Monthly Archives: July 2017

Thank you for all the great work you do. With all the classes of BP medications available, are there any more preferable and/ or safer for the CKD patient. For example I have heard that Ramipril is beneficial for the kidney patient.

In general, blood pressure medications that are ACE-inhibitors and ARB agents are preferred for most patients with chronic kidney disease (CKD).  Ramipril and Monopril are ACE-inhibitors and Diovan (Valsartan) is an ARB agent.  Verapamil is a calcium channel blocker and … Continue reading

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

Hello to all, I suffer from Stage 3 CKD, with about 40-50 kidney function. I was wondering if taking Glucosamine sulfate is safe, since it contains high amounts of potassium?

Glucosamine sulfate should not cause any problems for your kidneys.

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, Treatments

What are bulbous kidneys and do they cause problems?

I am not familiar with the term “bulbous kidney”.  That is not a medical term that I am familiar with.  I would ask for clarification from your physician.

Posted in Ask the Doctor, Chronic Kidney Disease

My three year old son is in remission with Stage II WILMS FH. He had a left radical nephrectomy. He is currently being followed by oncology. Recent test have shown that his GFR was a 38, according to the pediatric calculator. His BUN was 13 and Creatinine ranged from .40 to .45. The pediatrician and oncologist do not seem to be worried. We would like to be seen by a nephrologist but they do not seem to think it is necessary. What is your thoughts?

Wilm’s tumors are treated by a urologist.  Removing one kidney should cause a reduction in the overall kidney function.  That is an expected result from removing one kidney.  I suggest that your son continue to consult with his pediatrician.  Referral … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Pregnancy / Kids, Symptoms and Side Effects, Treatments

I have had uric acid kidney stones for over a year. I get them every month. They pass on their own. I go to the hospital for pain management if I have to. Recent blood test from hospital on June 10 showed chronic kidney disease stage 3. The creatine 1.33 gfr 46. CT tests showed multiple stones in left ureter. I am female 53 years old. Will I live long enough to see my 12 year old become an adult? My doctors never told me this. I never knew this could happen with just a year of stones. Could it go back to normal once stones pass?

Kidney stones are usually treated by a Urologist.  I am a Nephrologist and treat patients to prevent kidney stones.  I suggest that you consult with a Urologist and determine the best course of treatment for your existing stones.  You should … Continue reading

Posted in Ask the Doctor, Nephrologist, Urological Issues

I’m 26 year old Female, facing Proteinuria (++) since the last 6 or 7 months. Protein spot urine 148.8mg/dl, creatinine spot urine 160.8mg/dl. Protein/Creatinine ratio spot Urine 920.4mg/g. All other Urine and Blood tests are normal. Can you suggest me some proper treatment so that I may be recovered from this disease?

I am unable to make a specific diagnosis based on the information that you present.  Protein in the urine has many different causes.  A normal protein to creatinine ratio is less than 200.  Hence, your kidneys are leaking protein.  I … Continue reading

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

My fiance in the Philippines was diagnosed last month with CKD. He went to another nephrologist for second opinion because he doesn’t want to go through dialysis. Will his body be able to take all the toxins. I don’t know how to convince him to go through dialysis. I still have to petition him so he can come here and have close monitoring treatment. Our son is excited to see him soon and I want him to be alive and well by that time happens.

I am unable to make a specific diagnosis based on the information that you present.  I cannot determine the cause of the chronic kidney disease (CKD) or the proper treatment.  I suggest that your fiancé continue to consult with his … Continue reading

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

Doctor, My brother started Dialysis 3 weeks ago. They have told him to keep his liquid intake at 32 oz daily which he has done. But since doing this his legs are swelling up and they are painful to the touch after each treatment. He sweats at work and therefore loses even more fluids. He has been weak and light-headed, has dizzy spells and his heart rate has gone up. To me, he has the symptoms of dehydration. I’ve had it several times, so I know what it feels like. Plus, the only time he gets worse is at dialysis and right after. He has treatments 3 times a week. At first, his sessions were 3 hrs and he was doing better, but recently they have increased them to 4 hours and that’s when all of his symptoms started. During his treatment today his heart rate went so high that they rushed him to the hospital. Can you share your thoughts with me on what could be causing these sudden problems? He is very strict about following his diet, but I think he isn’t drinking enough fluids and with sweating at his job and the treatments it’s dehydrating him even more. Thank you Doctor, I really appreciate your time and anything you can share with me.

If your brother has swelling in his legs, then he has excess fluid in his body.  The goal of dialysis is to remove all of the swelling in his legs and to achieve a normal blood pressure and pulse.  If … Continue reading

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

Hello, My fathers kidneys have been declining since 1997 To make a long story short his PCP failed him by not referring him to Nephrologist (based on lab results) He had a complete workout w/ his specialist only to say his kidney functions were at 40% bloodwork, imaging showed no cause as to why his kidneys were declining in function. He recently July 18, 2017 switched to another specialist , the Dr ran extensive work up consisting of blood, lab, imaging tests as well as had his earlier medical records and tests. The dr said he had chronic kidney disease stage 4 All tests revealed indicating declines in both kidneys, Scarring on both kidneys. Sorry I’m not more precise as I’m getting info from my mother. I am going to request his lab results for myself. The Dr said he could not find a cause to what is causing his chronic kidney disease. My dad always had low blood pressure, no diabetes, was not overweight, led active lifestyle, no cardiac issues. No medical history that would explain. He served in Vietnam was drafted late 1960’s. He did receive 3 Purple Hearts. I do know he fell on landmine to save someone in his troop and had graphs put on his face. Also the use of agent Orange. I don’t believe (unsure) if Dr tested for genetic Markers, chromosomal etc.. he did have a biopsy years back which did not help or aid in explaining a cause. My question is what could be causing this? Is their a test that’s not standard or well known to do to help in finding a cause? I know environment, genetics and congenital could be possible causes. I am unsure if blood tests done or workup would show this. Any help would be appreciated. I am requesting my dads medical record. He is 73, Italian (born in Bari, Italy) has lived in MA area since he migrated here. He always had low blood pressure, his kidneys have high blood pressure, protein in urine . The ultrasound revealed small kidneys with extensive scarring. Hope this helps. I apologize for not being more specific while writing this. Any information or resources would be greatly appreciated.

A kidney biopsy should be definitive as far as indicating the cause of chronic kidney disease (CKD).  The kidney biopsy, if the tissue sample was adequate, should give the pathological cause of the CKD.  I suggest that you review the … Continue reading

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

I have a good family doctor, Today I received my 3 month blood test report. My creatinine serum was 1.18. They told me it was a little elevated but nothing to be concerned about. Everything else was wonderful. I am diabetic and have taken Metformin for many years and go every three months for a blood test. Do you agree with them and that I just should watch it to see if it continues to raise.

The creatinine result that you quote is mildly elevated.  I recommend that you continue to follow your doctor’s advice.    

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