My eGFR is 52; my creatinine is 140; my BUN is 21; my serum albumin is 4.2; my total cholesterol is 125; triglycerides are 43; non-smoker; no diabetes; normal blood pressure; no family history of kidney disease. I have had essential thrombocytosis for 14 years and take Hydroxyurea; I take a bunch of vitamins including a gram of vitamin C; no excessive urination; no loss of appetite. What can cause the creatinine and eGFR numbers?

I am unable to make a diagnosis based on the information that you present.  If your estimated glomerular filtration rate (eGFR) has been less than 60 milliliters per minute per 1.73 meters squared and has been like this for more than three months, then you may have Stage 3 chronic kidney disease (CKD).  I cannot tell you why or what to do without performing a complete history and physical examination. I suggest that you consult with your physician about your concerns.  Essential thrombocytosis is not commonly associated with CKD.  The blood disease can be associated with gout and elevated blood uric acid and this can cause CKD.  I suggest that you have further testing for CKD.

 

 

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function

I am a med school graduate working in Pediatrics. I am concerned about my kidney issue. I am 29 years old, weight 86kg, 5’11”. Slightly elevated cholesterol, having GFR 87 which was 89 2 weeks back and 102 a year back. So do my creatinine was 0.8 a year ago now 2 weeks back 1 and now 1.02…urinary creatinine level is 47.. And one 1+ hgb in urine R/E. No family history of kidney diseases.. But I’m having BP variation in last one year. 135/95 and 130/85. My ultrasound of abdomen is fine. The kidneys are morphologically OK. I am extremely worried about my condition. Kindly could please give me any suggestion/diagnosis..How bad it is?

The information that you provide is normal.  I do not detect any kidney disease at the present time.  You should check your urine for blood, protein and infection.  Your blood pressure may be borderline.  I suggest you continue to monitor your blood pressure and establish with a primary care physician to check your blood pressure over time.

 

 

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

I am a 45 year old white male, 5’11”, 210 lbs. Beginning at age 30, I experienced about 12-15 episodes of kidney stones, which were eventually diagnosed to be uric acid stones. In addition, I have had about 4-5 gout episodes. Since 2011 (age 40), I have been on 300mg of allopurinol and no further episodes. Uric acid is generally around 5.2. I have been taking blood pressure medication 25mg Atenolol for about 10 years (age 35). During a routine physical in 2014, it was noticed that my eGFR was about 68; as a result, my life insurance premium quotes went up considerably. Frightened, I went to a nephrologist who took ultrasound, urine test and blood test. My GFR was still 68, uric acid level normal, creatinine a bit high at 1.34 (considered about .01-.10 above top of normal range). Ultrasound revealed no damage to kidneys. Doctor said to me that GFR is not such an accurate number and that the number was essentially “meaningless” for me. Went back the following year (2015), all numbers the same except GFR went down to 59. Again, no concern on Dr.’s part. Everytime I read anything about kidney disease, I am terrified that GFR is a very important component of kidney disease and fear I might already have deterioration despite doctor’s lack of concern. My question is, is the GFR a completely personalized metric that really is as unimportant as this doctor has represented, or does the fact that I had a 59 GFR one year ago suggest I am already in a stage of kidney disease that was otherwise undetected? The doctor had me undergo a sleep study and I was found to have mild sleep apnea, so he felt that was not a big contributor. I am really flummoxed at the incredible focus on GFR in all of the literature but the doctor’s nonchalant dismissal of its importance. I am still terrified. In addition, would losing 20 lbs possibly increase the GFR readings? I was very fit my entire life, with the exception of my 30’s. For the past 3 years, I am very fit with weight lifting, running, etc., so much so that my blood pressure medication was cut in half. I haven’t lost the weight yet but also wondering what effect that could have on GFR, if any? Family history is paternal grandfather died of heart attack; father is 81 and very healthy. No cardio issues on mother’s side.

We use the estimated glomerular filtration rate (eGFR) as a standard for classifying kidney disease into one of five stages.  In order to qualify as a stage, the eGFR must be in a given range for at least 3 months.  Hence, we may see mild variations in eGFR that can vary from test to test.  Stage 3 chronic kidney disease (CKD) is diagnosed when the eGFR is less than 60 milliliters per minute per 1.73 meters squared.  In addition, you should have urine testing for blood, protein or infection in the urine.  If your urine testing is normal and your eGFR is really greater than 60, then you may not have CKD at all.  You physician may be waiting to confirm whether or not CKD is actually present.  I suggest that you discuss your concerns with your physician.

