Daily Archives: August 3, 2017

Good evening Dr. Spry, I was wondering if you can help me. I don’t know much about patient rights in regards to making a decision involving kidney disease treatment. My husband is on peritoneal dialysis and it had recently stopped working because he couldn’t drain after filling. He had a surgery just last week (7/28/17) & he’s still having issues. Today the surgeon tells him that he will need another surgery to try & fix it. Doesn’t my husband have a choice (depending on insurance coverage) to opt out & get a second opinion?

Yes, your husband is the final decision maker. He must sign the consent for surgery and if he is unsure that he wants surgery, then he can request a second opinion.  Your husband has control of his medical care and … Continue reading

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

My creatinine goes from 5.0 to 2.9 in a week. What does it mean? Is it an improvement in kidney function? Usually when creatinine is 5.0 it stays that way and rises higher, but for me it didn’t. What does it mean for me?

I am unable to make a specific diagnosis based on the information that you present.  There could be many causes including laboratory error.  I suggest that you discuss this with your primary care physician (PCP).  Kidney disease staging requires that … Continue reading

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

Hi, I am seeking information for a client involved with the legal system who also suffers from kidney disease. I have two questions. Have you ever known any of the following medications to falsely test positive for cocaine; Hydralazine, Carvedilol, Amlodipine, Renvela-Sevelamer, Dialyvite, and Calcium Acetate? Have you ever heard of or known kidney disease and/or dialysis in itself to cause a false positive for cocaine on a drug test? Any information is appreciated.

I have not seen this and am unaware of any false positive reports regarding dialysis patients and cocaine testing.  I would suggest that you consult with a toxicologist for a major laboratory company.  I think there are several ways to … Continue reading

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

Hello, I had a CT scan 5 years ago before I had my gallbladder removed. I was told I have a ‘horse shoe’ shaped kidney, that they are fused together making it a ‘super kidney’. They told me I was born this way and I have lived my life not knowing. I haven’t had issues that I know of but is their any advice you can give me? Any knowledge about this as they just told me ‘drink lots of water’. I did have a UTI with low back pain one but antibiotics cleared it.

A horseshoe kidney is a congenital (you were born with it) abnormality which results in the bottom of each of your kidneys joined together and lying over your spinal column.  It is normally a totally asymptomatic condition.  The only problems … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Treatments, Urinary Tract Infection/Pyelonephritis

This is the result of a CT UROGRAM done in 10/2012. There are bilateral renal calculi. Specifically, there is an approximately 9 x 5 mm right upper pole calculus with focal prominent thinning overlying cortex consistent with sequelae of prior infection. There is an approximately 3 mm calculus centrally mid to upper pole left kidney. IMPRESSION: BILATERAL RENAL CALCULI, LARGER ON THE RIGHT WITH THINNING OVERLYING CORTEX CONSISTENT WITH SEQUELAE OF PRIOR INFECTION. NO RENAL MASS OR OBSTRUCTIVE UROPATHY. I’ve had shockwave done twice, once on the right in 2012 and once on the left last year. Recently I have been seeing my primary because of a UTI. I had an urinalysis done in office with the following results; Component Your Value Glucose neg mg/dL Bilirubin moderate Ketones trace mg/dL Spec Gravity 1.025 Blood large pH 5.5 Protein >=300 mg/dl mg/dL Urobilinogen 2.0 E. u> /dl EU/dL Nitrite positive Leuk. Esterase large Color red Pale yellow Appearance other, on period All of my pain is on the right side. I am nauseous, occasional vomiting, loss of appetite, and difficulty urinating. At times it is difficult to start a stream and at times only a drizzle comes out. The CT scan I had on 07/07/2017 did not show a stone on the right side. I have scarring in my right kidney due to a prior infection. So I am wondering is the stone that was originally there, able to hide behind the scarring and not be seen on CT? How does a 9 mm stone just disappear yet the 3mm one in the other kidney still be there? and if there is no stone, then why the crazy numbers on the urinalysis? Any thoughts would be helpful.

The problem that you present is a urological problem.  I am a nephrologist and have no expertise in the surgical management of kidney stone disease.  You need to consult with a urologist.  A urologist is a surgeon who deals with … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

Micro-Chinese Medicine Osmotherapy have you heard of any positive real results under this treatment for patients with Iga Nephropathy? How does Cyclophosphamide help in reverting IgA Nephropathy?

I am not aware of any successful treatment of IgA nephropathy with Chinese Medicine Osmotherapy.  I believe this therapy is of no benefit.  Cyclophosphamide is a very potent immunosuppressive therapy that must be used with caution.  It is a cancer … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

For the last 7 months my GFR level has decreased from 71 to 54. I am a 55 year old white female with diabetes. Should I be concerned?

Yes.  A decline of kidney function by nearly 20 milliliters per minute per 1.73 meters squared in less that a year would be a source for concern.  I suggest that you also have urine testing for blood, protein and infection … Continue reading

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

A 82 year old frisky male has had reasonably well controlled DM and Hypertension for decades was diagnosed with CKD a year ago. He also has increasing microalbuminuria and stable retinopathy (of unknown causation). If all other possible causes of CKD can be excluded, can it be determined whether his CKD was caused by DM or hypertension?

High blood pressure (hypertension) and diabetes are the two most common causes of chronic kidney disease (CKD).  It is most likely that both hypertension and diabetes are the cause of his kidney disease.  The presence of the retinopathy and microalbuminuria … Continue reading

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