Is an 87 year old man with CKD and GFR of around 30 allowed to to engage in a religious fast. More precisely,what would be the danger in not drinking and/or eating for a 24 hour period?Would an individual in such a medical condition be allowed to abstain from food for 24hrs if he drank liquids?

Chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of 30 milliliters per minute per 1.73 meters squared should be able to go without food and water for limited amounts of time.  This partially depends on other medical illnesses that might be present including heart disease and diabetes.  Typical religious fasting from sunup to sundown, should not pose a problem.  Longer fasts for 24 hours might be best done is continued intake of water.  I don’t think his age of 87 would be a major factor in fasting.

 

What do you tell people who want you to find a CKD cure for them?

Chronic kidney disease (CKD) is usually managed to prevent a further fall in the function.  We do not usually discuss a cure of CKD, but rather managing the disease so as to prevent further damage to the kidney function.  I am  unaware of any known “cure” for CKD.

 

I am a 79 year old white male with Type 2 diabetes. My left kidney was removed 28 years ago due to a tumor. Fasting levels are in the 96-110 range. eGFR is 49 (up from 43 two months ago.) Serum creatinine 1.53; Potassium 5.4; BUN 29. Recent 24hr UA: UA Protein (calc) 80. Total Protein is 4.3. I feel my PCP is not taking enough action or giving me enough information about my lab results. His notes indicate that everything is normal with my lab results. My BP runs 120/78. My meds include 10mg of dextrostat and Lisinopril HCTZ 20/12.5 Does the dextrostat or (the supplement L-thinine 200mg) have a negative affect on my kidney function?

Dextrostat (dextroamphetamine) is a very potent stimulant and can cause elevation in your blood pressure.  I am not aware of the drug L-thinine.  This is not a compound with which I am familiar.  Since you only have a single kidney, an estimated glomerular filtration rate (eGFR) of 49 milliliters per minute per 1.73 meters squared is relatively normal for a single kidney.  Your urine protein is normal.  I suggest that you share your concerns with your primary care physician (PCP).

 

I need to know how many grams of protein I should aim for DAILY. I am a level 5 Hemodialysis dialysis patient. I HAVE the information in OZ, but want it in grams, Please!

The diet for a hemodialysis patient is usually recommended to be between 1.0 and 1.2 grams of high quality protein per kilogram of body weight.  You should review this with the dietitian who is assigned to you at the dialysis unit.

 

Recently diagnosed with CKD stage 3B. Also rheumatoid arthritis diagnosis recently. Is methotrexate safe for me to take?

The dose of Methotrexate must be monitored and sometimes reduced for patients with chronic kidney disease (CKD).  I suggest that you review your concerns with your Rheumatologist and your primary care physician (PCP).

 

My son has kidney failure since age 27. He received the gift of life of a kidney transplant two months after starting dialysis. The transplant lasted 3 years and had to be removed as it became infected. He has been on dialysis for the past 5 years and has a difficult time finding a match as he is highly sensitized because of his previous transplant and he had two blood transfusions. His doctor now says he needs a parathyroid surgery due to chronic depression of calcium levels. He is extremely anemia and has terrible pain in his feet that he is unable to walk. My question is whether the surgery will help with anemic and foot pain. No one knows why he developed kidney failure as no one in our family has kidney disease. Blood type O+. Thank you for your assistance.

Parathyroid surgery for dialysis patients has been reported to improve anemia and pain in the extremities (peripheral neuropathy).  It is impossible to anticipate if the surgery will help each and every dialysis patient.  I am unable to provide a prognosis without performing a complete history and physical examination.

 

Hi, One of my patient has HbsAg + and HCV RNA + . Which hemodialisis machine is appropriate for him?

A patient with both Hepatitis B and Hepatitis C should have a machine only dedicated to himself.  The patient should be isolated to that machine only and no other patient should use that machine unless they are also B positive and C positive as well.  The patient should be isolated from all other patients in the dialysis unit. Staff used to treat the patient should be immunized and responded to Hepatitis B vaccination and they should practice careful Universal Precautions.

 

Hi Doctor, About 4 months ago, I had vomiting, constipation and pain in lower back abdomen due to pushing and gas. I went to the doctor and he wrote few tests. My urine tests showed protein, traces of blood and my CBC blood test had WBC and NEU higher than normal. He wrote another test for creatinine and blood urea and it was 3.3 and 55. He referred me to a nephrologist. The next day, I couldn’t see nephrologist because he was out of town. I felt so much thirsty on that day and drank alot of water. The nephrologist wrote same tests again and this time my urine has no traces of blood or protein, my CBC was normal except Hematocrit little less and my creatinine was dropped to 2 while BUN was 43. My ultrasound report showed no back pressure, normal size kidney, high echogenicity suggested. The nephrologist said it is temporary and said to go for tests again after 15 days. The test are normal since then. No traces of blood in urine, no protein since 4 months now. I have done 4 more tests. I am concern if I have CKD or is there any chance of CKD and what my ultrasound report mean by high echogenicity suggested?

I am unable to make a specific diagnosis based on the information that you present.  You could have acute kidney injury that is in the process of recovery or you could have chronic kidney disease (CKD) with acute kidney injury superimposed.  Further testing will be required.  I am unable to interpret the ultrasound testing without reviewing the films for myself.  Increased echogenicity on a kidney ultrasound frequently means scarring has occurred in the kidney.  I suggest that you discuss your concerns with your nephrologist.

Hi. Are there any complications associated with hemodialysis and very HIGH platelet count due to past splenectomy?

Platelets are used in the blood clotting systems in your body and having a high platelet count could cause problems for blood clotting in the dialysis tubing or dialysis filter.  Your nurse or dialysis technician should be taking notice of the blood clearing from your dialysis filter at the conclusion of your dialysis treatments.  If the filter fails to clear or blood clots within the dialysis filter, then there may need to be some adjustments made in your blood thinning (anticoagulation) that is required for the dialysis treatment (typically heparin).

My son is 12 and evidently was born with a blockage to one kidney, which is now only functioning 3%. He had one UTI when he was 6, which was treated with antibiotics, but other than an annual urinalysis at check-ups, no tests were ever done to detect the problem. He felt good up until a year ago, when he started having a lot of headaches and nausea a couple of times a week. His pediatrician misdiagnosed him with migraines in January and no testing was done until he ended up in the e.r. several weeks ago and they (thankfully) ran many tests on him. What would be considered to be “standard” care for a 6 year old boy with a UTI that seems to respond to antibiotics but he has no other symptoms? Would a renal ultrasound be considered to be “standard?” Or for a 12 year old boy with migraine- like symptoms and a history of 1 UTI? For the time being he’s stable with the help of blood pressure meds. as we wait for his surgery and he’s actually feeling better than he has in a year. His other kidney is thankfully “fantastic,” according to the two specialists who read his scans. They are very well-respected and I trust their judgement. My son has to have a laparoscopic nephrectomy. What is the typical recovery from a laparoscopic nephrectomy like? I’ve been told there’s a 4 day recovery but that it will take quite a while after that for him to get back to 100%. I’m trying to figure out how much support he might need from his school after his surgery. Will he be able to walk from class to class? Carry a backpack?

The questions that you ask are surgical questions that come under the expertise of a pediatric urologist.  I am a nephrologist and do not see children.  Hence, the questions that you ask need to be addressed by a urologist and your pediatrician.  I have no experience with removal of kidneys (nephrectomy) in children.