 

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

What is the average life expectancy of a person with diabetes, a poor heart, and kidney disease who will be starting dialysis in a few weeks. This person doesn’t eat the recommended diet. His blood sugar is not under control. I am most probably going to become his caregiver when dialysis starts and want to have some kind of idea how long I might have this situation?

I am unable to provide a prognosis without performing a complete history and physical examination.  From the information that you describe, I sense that his life expectancy would be quite short, but the best way to get this information is to have a discussion with the nephrologist who is going to be caring for this person on dialysis.

 

Posted in Ask the Doctor, Chronic Kidney Disease, End of Life Issues, Kidney Failure, Kidney-Related Health Questions, Nephrologist, Treatments

My kidneys were measuring around 10.3 cm each last month. My recent ultrasound measures them at 16.2 cm each (roughly). I’ve been diagnosed with ckd stage 3. There’s no sign of hydronephrosis. What else could it be?

I cannot explain an enlarged kidney based on the information that you describe.  Enlarged kidneys may be seen in infection, blockage or malignant growths inside the kidneys.  I think it is much more likely that there has been an error made in measurement or recording of the kidney size.  I suggest you request a re-assessment of the ultrasound findings by your physician.

For more information on CKD please click here:

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

I have stage 3b kidney disease (creatinine 1.8, GFR 37). 75 year old male. I understand one must be careful when supplementing with magnesium due to kidney disease patients unable to excrete this mineral from diseased kidneys. I would like to take a magnesium supplement…but what safe amount would be allowed?

You should take a magnesium supplement only if your blood level of magnesium is low.  Hence, the dose of magnesium should be based on a knowledge of blood levels and if you take the supplement, blood levels should be monitored if you have chronic kidney disease (CKD).

 

Posted in Ask the Doctor, Chronic Kidney Disease, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Symptoms and Side Effects

I am currently taking 30mg of Zoton fastab every day, 60mg every second day, and have been for about a month. I also have a history of kidney problems and get kidney infections every now and again. Lately, I have been having more kidney infections recently. One doctor said that Zoton can aggravate the kidneys, but another said that it is very unlikely to be the cause of my recent kidney infections. So I was wondering if I could get a third opinion? Zoton has really helped with my acid reflux, so it would be a shame to have to stop taking it, but would like to know either way. If it is the case that Zoton is the culprit, are there any measures I can take to counter its effects on my kidneys, or would I have to stop taking them entirely?

Zoton is a proton pump inhibitor (PPI) that treats disorders of the stomach.  PPI’s have been associated with chronic kidney disease (CKD) but I am not aware that we know why they are associated with CKD or even if they can cause worsening of existing CKD.  Your physician is the best judge as to the risk and benefits of taking such medication.  I suggest that you consult with your physician and discuss your concerns with him or her.

 

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

My husband was diagnosed with Renal Cell Carcinoma 18 months ago. At that time they removed his left kidney, we later found out the right kidney was only functioning at 44%, as of today the kidney is functioning at 35%. What can you recommend to help slow down the decreasing functioning of his remaining kidney? Is there a way to improve the overall functions of the remaining kidney?

The best way to preserve function of a single kidney is to see his physician at least every 6 months and monitor his medical status.  The most important things to do are to maintain careful control of the blood pressure to less than 130/80.  He should follow a low salt diet.  He should eat a healthy diet and maintain a healthy weight.  He should not smoke and should exercise regularly in order to maintain his weight.  He should avoid kidney toxic drugs such as non-steroidal anti-inflammatory drugs (NSAID’s) such as Motrin, Ibuprofen, Advil, Naproxen, and Aleve.  If he does all of these things, he will promote good kidney health and prolong the function of his remaining kidney.  It is not possible to recover kidney function, once lost.

 

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Nephrectomy / One kidney

I want to know about a food list of to reduce high urea levels because of kidney problems?

Blood urea nitrogen (BUN) is caused by nitrogen wastes in the body that are normally eliminated by the kidneys.  The main source of nitrogen wastes are proteins.  Hence, if an elevated BUN test is a concern, we typically recommend that you reduce your protein intake to about 0.8 grams of protein per kilogram of body weight per day.

 

For more information on CKD please click here:

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

My son has undergone ultrasound test. Report says – “Reveal a solitary calculus 8.2 mm in lower calyx with mild focal calyectasis seen.” Sir, we do not understand the medical terminology. We are worried. Kindly advise us the line of medical treatment and probable impact on his general health. He has no diabetic or hypertension problems and no blood found in the urine.

The ultrasound report suggests that there is a kidney stone in the lower collecting system of one of the kidneys.  I cannot recommend medical treatment without performing a complete history and physical examination on your son.  Your son should consult with his physician, who ordered the test and ask for interpretation and recommendations.  In most cases, this will require consultation with a urologist.

 

 

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