Dr. Spry, can Vitamin D help improve kidney function? Does Vitamin D help the kidneys?

Vitamin D is sometimes used to treat the complications of chronic kidney disease (CKD) such as secondary hyperparathyroidism with bone and mineral disease.  The vitamin D is not used to increase kidney function or treat the CKD.

 

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

A nephrologist says a person with a high risk of bleeding can’t have dialysis because they will bleed to death. Bleeding complications that leads to death. No treatment can stop it. In this case what does the CKD patient do?

I am unable to offer a specific diagnosis based on the information that you present.  I suggest that you ask the nephrologist for clarification as to why the bleeding is occurring and why dialysis is not an option.

 

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Treatments

I am concerned about my kidney function. I am a 56 years old, white male in seemingly good health. About three years ago the doctor measured my GFR at 93. A year ago, my GFR had dropped to 82. I also had a kidney stone removed at that time. My GFR is now at 83. I’m concerned that my creatine levels increased so abruptly. How concerned ought I be about this? Should I have more tests run? What should I do now? FYI: I am generally healthy, except for occasional bouts with constipation (especially on weekends and long holidays). All of my other serum levels are normal (see below). My doctor is tells me I’m healthy, but based on what I found here (looking up GFR), it looks like I have Stage 2 kidney disease. My diet is very similar to the DASH, except that my wife likes to cook with a little more salt than I wish. My weight is good (I’m 5’8″ and 135-145 lbs). Also, my GI doctor had me on Nexium for nearly 3 months for gastritis. Recent Serum levels: SODIUM 137 POTASSIUM 4.5 CHLORIDE 102 GLUCOSE 80 UREA NITROGEN 9 CREATININE 1.01

I do not identify any kidney disease based on the information that you present.  There is some variability to the estimated glomerular filtration rate (eGFR) and the two levels that you mention are within the usual range of variability for normal kidney function. I suggest that you follow your doctor’s advice and perhaps be retested at a later date to see if your eGFR stays in this general range.

 

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

I am a kidney donor. I have pain in my upper right side. The doctor did a US abdomen. He says I have some kidney swelling. Would a CT (I’m allergic to iodine dye) or an MRI be a better exam for me.

I am unable to recommend medical testing or management without performing a complete history and physical examination.  Testing with computerized tomography (CT) scanning or magnetic resonance imaging (MRI) is done for specific reasons.  I suggest that you consult with your physician to see which imaging test will be most likely to yield the best information.  CT scanning can be done without iodinated contrast and could yield some information.  MRI scanning sometimes is done with contrast that does not contain iodinated contrast and could be helpful if contrast is needed to get the appropriate information.

 

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

Does dialysis warrant daily narcotic use? I am concerned for a dialysis patient that takes a minimum of 6 10mg hydrocodone and 400MG neurontin daily. ESRD, no other current medical issues.

Daily use of potent narcotics in patients who are on dialysis is not usually warranted.  I am unable to make any other specific diagnosis based on the information that you present.  I suggest that the dialysis patient make sure that his or her nephrologist is aware of the use of these agents on a daily basis.

 

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Medication and Kidney Function, Nephrologist, Treatments

I have recently been diagnosed with acute kidney disease. My GP has taken me off my anti-inflammatory Voltaren 75mg slow release. Before this I had been popping advil. I have a lot of arthritis and other inflammation going on and her offer of Tylenol does nothing for me. I have ordered a joint formula called Pro Flex by Naka, which does contain a form of curcumin. My doctor is not willing to discuss herbal therapy at all but a pharmacist told me I should stop taking the tumeric capsules I had started on. So I am kind of confused as to whether I can take this joint formula. I have been referred to a kidney specialist but it could take forever to get in. I also have high cholesterol but went off the drugs a couple years back due to muscle pain and cramps. Could high cholesterol cause elevated creatinine readings? I am finding it difficult without the anti-inflammatories and hope I can take this joint formula at least. Any advice would be appreciated.

Non-steroidal anti-infammatory drugs (NSAID’s) such as Advil and Votaren are associated with kidney disease and should be stopped.  Your kidney function may improve off of these NSAID’s and your physician likely wants to remeasure your kidney function off of all of these medications to learn if this is the problem.  I have no information about the herbal medications that you mention.  I am not sure what they could be doing to your kidney function and would recommend that you suspend use of these medications until all of your testing is complete.  Most herbal agents have never been tested in patients with chronic kidney disease (CKD) and hence your physician is trying to make sure your kidney function returns to normal.  If it does not, then further testing may be needed.

 

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments

My 88 year old husband has just been diagnosed with impaired kidney function (raised creatinine level on blood/urine testing). He has been advised that he needs a referral to a Nephrologist but there is a delay in this happening. In the meantime, he is suffering attacks of diarrhea on most days. I am currently modifying his diet in line with the advice on your website but, in the meantime, would you consider his diarrhea is related to his kidney impairment or should we seek urgent advice regarding this? He is losing weight, muscle, tone and strength too. Multiple myeloma has been ruled out by the Oncologists. Many thanks, in advance, for any advice you can give me whilst waiting for his referral.

Diarrhea is sometimes seen in late stage chronic kidney disease (CKD), but it not a typical finding in earlier stage chronic kidney disease.  Diarrhea can lead to dehydration which can make CKD worse and may lead to acute kidney injury superimposed on CKD.  If there is ongoing diarrhea, replacement with a sports drink and continued hydration will be important.  I would suggest that you consult with your husband’s primary care physician (PCP) about evaluation and treatment of the diarrhea.

 

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

An 83 male diabetic on hemodialysis for 7 yrs wants to discontinue treatment for reasons other than medical. No family, no income, cannot do without support. He cannot stand up on his own due to balance problems. Wants to discontinue HD. Can expect to stay alive for how long after stopping HD? Do not want suffering. Can you advise?

If someone stops dialysis after being on dialysis for seven years, it is unlikely that he will live for very long.  In most studies, patients who stop dialysis after being dependent on dialysis for 7 years will die within two weeks.  I suggest that you discuss this with a Hospice physician or a Palliative Care physician to determine whether this fellow can be helped with either Hospice or Palliative care.

For more information on choosing to stop dialysis click here:

 

Posted in Ask the Doctor, Dialysis, End of Life Issues, Kidney Failure, Kidney-Related Health Questions

I am taking blood thinners for a clot in my leg. I have stage 3 kidney disease. What are the risk?

Patients with Stage 3 chronic kidney disease (CKD) can take blood thinners but they should be carefully monitored with blood testing and monitored for bleeding.  Most blood thinners are approved for use in Stage 3 CKD.  You should discuss your concerns with your physician.

 

 

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

Hi, the patient has pain on her back, got done many tests and finally went for biopsy test, below is the test report. The doctor said nothing to worry just control blood pressure and stress and use less salt in food. But I consulted few other doctors, they said it is benign condition and can lead to kidney disease after 10 or 20 years but it is rare. It is a chronic kidney condition and has no treatment. Maybe after 20yrs, if unlucky can lead to end stage kidney disease. Another doctor says might the kidney have only 10yrs of life. Histopathology Report Clinical Data: Patient has microscopic hematuria, Negative family history. Specimen: A Light microscopy in formaldehyde. B. immunofluorescence in Michel’s medium. Diagnosis: IgA nephropathy with mesangial proliferation. Oxford classification score (M1E0SIT0). Interstitial fibrosis and tubular atrophy constitutes 20% No activity and mild chronicity Description: H&E, PAS, and trichrome stains. The biopsy consists of renal cortex containing 10 glomeruli. Seven glomeruli show segmental mesangial hypercelluarity (M1), without endocapillary proliferative lesion ( no celluar cresentsand no fibrinoid necrosis) (E0). Segmental sclerosis and adhesions to Bowmans capsule is seen in one glomerulus. (S1), no globally sclerotic glomeruli is seen. Thrichrome stains demonstrate segmental small mesangial red deposits. Blood vessels show mild degree of arteriolosclerosis. Interstitial fibrosis and tubular atrophy involves 20%of the cortex (T0) Immunofluorescence Microscopy (IF): Insufficien, renal medulla only. If stain performed on paraffin embedded tissue and show a cortex with 7 glomeruli. IgG: Glomeruli, negative. Tubules, 1+protein resorption droplets. IgA: Glomeruli 3+ granular mesangial staining. Tubules, negative, IgM: Glomeruli negative, Tubules, negative. C3: Glomeruli negative. Tubule: negative. C1q: Glomeruli, negative Patient Details : Female 26. Please give a Good Opinion on this report. I’m so confused and lot worried.

IgA nephropathy is a relatively common type of glomerulonephritis and has a variable course.  Some patients have only blood in the urine.  Others have protein and blood in the urine.  I am unable to give a prognosis without performing a complete history and physical examination.  You can go to our web site and learn more about IgA nephropathy at:  https://www.kidney.org/atoz/content/iganeph

 

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