dropped to 45, then 41 then 38. Being a diabetic, I had to have my metformin reduced. They said I was “low” and to drink 2 to 3 liters of water a day. My staghorn was 100% uric acid. I am drinking as much as I can, and GFR is back up to 45 as of my last test. But…my Vitamin D was 4. It had never been tested before so no idea how long it had been a 4. Taking 50,000 iu of vitamin D each week for months now, Vitamin D is only up to 21. I read where low vitamin D can indicate early kidney disease. Should I ask my doctor to pursue a kidney consult or just wait to see how high the Vitamin D can get. I think I read that it should be 70.

The Vitamin D replacement appears to be appropriate.  Normal levels are between 30 and 100 nanograms per milliliter.  Your level seems to be coming up nicely.  You should continue to monitor this with your physician.  If you are having uric acid stones, there is a treatment to prevent these stones from forming.  Staghorn stones composed of uric acid are unusual.  I recommend that you seek consultation for prevention of uric acid kidney stones.

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

I’m in stage 3 CKD due to IgA nephropathy. This has been the case for quite some years now. I’ve been asked to keep the blood pressure under control. Current medication is losartan 50mg daily. I’m successfully limiting salt to the extent that my BP is now under 100/72 all the time and the sodium levels in my blood has gone quite low. I’ve been asked to include a little salt in my diet. My question is is it better to keep blood pressure like this or to have it at recommended levels of 120? If I’m having salt which is better for me – table salt, pink salt(Himalayan salt) or Epsom salt?

I recommend blood pressure control to less than 130/80 and I feel that blood pressures less than 110 systolic are too low.  I would suggest that you target your blood pressure to be between 120 and 130 systolic.  If you add salt to your diet, I would recommend that it be just plain table salt but that you still keep your salt intake less than 2500 milligrams per day.  I do not recommend Epsom salts.

Posted in Ask the Doctor, Chronic Kidney Disease, Hypertension/High Blood Pressure, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions

For the last few years, kidney numbers have gone down. This last blood test, creatinine 1.99 and gfr 27. I have high blood pressure. I have COPD. My doctor said we didn’t need to do anything. Wait and see if numbers go up and drink plenty of water. Come back in 3 months. I’ve never talked about a diet or my meds or anything. I feel like he and another doctor, that found a spot on my throat wants to wait 2 months and see if it goes away. I’m not a good candidate for surgery because of my COPD and are just waiting for me to die. They can’t be bothered which honestly I understand. Too many things wrong. I just wish they where honest about it.

I can only suggest that you discuss your concerns with your physician.  You have many medical problems.  It is important to have frank and honest discussions with your physician.  I suggest further discussions with your physician.

For general information about chronic kidney disease please click here.

For helpful information about CKD diet and nutrition please click here.

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

My mother is at stage 5 renal failure. She lost one kidney due to cancer and the other kidney is failing. She does home dialasis every night and has encountered times when she does not urinate. I live all the way across the US from her. She was recently admitted into the hospital for fluids. Why is this? Should I be worried?

I cannot make a specific diagnosis based on the information that you provide.  You should discuss this with the nephrologist who is caring for your mother.  Once dialysis is initiated, it is common that urine output declines.

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

I am a kidney transplant patient and was operated on 26th August, 2004. I am Male and of 32 years of age. My weight is 82 kgs and height 5 feet 8 inches. My blood pressure is 140/90. My medications consists of – Nifedipine 10 mg twice daily, Cyclosporin 50 mg twice daily, Prednisolone 5 mg daily, Calcium+Vitamin D daily and Azathioprine two tablets of 50 mg daily. My creatinine level is 1.1 and Urea is 32. My haemoglobin, blood sugar and WBC levels are normal. Its been almost 12 years and I wanted to know how much more do I have to take the medicines like cyclosporine and prednisolone. I feel as if these medicines have side effects and don’t feel normal after taking them. Would you suggest reduction in any of the medicines?

If you have a well functioning kidney transplant, these medications should be continued as long as your kidney is functioning normally.  The information that you provide suggests that your kidney is functioning well and stopping or changing the medication may put your kidney transplant at risk.  You should discuss your concerns with your transplant physician.

Posted in Ask the Doctor, Kidney-Related Health Questions, Medication and Kidney Function, Transplantation

I had my left kidney removed 5 months ago because of a huge kidney stone and since my surgery I have been passing sand size stones and one bigger one. This wasn’t happening before my surgery. Is this normal to pass stones after my surgery?

I cannot make a specific diagnosis based on the information that you provide.  If you are continuing to pass stones, you should ask your physician to analyze some of these stones and determine what type of stones are being passed.  This would lead to a more specific diagnosis and then proper treatment can be prescribed that may prevent future stone formation.

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

I am 30 years old and have had type one diabetes for 27years. I went to the go recently for a suspected UTI. Results showed I had white blood cells in my urine and my kidneys were leaking a high level of protein. My GFR is 80. My doctor wants to wait to see if an infection turns up and deal with my leaking kidney at a later stage. Is this the right approach?

A urinary tract infection (UTI) can cause protein in the urine.  I believe that your physician is acting appropriately.  You should continue to follow with your physician.

Posted in Ask the Doctor, Kidney-Related Health Questions, Proteinuria, Urinary Tract Infection/Pyelonephritis, Urological Issues

I am 49 years old. I have given blood for kidney test as a results my S.Creatinine is 1.10 mg/dl is it ok for me ? I have in Pre dibetes.

I am unable to provide a specific diagnosis based on the information that you mention.  You should also have urine testing for blood, protein, and infection.  I suggest that you use our web site to calculate your estimated glomerular filtration rate (eGFR) based on your vital information.  You can access our calculator at our web site at:

You should then discuss this with your primary care physician (PCP).

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Risk factors

Are there any health conditions that would prevent someone from being a kidney donor?

There are a number of health conditions that would prevent someone being a kidney donor.  Each individual transplant center determines the criteria they will use to accept someone as a kidney donor, so there are no nationwide standardized criteria for evaluating and deciding who will and who will not be a kidney donor.  Heart disease, cancer, diabetes and older age are the most common reasons why someone may not be accepted as a donor.

For more information about living donation please click here.

Posted in Ask the Doctor, Living Donation