What is my brothers prognosis? He is 59 yrs old, has Type 2 diabetes, kidney failure, on dialysis 3x/wk, cardiovascular disease, peripheral neuropathy, high blood pressure, vision loss, confusion, above the knee amputation, addiction to marijuana, very moody, angry, and nasty. Does not watch his diet or exercise.

I am unable to provide a prognosis without performing a complete history and physical examination.  With the information that you present, your brother is very ill.  His life expectancy is likely very short.

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Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing

How do you treat CKD patients with atherosclerotic disease of the left common carotid artery? What medications do you give to treat the atherosclerotic disease?

Hardening of the arteries (atherosclerosis) is a disease of blood vessels associated with high blood pressure and elevated blood cholesterol levels.  It is also passed down in families and is thought to be related to genetics.  The treatment in patients with chronic kidney disease (CKD) is the same as treatment in people who do not have CKD.  Blood pressure control should be established to less than 130/80.  Blood cholesterol levels should generally be treated with a statin drug.  If diabetes is present, diabetes should be carefully controlled.  You should maintain a healthy body weight, follow a low salt diet and exercise on a regular basis.  If the narrowing in the left carotid artery is significant and there are symptoms related to the narrowing, surgical treatment may be needed.  I also commonly recommend treatment with low dose aspirin.

 

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Treatments

Good morning. For the last approximately two months I have been into hospital for my colonoscopy. I’m required to have approximately every two years because of family history. When I spoke to the Anesthesiologist, I mentioned a burning around my kidneys that occurs even if I do say for example my housework? Wandering if I need to have a check. I’m 61 almost and I am very healthy and give Plasma and Blood. I was thinking about going on the Bone Marrow register.

I am unable to provide a specific diagnosis based on the information that you present.  There are many causes of a burning sensation and chronic kidney disease is not a common cause of this burning sensation.  If your symptoms continue, I suggest that you consult with your physician for an examination and further testing.

 

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

Dr Spry; My new Doctor ran a complete panel of blood work and my GFR came back at 52 on 1/3/17, (after two days of symptoms of diarrhea and taking 4 tablets of Imodium to stop it.) She listed in my file stage III CKD. I was unaware I was ever even a stage II! I called her about it and reminded her I had been sick the day before the test and I was fasting. I had submitted a non-fasting blood test before our call and during the call she gave me the results of that test, but had not re-tested for the GFR. When I asked why not she said “If I can catch the blood at the lab, do you want me to run it again?” I said absolutely, I think we need to. Well now she says it came back at 61 and in her words ” I am now normal and has changed my diagnosis in my record as stage II. I don’t know what to think or what to do now. Suggestions?

Chronic kidney disease (CKD) is diagnosed when there has been an abnormal test for at least three months.  If these tests were done days apart, then CKD cannot be diagnosed.  This may have been an episode of acute kidney injury related to your diarrhea episode.  I suggest that you allow some time to pass and then see your physician for further testing to include a serum creatinine, a calculated estimated glomerular filtration rate (eGFR) and urine testing for blood, protein and infection.  If the test remains abnormal, then further testing for CKD may be in order.

 

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

I was given 5 fluorourcil injections for squamous cell cancer on my nose, some months ago. NOW with a kidney problem, I was given a blood test which showed a 23.8 in the (6.0-20 )scale. Which is high. A computer article by a doctor, I presume, said that the test would be invalid in the presence of fluorocytosine. Could this be the case for 5 fluorourcil.

I do not know what test you would be referring to. 5 Flourocytosine and 5 flourouracil are different compounds and I do not know what test they would interfere with.  I suggest you consult with your physician for further clarification.

 

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

Five months ago My daughter (44yrs) was told she has HSP Henoch-Schonlein Purpura. It started with rash on legs that spread throughout. Her kidneys are leaking protein and blood and she is retaining fluid in her legs and painful joints. Her own immune system is destroying her cells and was put on an immunosuppressant drug and mega doses of steroids. Her bowels were bleeding caused by capillary leakage. She had skin biopsy on her rash for Lupus, Lyme and cancer and all negative. Kidney function blood tests are normal. Tomorrow she is scheduled for kidney biopsy to determine a cause for the hematuria and protein that persists in her urine. Have you heard of this virus (in an adult) attacking the kidney and the consequences of this virus ? I would appreciate your views.

Henoch Shoenlein Purpura (HSP) is not caused by any virus that we know of.  The cause of HSP is unknown.  I suggest you wait for the results of the kidney biopsy and then follow the advice of the nephrologist who is caring for your daughter.

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Nephrologist

I have stage 3a ckd. I noticed on my deodorant it said not to use if you have kidney disease. Is there a safe deodorant to use?

The deodorant likely contains aluminum and this is hazardous to kidney patients if you eat the deodorant.  As long as it is not ingested, there is no concern.  You cannot absorb the aluminum if you place it on your skin.  Using the deodorant as listed on the package should not cause any harm.

 

Posted in Ask the Doctor, Kidney-Related Health Questions

I originally posted a question on 1/17/17 about my 9 year old son. I don’t see a way to respond to the reply, but have some more information that might be helpful to others looking for information on the same thing. At his doctor’s request, I was able to scrape some off to take in to the lab, and the stone analysis came back as 65% calcium oxalate dihydrate and 35% carbonate apatite. Additionally, a 24 hour urine test indicated a calcium/creatinine ratio of 245 (normal 30-20-) and an elevated creatinine level of .81 (normal 0.11-0.68). The doctor said for him to follow a low oxalate diet and follow-up with a pediatric nephrologist, which we will. Is it important to find the cause of the high creatinine and calcium rather than just treat the symptom? I remembered that my aunt (would be his great-aunt) died from nephritis at age 7, but don’t know if that would be considered a genetic risk for him that far removed.

I am unable to make any specific diagnosis based on the information that you present.  It is best if you see a pediatric nephrologist and have further testing.  It is possible that he has a genetic kidney stone disease but further testing will be needed.

 

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Pediatric Issues, Pregnancy / Kids, Treatments

So my doctor told me to start dialysis but I pee 3 times a day or even more. How is that possible? I really don’t want to do dialysis. I would rather die then live with a machine pumping my blood 3 times a week or even do transplant because it won’t last forever.

You should have further discussions with your nephrologist.  If you feel you cannot be helped with dialysis, then perhaps consider talking with a physician or a professional about palliative care.  In some cases, people do decide to live as long as they and as well as they can, without dialysis or transplant treatments.  The decision to undertake a treatment course that includes dialysis or transplantation is your decision to make.  You should understand the risks and benefits of treatment.  If you refuse treatment, and understand the risks, then you are free to make such a decision.

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

My brother is a kidney patient and doesn’t want to have dialysis. Three days after discharge from the hospital, we observed that he keeps on smiling and talking alone. We don’t know what to do for him. He really doesn’t want dialysis when he is in normal condition.

If your brother is competent and able to make his own decisions, then it is his right to refuse care such as refusing dialysis.  I think you will have to talk with your brother and his physician.  If they both feel that he is competent to make such decisions, then you must abide by his decision.

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Posted in Ask the Doctor, Dialysis, End of Life Issues, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments