Daily Archives: May 3, 2017

What if any clinical significance is there when the creatinine level is elevated and indicates CKD, but the BUN and the BUN-creatinine ratio are normal?

The serum creatinine is a much better test for kidney function than the blood urea nitrogen (BUN).  There are many things that change the BUN test that do not have anything to do with kidney function. The serum creatinine is … Continue reading

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

Hello, I’ve been in Mexico for the past 3 months. About a month ago I discovered I had some sort of worms living inside me and started a course of medicine to get them out. It was 3 days straight of very strong medicine (can’t recall the names of which) which ended up not working. I read those medicines can be toxic, so I took a naturalist approach after 2 days of finishing the medication. Started with just garlic and lime juice. 2 days into that, had sharp pain in both kidneys. I kept treating for 5 more days with papaya seeds, coconut oil, and the garlic and lime juice. Stopped everything a day ago because although the pain has gone away, I have this constant pressure always in my left but sometimes both kidneys. I got a urinalysis and blood test and both say everything is normal. Just wondering what this could be? It does not hurt but it is a little uncomfortable and definitely does not feel ‘normal’. Many thanks for reading and I am looking forward to your reply.

I am not able to make a specific diagnosis based on the information that you present.  You need to see a physician for a complete history and physical examination.  I believe you should see your physician.  

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

I am a 51 y.o. caucasian woman with a GFR of 45, Creatinine of 1.27, 4.3 Albumin and BUN of 11. I am overweight, have slightly elevated cholesterol (204) though I exercise religiously 3x a week – 180 minutes total – doing cardio exercise, circuit training, and weight lifting. My BP is pretty average and I am not diabetic. My question is this: Am I at a point that I should pursue treatment with a nephrologist, or is it still relatively early? My GFR has dropped steadily for years and this is the highest creatinine reading I’ve had as well, so I am concerned.

The information that you provide would suggest that you have Stage 3 chronic kidney disease (CKD).  Most primary care physicians (PCP’s) are very capable of managing Stage 3 CKD.  The main treatment for your disease is likely to lose weight, … Continue reading

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

I had my transplant just under a year and a half ago after being on dialysis for roughly a year. Since transplant my kidney function has been steadily worsening to the point that now I am at 25% function which is where I was when I started dialysis. Two Biopsy have shown no signs of rejection but my most recent creatinine is 2.5 and my proteinuria is 3000. The journey has been very frustrating for me especially since my nephrologist seems to be just “throwing things up against a wall to see what sticks.” The only thing that seemed to improve my situation was being put on prednisone although my DSA showed no reason why that would be the case. Have you heard of any similar cases and what seemed to work for them?

Kidney transplantation is a very inexact science and can be very difficult to anticipate complications and treatments.  In most cases, kidney transplant biopsy should lead to a specific diagnosis of the transplant dysfunction.  In some cases, there can be a … Continue reading

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

My Husband has CKD stage 4. Last May 2016, he had a UTI and was prescribed trimethoprim. After 4 days he was admitted to hospital with hyperkalemia (6.4) and an acute on chronic kidney injury. He is now on a diet to keep his potassium levels satisfactory. Today his local GP has diagnosed that he has a chest infection and has prescribed amoxicillin 500mg capsules for 7 days. Is this a suitable prescription for a patient with CKD stage 4. Would it be necessary or a worthwhile procedure to have a blood test taken when he has completed the 7-day course to identify if his potassium levels have been affected? What symptoms should one look out for or what tests should be done to check if he is diabetic.

Trimethoprim is known to cause high blood potassium because it interferes with the kidney elimination of potassium.  Penicillins such as amoxicillin do not usually cause potassium problems.  Your husband’s physician should be able to determine if he is a diabetic … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis

My 67 year old father with heart ejection function 10 percent, having diabetes and hypertension. According to tests, doctor recommended dialysis 2 times a week. His blood urea and creatinine level is very high. He is on dialysis and insulin. Are there any chances of survival?

I am unable to provide a prognosis based on the information that you provide.  I recommend that you contact the physicians caring for your father and ask them about prognosis and treatment information.  I suspect his heart disease is the … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Nephrologist, Symptoms and Side Effects, Treatments

Question on use of anti-rejection meds post chronic kidney transplant rejection. What has been the experience of kidney transplant patients who have lost their kidneys due to chronic rejection or other reasons as far as continued use of anti-rejection meds (cellcept, prograf, rapamune)? Can one come off or wean off the anti-rejection meds or will patient need to stay on anti rejection meds to prevent immune system attacking a kidney that is still receiving blood flow though the kidney is not functioning?

There has not been a randomized controlled clinical trial of when and if to withdraw immunosuppression from a kidney transplant patient after the kidney transplant has ceased to function.  Each transplant center determines the protocol for withdrawal of medications that … Continue reading

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

Please explain non obstructing nephrolithiasis, right kidney normal ultrasound of the left kidney and urinary bladder.

Stones may be within the substance of the kidney and not obstruct the kidney.  I recommend that you clarify this with your physician.

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

(Lab #1) S-creatinine 123 umol/L Abs. eGFR 50 mL/min U-alb. 100 mg/L; U-cre. 6.25 mmol/L ACR 16.00 g/mol 2016-10-07 09:24 (Lab #2) S-creatinine 150 umol/L Abs. eGFR 46 mL/min U-alb. 98.3 mg/L U-cre. 8.45 mmol/L ACR 11.63 g/mol 2017-03-23 11:07 (Lab #2) S-creatinine 144 umol/L Abs. eGFR 48 mL/min U-alb. 89.3 mg/L U-cre. 14.48 mmol/L ACR 6.17 g/mol A) From these numbers can it be said that the kidneys’ condition is probably a) getting worse, b) stable c) getting better? B) Why or why not? Thank you, Doctor!

The urine microalbumin level and the estimated glomerular filtration rates (eGFR’s) that you quote are not different from each other.  These measurements are within the usual variation expected with laboratory measurements.  Hence, these measurements are stable.  

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