I had adrenal corticol carcinoma in 2011 my left kidney was removed as a result. Now I’ve been told I have 3rd stage renal failure in my remaining kidney. I’ve heard 2 different opinions to my question and it is; is 3rd stage kidney failure worse symptomatically and otherwise, for a person with 1 kidney vs a person with 3rd stage renal failure with 2 kidneys?

The stages of chronic kidney disease (CKD) are based on two factors.  First, is there evidence of kidney damage such as a missing kidney, abnormal findings in the urine, or abnormal radiology studies.  If any of these are present for more than 3 months, it qualifies as CKD.  Hence, with your missing kidney, you have CKD because of the reduction in overall kidney tissue and function.  The second factor is an estimate of your kidney function based on a estimated glomerular filtration rate (eGFR). The eGFR is calculated based on a serum creatinine and other variables that are entered into an equation.  You can review the equation at: https://www.kidney.org/professionals/KDOQI/gfr_calculator

Hence, your stage of CKD is then dependent on your eGFR and does not matter whether you have one or two kidneys.  You can enter your data into the equation and determine what stage of CKD you have.



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

I had a kidney tumor removed (partial nephrectomy) – was clear cell renal carcinoma limited to the kidney – grade 1 (2.4cm) but stage 4 (WHO/ISUP 4) with clean margins. Pathology said it had sarcomatoid differentiation (95% sarcomatoid element) and extensive necrosis, extreme nuclear pleomorphism, multinucleate giant cells and /or rhabdoid sarcomatoid differentiation. Adrenal gland not identified and regional lymph noded pnx (could not be assessed. Pt1a grade. 5 questions: 1. Because it was grade 4 my doctor is recommending full removal of the kidney in 6 weeks. Is that the recommended course of action – is it likely that recurrence would be at that kidney again and removal lessens my chance of recurrence? 2. Should I have a PET scan, brain scan, bone scan, etc now since it was grade 4? They are saying just a chest CT is required now? 3. Is my likelihood of recurrence or distant metastes high because it was grade 4 even though it was very small stage 1a? Lots of conflicting information? 4. If the tumor was removed am I considered disease free and now just need aggressive regular surveillance? 5. How would I know if there was microvascular invasion and is the necrosis and sarcomatoid indicators of a recurrance? I’m quite scared so thank you so much for answering my questions!

The questions that you ask are surgical questions and must be asked of a urologist.  I am a nephrologist and do not have any surgical expertise in regards to kidney cancers.  If you have concerns about the opinions of your current urologist, I suggest that you get a second opinion.  I am not able to provide any surgical advice about treatment of kidney cancer.



Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Cancer, Kidney-Related Health Questions, Nephrectomy / One kidney, Treatments, Urological Issues

Dear Dr. Spry, I am 31 years old. I am a man. I have glomerulonephritis and FSGS for 7 years. Now I take my medicine (Neoral sandimmun 4*25, Prednol 4mg/ day, Olmetec 20mg/day, Drisentin1*1) regularly but last 6 months I had problem with edema around my ankle. Besides edema I have muscle weakness and tiredness. I can’t move as I want to do. I am doing sport but It effects me very much. I can not go on long. I want to ask you how long I should take this kind of treatment? Is there any other treatments for this disease? I am desperate about my future.

Focal segmental glomerulosclerosis (FSGS) is a very difficult disease to treat.  In many cases, the disease is not cured but rather controlled.  If you have concerns about your treatment, this should be discussed with your nephrologist.  I am unable to recommend treatment without performing a complete history and physical examination.   I suggest you consult with your nephrologist.

For more information on FSGS click here:

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

My BUN/Creatinine ratio is high. What does this mean?

If your serum creatinine test and your blood urea nitrogen (BUN) test are normal, then an elevated BUN/Creatinine ratio does not signify anything.  It is a calculated value and does not make any diagnosis.


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

Hi! I wanted to know how long the best patients with a kidney transplant have lived. The question is also if those involved in kidney transplant research would like to study my dad’s case. My dad was transplanted some 36 years ago, and we were just discussing that’s been a pretty long time and a pretty good time. He has had health issues, but the kidney has always behaved. The funny story is that when he switched to a new doctor, the new nephrologist didn’t believe that he was trasplanted because the blood test results were great. It was when he explored him, touched his tummy and felt the kidney, that he said “wow! You are indeed transplanted!” We are now taking care of a likely effect of the medicine he has taken for life to keep the kidney safe, and that is what has brought us to look back to our life and how good it’s been to be together this long. If you’d like to contact us, please feel free. We would be happy to share the story as well as any information that would be of benefit to future patients. I personally cannot thank enough his surgeon, the donor and those that made this possible. My dad has been my greatest friend ever, my guidance, my family and a joy.

Congratulations to your father and to you.  This is a testament to his overall health, his adherence to his medical treatment and the miracle of transplantation.  The first successful kidney transplant was done in 1954, so kidney transplantation has only been around about 63 years (since 1954).


Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Transplantation

Sir, I am feeling pain in right and left of spinal column for some days. I also feel pain in my flanks when I wake up, for sometime. Please help me find if it is related to kidney problem and suggest me the way to cure it. Thank you.

Pain is an uncommon way for kidney disease to present, unless you possibly have a kidney stone.  I am unable to make a specific diagnosis based on the information that you provide.  I suggest that you consult with your physician for an examination and consultation.  You need further examination.

For more information on tests to measure kidney function click here:

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

I have CKD and sometimes I cough up. I don’t cough up food or drink. I cough up what looks like silvery liquid. What looks like trapped clear liquid fluid that sometimes needs to come out. I cough up a little bit of it when it happens. What’s wrong with me?

I am unable to provide a specific diagnosis based on the information that you present.  I do not recognize your symptoms as something related to chronic kidney disease (CKD).  I suggest you consult with your physician.


Posted in Ask the Doctor, Laboratory Testing, Symptoms and Side Effects

My mother’s biochemistry reports says that she is having blood urea around 42.0 mg/dl and serum creatinine around 0.6 mg/dl. So I just want to know about it. What does it mean?

I cannot determine a diagnosis based on the information that you provide.  You can use this information to calculate her estimated glomerular filtration rate (eGFR).  You can enter the information on her blood testing into an equation that will calculate her eGFR.  This will give you an estimate of your mother’s kidney function.  You can access the equation at:  https://www.kidney.org/professionals/KDOQI/gfr_calculator


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

Renal tiny 2 mm calculi noted in left kidney. Please guide me how to cure this? I am from India.

The small stone that you describe should not cause any problems.  This is a very small stone.  I suggest that you follow a low salt diet and a DASH diet.  This should help to prevent further stone formation and may help to prevent growth in the stone that is already there.  You can review the DASH diet at: https://www.nhlbi.nih.gov/health/health-topics/topics/dash


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

I am a 51 yr. old woman. They say I have stage 5 kidney disease. I urinate 1,300 to 1,500no per day. When I started dialysis, I felt better, but now I feel very sick. I’ll get on the machine, blood pressure is at 137/75. An hour or two in, my blood pressure is 179/92. They prescribed more high blood pressure meds. I would always feel like I was on fire inside my body. Legs cramping while sleeping,(Charlie horse), blurred vision, dried mouth, numbness in legs, hand stiffness and when I urinate it hurts. Now I have crackling when I breath. I feel bloated. Muscle pain. Joint pain. Weakness. I tell my team but they say I’m not getting enough dialysis and prescribe more meds. I think they forget that I still urinate normally. Someone has to take under consideration that I still urinate. Please help me. I feel like I’m dying. They said I was suppose to feel better but I am worse. I think we need to reevaluate my situation.

I am unable to make a specific diagnosis based on the information that you provide. I do agree with you, that you need to be re-evaluated.  I suggest that you ask to meet with your nephrologist and you may have to make a special appointment to visit with him or her in their office to discuss your concerns.  I believe there may need to be changes made in your dialysis prescription.  I suggest that you ask for such a meeting.


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