Monthly Archives: December 2016

Hi! I found out a year ago that I have Stage 3 CKD. It was most defeating when I found that out, as I also found out on that same day that my “Harvoni” Hep C treatment cured my liver. So, the “joy” of learning about the Hep C being gone was in the same phone call my doc told me of the CKD. I have lived 37…yes…37 years with being HIV too. The learning of the CKD has “put me over the edge”. I am tired of “tracking diseases”. I see no sense in going on a kidney diet, as basically from what I have learned, CKD is a “tick-tock” to dialysis. (insanity to opt in for that). So, I am wondering how long I may live with stage 3 CKD being I will not go on dialysis.

It is impossible to provide a prognosis based on the information that you provide.  Stage 3 chronic kidney disease (CKD) is an early stage of kidney disease.  I suggest that you continue to consult with your physician on how best … Continue reading

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

I have an extarenal pelvis. I had a mag 3 renogram which showed that there was no blockage but also a split kidney function of 62 to 38 per cent. Is this a normal result where there is one normal kidney and one with an extra renal pelvis, or does it indicate something else is going on? My GP said I had a lazy kidney, but I don’t understand what this means and if it can be made un-lazy. Could there be a connection between the lazy kidney or extrarenal pelvis and the mild pericardial effusion that I also have?

An extrarenal pelvis should be no consequence for kidney function.  If one kidney is smaller than the other, then there can be a difference in the perfusion scan.  I suggest that you consult with your physician for further clarification. It … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Urological Issues

My mother is 85 years old with many health issues (kidney disease, atrial fribillation, peripheral vascular disease, COPD, and Lung Cancer in remission). Her last BUN result was 170 and her Creatinine was 4.3. The nephrologist feels that she is not an appropriate candidate for dialysis. I know that this is limited information but can you please give me your opinion?

The nephrologist who knows your mother and can examine her can provide the best prognosis and treatment recommendations.  I am unable to provide prognosis or treatment advice without performing a complete history and physical examination.  I suggest that you continue … Continue reading

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

Dear Sir, My question is that I have a stone in my kidney. The stone is seen through CT scan but it is not seen in ultrasound. Doctor suggested lithotripsy. I want to ask can lithotripsy shock damage my kidney or is it safe for kidney stone, or any other way to break kidney stone naturally. Kindly guide me. I am fearing for lithotripsy operation due to its side effect.

I am a nephrologist and do not perform lithotripsy.  This is a problem to be discussed with a urologist.  You should discuss the risks and the benefits of the lithotripsy with your urologist. To learn more about Lithotripsy click here:

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Urological Issues

My father is a CKD patient for last 10 years. His current biochemical profile is urea-202 creatinine-9.6 sodium-128 potassium-4.5. He is on antihypertensive drugs and passes 2 liters of urine/day. Intake is restricted to 1 liter. No respiratory distress, lack of appetite, drowsiness, or vomiting. Is it time to initiate dialysis?

I am unable to make a recommendation for dialysis without performing a complete history and physical examination.  The decision should be made by a nephrologist who can consult with and examine your father.

Posted in Ask the Doctor, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Serum Creatinine, Symptoms and Side Effects, Treatments, Urological Issues

My wife is on dialysis since March 2016. She has a fistula in her arm. Her arteries and veins are deep. So they have been having some problems using the fistula. We were talking to one of her doctors. He remembered a medical sales man talking to him about some sort of tube to connect to the fistula, with one end lying just under the skin. Then they would use that end and stick the tubing. He believes it was made of titanium. He is having someone trying to find the salesman. Have you heard of this? If so, do you know the name?

The only device that comes to mind is known as the Vital Access V-Wing device.  You can review the information about this device at:  http://www.vital-access.com/vwing/  

Posted in Ask the Doctor, AV Fistula, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Treatments

Hi, my son aged 16 had a kidney removed last year due to a blockage. He has been monitored regular and his creatinine levels have been from 96-105 this month. Our doctor decided to test his Cystatin C level and it came back this week at 73ml. He has referred him back to GOSH. What does the outcome look like and can it get better?

The Cystatin C level is another way to estimate the glomerular filtration rate (eGFR).  An eGFR of 73 milliliters per minute per 1.73 meters squared would be normal for someone with a single kidney.  I am not sure I see … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrectomy / One kidney, Pediatric Issues, Symptoms and Side Effects, Treatments

Hello doc! My daughter is one and a half months old. She is having hydronephrosis plus hydroureter. The neurologist has recommended a test in which a tube will be passed inside her to check the actual problem. She is passing normal urine. An ultrasound concluded that the left side kidney is having a wrong replacement of its tube which connects the kidney with the bladder. That tube is going in the wrong direction. My question “Is this test is safe for one month baby?

I am an adult nephrologist and do not see children or infants.  I suggest you consult with a pediatrician or a pediatric urologist. For more information on Children’s health click here:

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Treatments

Hello doc! My daughter is one and a half month old. She is having hydronephrosis plus hydroureter. The neurologist has recommended a test in which a tube will be passed inside her to check the actual problem. She is passing normal urine. An ultrasound concluded that the left side kidney is having a wrong replacement of its tube which connects the kidney with the bladder. That tube is going in the wrong direction. My question “Is this test safe for a one month old baby?

I am an adult nephrologist and do not see children or infants.  I suggest you consult with a pediatrician or a pediatric urologist. For more information on Children’s health click here:

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Kidney-Related Health Questions, Pediatric Issues, Pregnancy / Kids, Treatments

Does sodium bicarbonate increase serum sodium level?

Sodium bicarbonate taken as a pill by mouth should not result in an increase in the blood sodium concentration.  

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