Daily Archives: September 14, 2016

I had a kidney infection for the last few months but I have treated it. Now I have a swelling on my left side and sometimes I feel some pain. What should I do?

I am unable to make a specific diagnosis based on the information that you provide.  I suggest that you contact your physician for a complete history and physical examination.  The swelling on your side needs to be examined by a … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

I have a question regarding my wife’s transplant. She had a blood transfusion and now with her PRA’s at 98 percent. She was told that the living donor could not donate. What are the chances of Plasmapheresis and are they expensive? John’s Hopkins says incompatible transplants are okay. What do you think?

This is a complex question and I do not have easy answers.  If your wife has 98% panel reactive antibodies (PRA’s), it means that it will be difficult to find a matching kidney for her because she is likely to … Continue reading

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Transplantation, Treatments

I have had an estimated glomerular filtration rate (eGFR) of 58 milliliters per minute per 1.73 meters squared for greater than 3 months, (from 2012 to present, with past 3 tests being 5 months apart). Does this rate alone mean I have Stage 3a CKD? All other blood work is within normal range other than positive ANA, (though rheumatologist ruled out lupus, diagnosing me with osteoarthritis & fibromyalgia) If I have kidney issues, how do I go about, or what do I request, to identify underlying cause? If I don’t have protein in my urine, do I still need to limit protein?

Under the staging system developed by the National Kidney Foundation (NKF), your testing would qualify you as having Stage 3a chronic kidney disease (CKD).  I am unable to tell you why you have kidney disease.  You must be evaluated by … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I’m a 34 y/o old woman with a 20 yrs kidney transplant. Eight years ago I had a healthy baby boy. My pregnancy was high risk with high blood pressure complications. I would love to have another child but am unsure after the difficulties with my first one. How common is it for women to have babies after kidney transplants? Would you recommend it?

Women with kidney transplants can and do have successful pregnancies, but have a greater risk of complications.  I recently wrote an article in the Huffington Post about this issue.  I suggest that you read my article at: http://www.huffingtonpost.com/leslie-spry-md-facp/women-with-chronic-kidney_b_10163148.html For more … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Pregnancy / Kids, Transplantation

My kidney transplant happened just now on 18th August in India. My steroids & immunosuppressants are as follows: Steroid- Predinisolone, Immunosuppressants: 1) Pangraph 2) Myfortic. One more for virus- Valstead. For Pangraph adjustment they are doing regular Tacrolimus level test, but for Myfortic, no such test is being done. Should there be a test for Myfortic also?

Testing for levels of Myfortic (mycophenolic acid) can be done but are not helpful in treating patients with kidney transplants.  I suggest that you continue to follow with your transplant physicians.  It sounds like you are being treated properly. For … Continue reading

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

I have Type 1 diabetes for last 26 years. I have CKD Stage 3 with creatinIne of 1.8 to 1.9, urea is 25. I am from India. I am taking cardace 5 and 2.5 mg. I have no appetite and no thirst for last 10 years. I am also taking aspirin and insulin. The HGBA1c is 6.2. Kindly help me in this regard.

Based on the information that you provide, you may have diabetic kidney disease.  I suggest that you have urine testing for protein to see if your urine protein test is elevated.  If this is the case, then it is much … Continue reading

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

My urea nitrogen is 38.4. Normal range seems to be 10-20. I have been a diabetic 6 years and take 3 pills per day. I am active and in good physical condition, my sugar is controlled. My doctor sent me a letter stating that this was normal range when I see it as double normal range. Should I be concerned. I was taking medicine for my cholesterol that was given to me by the VA but had severe side effects but had side effects, dizziness, nausea, severe neck and shoulder pain and close to passing out. Gemfibrozil 600 mg. twice daily. Just wondering if this could have damaged my kidneys or caused high reading. Was also taking Metformin for about 2 years, and recently was taken off because of kidney levels. I am now taking Saxagliptin HCL 5 MG daily, also Glipizide 40 mg daily. Recently started taking lisinopril 2.5 mg daily to protect my kidneys. My numbers on (BUN) test have always been in normal range. Does this mean my kidneys have permanent damage or could it be from cholesterol medicine I quit taking. I am 72 year old white male.

The blood urea nitrogen (BUN) is not a very accurate way of measuring kidney function.  I suggest that you have this test repeated and see if there is a laboratory problem with the elevated BUN.  If the creatinine is normal, … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Diet/Nutrition, GFR, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Serum Creatinine, Treatments

I am trying to learn about primary vs secondary Hyperparathyroidism, and the relationship to CKD. My 78 year old Caucasian mother has been diagnosed with stage 3 CKD (GFR over the past 15 months around 35-40, low of 27 last summer, 48 this past June, 34 most recently). Her PTH has been consistently well over 100 for the past two years, most recently at 240. Her calcium has been a bit volatile, mostly within normal range of 8.6 – 10, but has crossed over 10.0 twice in the past 15 months. Vit D levels have been around 40, and she is on 5000 vit d supplement. Is her high PTH level a result of her kidney disease (secondary hyperparathyroidism), or could her kidney issues be a result of primary hyperparathyroidism, given that her calcium has crossed over 10? These questions have come up as she is experiencing varying degrees of cognitive impairment over the same 15 month period. At a recent Memory Clinic evaluation, the geriatric internist recommended a referral to an endocrinologist for the high PTH levels, while her primary care internist feels that it is secondary and caused by the kidney issues, and doesn’t want to make the referral. As I learn about primary hyperparathyroidism, she has nearly every symptom. She has an appointment with her kidney doctor in the next couple weeks. What should we be asking?

The main way to differentiate primary from secondary hyperparathyroidism is with a serum phosphorus.  The serum phosphorus should be normal to slightly elevated in patients with secondary hyperparathyroidism.  In patients with primary hyperparathyroidism, the serum phosphorus should be low and … Continue reading

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