Daily Archives: March 6, 2017

I am a 71 yr. old female in good health. My eGFR has been in the low 50’s for a few yrs. My doctor has not said anything about it. Should I be concerned?

I suggest that you have testing of your urine for blood, protein and infection.  If this is normal, some elderly females can have a mildly low estimated glomerular filtration rate (eGFR) and do not have chronic kidney disease (CKD).  As … Continue reading

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

Hi. I have IgA Nephropathy, with a eGFR of 70-ish. I eat healthily with lots of fruit and veg, low sodium etc. Unfortunately my potassium levels are high 5.7. I am concerned that to change my diet to low potassium will be a diet less supportive of low blood pressure. What would you suggest? Also I was seeing a kidney consultant a year ago but was discharged as kidney function was not too bad. My GP in my last OPA denied that the kidneys excrete toxins, denied that creatinine was measured as a marker for small molecule filtration and seemed generally defensive and dismissive of what I had learned about my own condition. I am concerned that she does not have a good understanding of this condition. I work in a specialist mental health team and I am very aware that GP’s lack in depth knowledge of subjects as they need instead to have some understanding of terrifically broad subjects. I am however concerned that her advice may not necessarily be well informed. I am also concerned that one should also be careful with internet sources.

Your potassium should generally be in the range of 3.5 to 5.5 milliequivalents per liter (mEq/L).  Your potassium is mildly high.  I might suggest that the test be repeated to see if the potassium is consistently high.  If it is … Continue reading

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

I have a graft access for dialysis, my dialysis center just started using it today. My question is, after dialysis do I have to keep the injection site covered with gauze and tape? Or can I leave it uncovered as long as it’s not bleeding?

You should check with your dialysis center about their recommendations.  I generally ask patients to remove the tapes and bandages within 12 hours after your dialysis session so long as there is no bleeding.  You should carefully monitor your access … Continue reading

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

I had an ultrasound done and these were the results : Decreased size and cortical thickness of the right kidney likely related to chronic infectious or inflammatory process. The kidneys demonstrate decreased cortical thickening on the right with increased cortical echogenicity on the right. No hydroureteronephrosis is identified bilaterally. The right kidney is slightly smaller than the left measuring up 3.3 cm on the right and 10.4 cm on the left. My blood work was : BUN 17, Creatinine 0.84, GFR greater than 60 with ratio of 20.2. The doctor said not to worry about it because I have another kidney and my blood work is normal. I do have HBP for which I take Lisinopril 10 mg. Would you suggest I follow up with a specialist or is there nothing that can be done?

From your description, you appear to have a small atrophic right kidney and a more normal left kidney.  I don’t think there is anything else that needs to be done as long as your blood pressure is well controlled and … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Treatments

I have stage 3 kidney disease (gfr 35). My orthopedic surgeon tells me I must take an antibiotic for any dental procedures, including cleanings, due to recent total knee replacement. He prescribed one dose of amoxicillin, one hour prior to my dental cleaning. The dose is quite high, 2000mg (500 mg capsules X 4). Can I safely take this dose without further jeopardizing my compromised kidneys?

Amoxicillin is generally safe for kidney disease as long as the dose is adjusted for your kidney disease.  The dose that you quote, 2000 milligrams, as a single dose is the standard recommendation for prevention of infections after dental treatment. … Continue reading

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

I am a dietitian working in dialysis. I have found a very tasty high protein ice cream, but it contains erythritol, an sugar alcohol. I’ve read that erythritol causes less GI problems than most sugar alcohols because it is absorbed in the small intestine and excreted in the urine. So I’m assuming it is not safe for our patients.

I have no information about erythritol.  I suggest that you visit with the nephrologist who is supervising your unit.  I have not used or seen this substance used in my practice.  

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

My loved one had surgery for peritoneal dialysis in 2015. He never had dialysis until they requested it in late 2016. His tube was blocked and had to have surgery. Since then we’ve been thru infections and what we feel is negligence from his surgeon doctor. He still is not on dialysis. Last instance is his cap came off and he went to hospital office to see surgeon and put tape around it and said when you go and get started on dialysis in 2 weeks they will replace cap. We’ve been trying to start training but the Center doesn’t want to start because they think he has an infection. But the hospital says he doesn’t. It’s a lot in between. Where do we go?

I am unable to make a specific diagnosis based on the information that you present.  This sounds like a very complicated matter that must be guided by the nephrologist who is caring for your loved one.  I suggest consultation with … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Treatments