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 pathological interpretation of the kidney biopsy.

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