Daily Archives: September 12, 2016

I just had a colonoscopy, hip replacement, hernia strangulation surgery all with in a week and an half span. Recently I was in hospital for bowel obstruction twice. I was just informed that I am anemic. I am in end stage renal failure. My level is at 12 right now. It bobs back and forth between 10 and 12. What should I do? I am waiting for a call from a nurse. But I am sick. I have all the classic anemic signs.

In patients with End Stage Kidney Disease, we strive for a hemoglobin between 10 and 11 grams per deciliter (g/dl).  If your hemoglobin is normally 12, then you are very fortunate.  I suggest that you consult with your nephrologist. For … Continue reading

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

I have a kidney stone in my bladder, just big enough that it won’t pass. It causes me a lot of pain, no bleeding, just hurts. What are my options?

This is a urological problem and must be evaluated and addressed by a urologist.  I suggest you consult with a urologist.  I am a nephrologist and do not have any expertise in bladder stones. For more information on kidney stones … Continue reading

Posted in Ask the Doctor, Kidney Stones, Treatments

I am a 60-year-old female. Recently blood test show my Glomerular Filtration Rate >60ml/min. Should I be concerned with this result? My blood pressure runs below normal, no diabetes.

An estimated glomerular filtration rate (eGFR) of greater than 60 milliliters per minute per 1.73 meters squared is a normal.  You should also have urine testing for blood, protein and infection.  No other testing would need to be done for … Continue reading

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

In Dec 2015, my eGFR (first time it was ever done) was 54.91. In August 2016 my eGFR was 58.89. Complete bloodwork was done because I’ve been really fatigued and not feeling well. I also have RA and osteoarthritis, and food and seasonal allergies. I don’t drink alcohol or caffeine. I drink lots of water. I am at my ideal weight and am extremely active and I’m 62. No high BP, cholesterol numbers good. I currently take Hydroxychloroquine, Ranitidine, and Meloxicam. In the past, I took diclofenac for 6 yrs (which caused stomach damage, and then took omeprazol for 2 years, then switched to ranitidine). After researching the kidney foundation site, I followed up with my doctor about the low readings and his response was that 54 and 59 are “barely out of range”, so we’ll just follow up again in a few months. Is he right to not worry about this, or should I push for more testing/follow-up?

This may be early Stage 3 chronic kidney disease (CKD).  If you are otherwise healthy and following your doctor’s advice, there may not be anything that can be added to your treatment.  Monitoring your kidney function may be the only … Continue reading

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

Could you please explain why a fena level would be done and what it indicates. I was in acute renal failure after taking a diuretic. My fena level was over three.

The fractional excretion of sodium (FENa) is a test that examines the functioning of the tubules in your kidney.  The estimated glomerular filtration rate (eGFR) examines the functioning of glomeruli in your kidney.  The FENa should normally be less than … Continue reading

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

I did a cat scan, nuclear test and a blood test. My doctor told me that one of my kidney is not functioning and the other is functioning halfway. Can you please advise me?

Many people live a normal life with one functioning kidney.  I suggest that you ask your physician to clarify this issue and discuss the reasons behind one kidney being abnormal and the other functioning to a greater degree.  I cannot … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Nephrectomy / One kidney, Treatments

Someone told me that a person’s nephrologist is associated with only one dialysis center, either Fresenius or DaVita and that doctor will want his patients to go to that chosen dialysis if choosing hemodialysis. Is that true?

There is no easy answer to this question.  There are two large dialysis organizations (Fresenius and DaVita) in the United States that operate most of the dialysis units.  Nephrologists may admit patients to either of these units if they have … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Nephrologist

My (89 yr old) father just received test results indicating his creatinine levels to be 1.38 mg/dl and his GFR level is 48. He is worried he has the beginning stages of kidney disease and is wondering if he needs to go back to the doctor asap. He would like to see a specialist if necessary and figure out if he should avoid certain foods etc….in order to help his kidneys stay healthy.

I am unable to make a specific diagnosis based on the information that you present.  Your father may have early chronic kidney disease (CKD) but I cannot establish the specific kidney disease.  In order to establish CKD, he needs to … Continue reading

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

Thanks very much for responding to my question of yesterday regarding 24-hour protein of 530 mg along with a possible autoimmune disease. I appreciate that you cannot provide a diagnosis or give specifics regarding treatment. But, perhaps you can just give me some general direction on something. Based on the finding of 530 mg’s of proteinuria, my family doctor acknowledges this is abnormal but is not overly concerned and has not recommended any treatment nor any referrals to a nephrologist at this time. Rather, he just wants to re-check the 24-hour urine protein test in a couple of months. Does this sound like a reasonable approach? I am just questioning whether I should be sitting around two more months without doing something about this! Should I be trying to see a nephrologist NOW to pursue the cause and possible treatment?

I would follow your physician’s advice.  This is a relatively small amount of protein in your urine.  Normal is less than 150 milligrams per day.  Follow up testing could tell you whether this is getting better or getting worse.  A … Continue reading

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

I’m trying to find out how much potassium is in swiss cheese?

You can learn the chemical and nutritional content of foods at the United States Department of Agriculture nutritional database web site at:  https://ndb.nal.usda.gov/ndb/foods/show/40?fgcd=&manu=&lfacet=&format=&count=&max=35&offset=&sort=&qlookup=Swiss+cheese  

Posted in Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions