Daily Archives: September 27, 2016

Why are African Americans at a greater risk for developing kidney disease than other races in the U.S.? Our nephrologist Barry Freedman at Wake Forest Innovations has linked the APOL1 gene to a test African American kidneys for improved donation: http://www.wakeforestinnovations.com/discover-innovation/charting-new-waters/

I think you have answered your own question.  We feel that one of the answers (not the only answer) is the genetics of black individuals and the link to a greater incidence of kidney disease and transplant failure.  The genetics … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR

Hi.. I am 46 year old female. I feel very well and and I work out hard on average 6 days a week upto to 2 to 2.5 hours per day. I have learnt today my GFR has been up and down but below 60 (54 and 57 from memory) since 2012 and earliest blood test result. No family history that I am aware of. Lower back pain regularly but comes and goes. Large amounts of clear non smelly discharge over the years from vagina and rectum (no idea if related but never explained…) GFR low before I started taking furosemide for water retention in 2014. My doctor has told me today to stop and repeat blood in a month. Apart from the termination of this drug and I will lessen my alcohol intake (currently approx. 14 units a week) is there anything else I can do?

It sounds like you lead a healthy life style.  I suggest you follow a low salt diet and maintain a healthy body weight.  I am a proponent of the DASH diet.  You can review the DASH diet at:  https://www.nhlbi.nih.gov/health/health-topics/topics/dash You … Continue reading

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

I have never smoked marijauna in my life and I tested positive for it in my urine. Can this happen because of my PKD?

Chronic kidney disease (CKD) and polycystic kidney disease (PCKD) should not cause urine testing for drugs to turn positive.  There may be laboratory errors and false positive reactions.  This would have to be discussed and reviewed with the laboratory director. … Continue reading

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

I went for my annual physical and after discussing loss of balance and dizziness along with fatigue and was sent for a stress EkG and stress test along with chest x ray. He suggested taking my BP every time I had a dizzy occurrence and it was always on the low side. Even taking my BP at normal times it was low for my normal of around 136/78 it has been staying around 112/66 and often 97/63. Therefore, I cut my BP med in half and most of the dizziness has passed. I was concerned as I realize increased BP can contribute to the kidney disease so I went back to full dose and all seems well. Results came back from my tests showing no problems. Nothing further from my doctor, an internist, so I decided to look at my lab sheets again and see if I couldn’t figure out what could possibly causing my problems. Upon having my physical the office gives a copy at check out of everything ordered that day along with a list of diagnoses. The doctor never mentioned kidney disease to me but it lists me as having Stage 111 kidney disease which leaves me totally confused as to what to do. All he said to me was that my kidney levels were a little high which he said were from not drinking enough water or eating too much protein and wondered if I had any types of infections as of late, which I had not. I have always had at least 10 – 12 glasses of water daily and never have more than the average amount of protein daily. My GFR is 46.1, BUN 28, Creatinine 1.2, BUN/Creatinine ratio 23, no protein in urine. I am bewildered as to how to continue with medication for BP and diet? Wouldn’t the doctor have discussed such with me if I had kidney disease? I am just in the obese category with controlled BP and 80 years old.

Stage 111 chronic kidney disease (CKD) is not a staging system that I am familiar with.  I suggest that you ask your physician to clarify this diagnosis.  This could be Stage 3, based on the information that you provide.  I … Continue reading

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

I HAVE BEEN GOING THROUGH THESE STONES. BLASTING AND LITHOTRIPSY BUT STILL KEEP GETTING THEM. DIET HAS NOT WORKED. IS THERE A RESEARCH PLACE TO FIGURE WHY I KEEP DEVELOPING PLEASE?

I recommend that you see a nephrologist and have a 24 hour urine test for urinary supersaturation index.  There are several laboratories that perform this testing including Mayo Clinic, University of Chicago (Litholink), University of Texas in Dallas and others. … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Laboratory Testing

I AM A 78 YR OLD WHITE FEMALE- CKD3 GFR 47 CREATININE 1.13 URINALYSIS AND ALL OTHER LABS WNL. DRINKING GALLON WATER PER DAY AND KEEPING PROTEIN INTAKE TO 40g OR LESS. WHAT ELSE CAN I DO TO MAINTAIN CKD3 OR GO BACK TO CKD 2? IS THERE ANYWHERE THAT CURRENT CHINESE TREATMENT IS GIVEN? SEEMS THEY HAVE A BETTER HANDLE ON THIS DISEASE, BUT CANNOT IN ANY WAY GO TO CHINA.

I am not aware that the Chinese have any superior treatment of chronic kidney disease (CKD) as compared with treatment in the United States.  Your physician should be able to recommend treatment that slows the process of CKD and does … Continue reading

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

My son has IgA Nephropathy (stage 3b brought down from stage 4) and is currently on a conservative treatment (Losartan and a direutic) plan that has significantly brought down his proteinuria and hematuria (trace). My concern is if he should be taking any other medicines that directly treat his condition. I read that with stage 4 (egfr less than 30) no additional treatments are given but now that he has been in stage 3 for nearly a year should he be getting any additional treatments?. I recently read about the completion of a clinical trial for Rituximab for progressive IGAN. Is this drug now available for treatment for IGAN? Or are there any other treatment options in addition to the blood pressure medicines that he is currently on. Many thanks.

Rituximab (Rituxan) is not approved by the Food and Drug Administration (FDA) for the treatment of IgA nephropathy.  There have been many treatments proposed for IgA nephropathy, but no specific treatment has shown remarkable success.  Hence, it is best that … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, IgA Nephropathy/IgA Dominant Glomerulonephritis

Hi, I have just been diagnosed with having a pituitary tumors and my GP has run some blood tests which came back normal this am except for the kidney function. I was told that one of the elements was slightly raised at 5.9 instead of 5.3. I have tried to research this and all tests mentioned do not show anything like these figures. Would you please advise as to which aspect of the test could be raised?My Doctor is not available to talk to until next week.

I am unable to make a specific diagnosis based on the information that you present.  I do not know what test you may be referring to in regards to the “5.9” result.  I suggest that you await further testing and … Continue reading

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

My mother was recently in a rehab nursing facility and ended up in ICU for kidney failure due to dehydration and malnutrition. She is 90 years old. I have been told that the normal number is 90 and she was down to 18 when she went to ICU. She has not been the same since, both mentally and physically. What kind of effects does this have on her long term?

Chronic kidney disease (CKD) in the elderly is difficult to manage and must be managed by carefully considering the wishes of the elderly person.  Dialysis can be very difficult to do in very elderly people.  I suggest that your mother … Continue reading

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

Hello Sir, My father is diagnosed with an elevated level of 1.8 serum creatinine. It has effected his thyroid glands. It has mildly damaged the liver. There is a cyst in one of the kidneys. He has high blood pressure level too. There are traces of blood and protein in his urine. The doctor has given medication to keep it controlled, but there is no treatment to cure this he said. The diet plan is quite rigid and limited too. He has lost some weight too. I was wondering what are the options that could be opted? Foods that can be taken?

Your father may have chronic kidney disease (CKD), but I am unable to make that diagnosis based on the information that you provide.  In order to recommend diet and treatment, it is necessary to make a specific diagnosis as to … Continue reading

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