I have two kidneys but only one is working. I was hit by a car at 4 years of age and my one kidney stopped growing and stopped working at that age. Lately, I have had high blood pressure, and symptoms of adrenal fatigue. There is protein in my urine, so they put me on Lisinopril. Do you think that my non-working kidney is causing problems? I am going to the see the urologist in June, and I really haven’t been feeling well. What should I tell him? How can he help me?

The problem that you describe is usually not diagnosed or treated by a urologist.  I suggest you see a nephrologist to see is your injured kidney could be leaking protein and could be affecting your remaining good kidney.  You may want to discuss this with your primary care physician.

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

What are the real differences between Type 1 Diabetes Mellitus and Type 2 Diabetes Mellitus?

Type 1 Diabetes Mellitus is caused by an absolute deficiency of insulin in the body.  This leads to elevated blood sugars in the body and an inability to get sugars available to body cells.  Insulin levels are usually low or absent.

Type 2 Diabetes Mellitus is caused by a resistance of the body to the actions of insulin.  This leads to elevated blood sugars and very high insulin levels.  Type 2 DM is usually associated with obesity.

Posted in Ask the Doctor, Diabetes

My question is why does soft drinks affect the kidney, like Coca Cola drink.

Soft drinks and sugary drinks can cause weight gain and diabetes which increase the risk of kidney disease.  Soft drinks have also been associated with gout and kidney stones.  So far, we know of only associations and cannot prove that soft drinks actually cause kidney disease.

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition

Yesterday I had sudden pain in my back so I went to the doctor. He did an ultrasound and x-ray and tells me that I have a stone of 4mm. In the report, this is written – (mild hydronephrosis with hydroureter due to 4-5 mm right lower ureteric calculus) Can you tell me what that means in detail and about any eating precaution.

I suggest plenty of water and a low salt diet.  You should keep your sodium intake to less than 2000 milligrams per day.  The ultrasound merely indicates that you have a stone incompletely blocking your right kidney leading to a mild enlargement of the ureter (tube connecting your right kidney to your bladder).  I am an advocate for the DASH diet.  You can review the DASH diet at:  http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

Posted in Ask the Doctor, Diet/Nutrition, Kidney Stones, Urological Issues

I have just finished my phlebotomy externship. I love the work and my goal was to become a Patient Care Tech to work with Kidney dialysis Patients. Can you tell me where to start? No one seems to be able to answer this. Not even the college I attended.

Patient care technicians (PCT) are hired and trained at dialysis units.  Hence, you should contact a dialysis unit and ask if there are any openings for PCT.  There is a period of training usually lasting several months and then you must take and pass a national test for PCT.  It is best to contact several local dialysis centers and look for open positions.

For more information about dialysis tech training please click here. 

Posted in Ask the Doctor, Dialysis

My mother is in end stage kidney failure and will start dialysis soon (discussing on May 11). She is 77 years old, has diastolic Congestive heart failure, A Fib and has had a mini stroke in December 2014. She just went through major health issues with the CHF in the hospital and is currently has in home rehab. I feel that dialysis is not a good option but is that my fears or am I seeing things clearly? I have read several articles on the aged and dialysis and she is already frail, has issues with her veins and is on blood thinners. What are your thoughts? What should I ask her nephrologist? The heart doctors have already said there is nothing more they can do and that the dialysis is more of a comfort for her condition.

These are always very difficult decisions to make.  The best advice I can give is to speak with the nephrologist who is caring for your mother and also discuss this your mother’s primary care physician.  You should also listen to your mother.  It is best to try and determine what your mother would want to do.  If she is competent to make a decision, then you should honor her decision.  If she is not competent, then the primary care physician and the rest of your mother’s close family should try to come to a consensus about what your mother would want to do (given that the family knows her best) and then make the decision in your mothers best interest.

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis

I have CKD and my eGFR is 31. Ten years ago when my GFR was 42, short movements (trembling, vibrations) just beneath my skin all over my body but mainly under my feet, started. It still continues and is progressive. It is till now my biggest problem because it disturbs falling a sleep and I can never relax of the never ending movements. My nephrologist in the Netherlands till recently did not see any relation with my CKD because he only sees these problems in patients in a more severe state of CKD. Recently for the first time, I appeared to have a hypocalcemia (2,16 mmol/L). Because I did not use alfacalcidiol, yet my doctor thinks that maybe my problems are caused by a shortage of calcitriol. My other outcomes are: – K 4,1, Bicarbonate 25,6 mmol/l, Phosphate 0,78 mmol/L, creatinine 164 micromol/L, albumine 37,2 g/L, Hb 8 mmol/L, PTH 8,9. Urine: protein/creat ratio 181,9 mg/mmol. – blood pressure 130/90 Med: simvastatin 40 mg, lisinopril 5 mg, alfacalcidiol 0,25 microgram. Age 52, woman. My questions are: – Do you see an explanation for the tremblings? – Do you have an advice how to treat them or how to cope with them? If there is no treatment? Because I think in the USA, the knowledge about CKD is very well developed.

I also believe that you may have a peripheral neuropathy but I also agree that we typically see peripheral neuropathy in patients with chronic kidney disease (CKD) who have much more advanced kidney failure that you seem to manifest.  I cannot provide a specific diagnosis based on the information that you provide.  I can only suggest that you continue to work with your physician and try to establish a specific diagnosis and this will then likely lead to a specific treatment.  You may need to be seen by a neurologist (not a nephrologist) in order to establish a more specific neurological diagnosis.  You are also anemic and this can be associated with a peripheral neuropathy if the anemia is caused by a vitamin B12 deficiency.  I suggest you discuss this with your primary care physician.

Posted in Ask the Doctor, Chronic Kidney Disease, Symptoms and Side Effects

What food should one avoid for kidney and gall bladder stones?

I do not know a diet for gallbladder stones.  In order to avoid kidney stones, I am a strong advocate for the DASH diet.  I suggest you follow a 2000 milligram sodium diet for daily consumption and that you follow the DASH diet which can be reviewed at:  http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

Posted in Ask the Doctor, Diet/Nutrition, Kidney Stones

Is it safe to take a hydrolyzed collagen supplement for someone with stage 3b kidney disease?

I am not familiar with Hydrolyzed Collagen as a nutritional supplement.  I am unaware of any study of using this supplement in patients with chronic kidney disease (CKD).

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

Would you please let me know for the patients who are known to have DM and HTN for a long period of time and developed CKD but U/S shows one kidney is shrunken and other kidney is normal. Why does the creatinine level rise in patients? CR Level 4.5 BUN 84.

Both high blood pressure and diabetes cause damage to the filters of the kidney and cause a reduction in the glomerular filtration rate (GFR).  As damage occurs, there is an accumulation of creatinine and blood urea nitrogen (BUN) in the blood stream.  These elevated tests reflect the kidney’s inability to eliminate these waste created by metabolism from the body and hence the elevation of the BUN and creatinine tests in the blood.

Posted in Chronic Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions