I have bubbly urine and traces of protein have been found (when I test at home with Albustix). I had my creatinine checked and it was at 73 so in the normal range, but maybe a bit high for a 25 year old woman? I also had my creatinine checked exactly a year ago and then it was 71. Is two points a normal rise in a year? The reason im very concerned is that a few years ago I held my urine from early in the morning to late at night while drinking a lot of water. I understood it can cause great harm to the kidneys. In the night, I had such anxiety from holding it in and almost fainted. An answer will be so appreciated and will do a lot to help me!

The difference between 73 and 71 is not significant.  This is within the expected range of variation for the laboratory test of creatinine.  You physician should be able to re-test you at a later date and re-assure you that there has not been any harm to your kidneys.

Posted in Ask the Doctor, Kidney-Related Health Questions

I have a niece who is 17 years old. She has been sick for the last month and they finally figured out that she has a UTI that spread to her kidneys. She got an intravenous antibiotic and then they sent her home with antibiotics. She has been on the antibiotics for 2 days now, but she started complaining of chest pain, extreme fatigue and abdominal pain. She was taken to the ER and they told her it was just her UTI and that she is fine. Should she be taken somewhere else to get a second opinion? She says she feels like she is dying

A urinary tract infection (UTI) that spreads to the kidneys is known as acute pyelonephritis.  This can take several days to resolve.  It may take some time for her symptoms to resolve.  I suggest that she be followed carefully by her primary care physician and have a follow up urine culture to make sure the infection is clearing.

Posted in Ask the Doctor, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis

I have participated in medical research unrelated to kidneys for many years. In the last few years, this has involved functional PET scans. I am now 84 and based on GFR I have been placed in CKD. Is there any research or medical opinions about ability of radioactive tracers damaging the kidneys?

I am unaware of any information about the use of radioactive tracers and radioactivity causing chronic kidney disease (CKD).  I know of no literature on the subject.

Posted in Ask the Doctor, Chronic Kidney Disease, Clinical Trials/Studies, Kidney-Related Health Questions

I had a C-Section which went awry and went into shock due to excessive bleeding. Eventually, an emergency hysterectomy was performed and my 2 ovaries were also removed. Shortly after, I had urinary urgency but my GP told me it might be due to hormonal imbalance. Some years later, I was diagnosed with stage 3 CKD with mild protenuira. I have no history of high blood pressure, no diabetes and cholesterol level OK. What do I do to stay healthy?

You should consult with your physician regularly and have blood and urine testing for your kidney disease.  Careful follow up and management of your kidney disease requires testing and follow up.  Your physician is best to advise you about any needed treatment.

For general information about CKD please click here.

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

I was just diagnosed with Medullary Cystic Kidney Disease. I am 30 years old. I have been ran through many blood tests and urinalysis’. I am at Stage 3 CKD with gfr at 44 and Creatinine at 1.4. 50% renal function. My nephrologist says this is a rare disease and I am the first he has “researched” in 25 years of practice. I do not live in a small city. My fathers kidneys failed when he was 32. My grandmas kidneys failed when she was in her early 20s (she was born with one kidney). We don’t know much about this disease. How many people are Dx with this a year? How much longer until my kidneys fail?

Medullary cystic kidney of the kidney is a rare disease that is commonly hereditary.  You may have inherited this disease.  You can learn more about this disease at:  https://www.nlm.nih.gov/medlineplus/ency/article/000465.htm

Further information is available on the National Institutes of Health web site for rare diseases at :  https://rarediseases.info.nih.gov/gard/10801/medullary-cystic-kidney-disease/resources/1

I cannot provide a prognosis based on the information that you present.  You should continue to consult with your nephrologist.

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

My father is 49 years old. He is on dialysis for more than a year now. The doctor increased his dry weight because for the last 2 months he had been experiencing headaches, cramping of legs, feeling thirsty and deafness during dialysis sessions. The symptoms will stop if they stop the session around 1 hour before he finished. He is also experiencing hypertension more often during and after dialysis. Before dialysis, his gained weight not too much. The doctor advised to increased dry weight and remove only 1 liter per session because he cannot tolerate more than that. What is the reason for his hypertension and slight deafness during dialysis? We are confused about his symptoms. Please help us clarify our doubts and questions.

I cannot provide a diagnosis without performing a complete history and physical examination on your father.  It is best to discuss your concerns with the nephrologist who is caring for your father.  Symptoms during dialysis have many causes and must be addressed by a physician who knows your father and can examine him.  In some cases, more frequent dialysis for shorter periods of time may be necessary in order to prevent these symptoms from occurring.

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

I have stage 3 CKD (eGFR 45) and have had this level of kidney disease for last few years. I am having pain between my shoulder blades when I take a deep breath. No fever. Mild swelling of feet and lower legs. I have been tested multiple times for lupus. My ANA has been positive a few times but only to 1:320 or 1:160. Is it possible to have lupus despite normal antibody titers? What additional tests are done to evaluate for lupus, especially lupus nephritis?

The best test for systemic lupus erythematosis (SLE) of the kidney (also known as lupus nephritis) is to do a kidney biopsy.  There are many people who have positive Anti-nuclear antibody (ANA) tests but do not have lupus nephritis.  I suggest that you consult with your physician.  A kidney biopsy should only be done if your physician has a reasonable suspicion that you could have SLE and that your kidneys could be affected.

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

For a CKD Stage 4 & Type 2 Diabetes patient with a HbA1c currently in the 8.5%-9% range, in your experience would stricter control to bring it down?

I recommend that patients with diabetes keep the Hemoglobin A1c between 6 and 7%.  Improved control of your diabetes will result in a slowing of chronic kidney disease (CKD), but will likely not result in an improvement in your estimated glomerular filtration rate (eGFR).  The goal of better management of diabetes is to slow the disease, but it is not usually possible to reverse the disease.

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

How much of a drop in GFR is related to random variation, dehydration, etc.? I had a test (as part of lots of other blood work) a year and a half ago when it was 97 mL/min (CKD-EPI). My test results now say it is 67 mL/min/BSA. I am a 30 year-old female (5’7″, 122 lbs) with no known health problems that might result in kidney damage. My creatine is 0.97. Information online seems to vary widely as to whether such a drop and/or the current GFR value should concern me or not.

The normal for an estimated glomerular filtration rate (eGFR) is greater than 60 milliliters per minute per 1.73 meters squared.  Hence, both of the numbers that you present are normal and likely represent normal variation in the laboratory testing.  You should also have testing of your urine for blood, protein and infection to see if there are other ways in which kidney disease could be diagnosed in your particular case.

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

I just spent 10 days with my Mom who has advanced kidney disease. At her April 8th nephrology appt. her kidney function was at 11 percent. By April 22, her kidney function had dropped to 9 percent. Her creatinine level had risen to 4. I also witnessed a general decline in functional mobility. I flew home to LA yesterday. She lives by herself in NY. My question is do you think her prognosis is so poor that I should return next week, rather than wait until the first week in June, as had been my plan? I might add that she is 87 years old, and has congestive heart failure also. She has decided that she doesn’t want dialysis.

I cannot provide a prognosis for your mother without performing a complete history and physical examination.  This is a question you should ask of her physician.  It sounds like she has very advanced chronic kidney disease (CKD) and should be followed by her physician very carefully.  Her heart disease will likely complicate her kidney disease.

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