Monthly Archives: April 2018

When you have CKD does your red blood cell count increase or decrease? Explain why?

The kidney produces a hormone known as erythropoietin as called EPO. That hormone helps to produce red blood cells. When someone develops chronic kidney disease (CKD), the kidney produces less of that hormone and anemia or low red blood cell … Continue reading

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

My husband was diagnosed with type 2 diabetes a week ago. He was in ketoacidosis which is what caused us to go to the ER. Since he’s been released from the hospital he’s developed an ammonia smell to his breath. What test should we ask for? He hasn’t had his post hospitalization appointment yet.

An ammonia odor to the breath can mean many things, including a recurrence of the ketoacidosis. I suggest that your husband call and visit his primary care physician (PCP) for evaluation and diagnosis of his current status.

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

Hello Doctor, I don’t have any kidney related problems. As part of routine health screening, the following reading were observed for Kidney Screening. Is this a concern? Can I get these under control with healthy diet or should I start any medication? Can I go for kidney re-screen after 1 week or when should I go for re-screening? Please suggest diet I should follow. 1. Uric Acid – 10.3 mg/dL 2. Creatinine – 1.0 mg/dL 3. Urea – mg/dL 4. Blood Urea Nitrogen – 5 mg/dL 5. e-GFR Study – 85 mL/min/1.73 sq.m

The only abnormal result that you quote is the uric acid.  A normal result for a serum uric acid is less than 6.0 milligrams per deciliter (mg/dl).  I am not able to comment on treatment unless I am able to … Continue reading

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

OK, first I am on dialysis and have been for the last 10 years. My question is how does smoking weed cause infection and what if you are eating the edibles or the CBD oil? All 3 help with pain, nausea and every thing else I am dealing with. But to get back on the transplant list in my area, I have to quit smoking weed.

The decision to require you to stop smoking marijuana is a decision made by your local transplant center. There is no nationwide transplant guidelines that prohibit giving a kidney transplant to someone who smokes marijuana. Some transplant centers do not … Continue reading

Posted in Ask the Doctor, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions

I am 81 year old male with vascular problems. In April 2016, the right renal artery blocked and my right kidney began atrophy. In 2012, my left renal artery had stent installed via iliac /aortic arteries. Latest ultrasound scans show right renal artery dried up and right kidney down to 5.1 cm. Left renal artery has no blockage and blood flow is normal. Left Kidney seems to have grown as it is now 11.2 cm. However, blood pressure remains difficult to control. I take 100 mg Metoprolol, 12.5 mg HCZT, Doxazosin 2 mg, and 10 mg Simvastatin per day. My Nephrologist just prescribed 12.5 mg (1/2 pill) of Spironolactone for trial period. Vascular surgeon told me when last CT scan was done with contrast, 2 small arteries are still supplying right kidney so there may be some use coming from that. However, I have been led to believe as this right kidney atrophies down to whatever level that is still alive, I am getting a hormonal response that drives up my blood pressure. Can you comment on that ?

Yes, this is likely true. Your blocked right kidney, which is now very small and likely has very little function, can still produce a hormone known as “renin” that will then stimulate your “renin-angiotensin-aldosterone system” also know as the RAAS. … Continue reading

Posted in Ask the Doctor, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Function, Nephrologist

Hello, Just got a quick question out of curiosity. I tried to google it but not much came up. Say you needed a transplant for your right kidney, could it be replaced with the left kidney of a donor or does it have to be the right one?

A kidney transplant is not placed at the site of your old kidney. Your native kidneys are generally left in place and the new kidney is placed in your lower abdomen just above your leg. There are two blood vessels … Continue reading

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

I am a Vietnam Veteran who had a right kidney nephrectomy in December of 2007. I had an acute exposure (immersion) to Agent Orange, patrolling through contaminated waterways in a totally defoliated area in the Mekong Delta in January 1967. I have submitted a claim to the Veterans Administration for service connected disability for the loss of the kidney. The VA has rejected my claim. Are there nephrologists and/or oncologists who are familiar with the effects of dioxin exposure on kidney function and might be able to help me with my claim. I am asymptomatic, but need an advocate with credentials in dealing with Veterans previously exposed to Agent Orange.

I do not know of any experts in Agent Orange exposure outside of the Veteran’s Administration (VA). I am familiar with the benefits policy decisions by the VA and you can access their web site at:  https://www.benefits.va.gov/compensation/claims-postservice-agent_orange.asp In addition, the … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Risk factors

I know I have kidney disease since birth. Today I received blood work with my urine total protein/creatinine ratio of 1886 which is much high than I have ever seen it. Should I be worried, as I am until my doctor returns next week?

Depending on the units of that measurement, a normal urine protein to creatinine ratio should be either less than 200 milligrams per gram of creatinine (mg/g) or less than 0.2 milligrams per milligram of creatinine (mg/mg). This number is likely … Continue reading

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

Hello, I am a 59 yr female, 140 lbs, mild controlled hypertension, with a persistent gfr in the 50’s x 2 years. I had a cystatin c done, of .75 and a creatinine of 1.06, my gfr is 78. I wrote this question to you a few weeks ago. normal renal u/s and normal urinalysis. You wrote that cystatin c is more accurate; my question is ” am I ok to go back on ibuprofen, as I have bad osteoarthritis? 600 mg once or twice a day? Thank you.

I cannot recommend medical treatment without performing a complete history and physical examination. The decision to use Ibuprofen is a decision that you and your physician must make. Ibuprofen is not intended for long term use. It is used for … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

What is the chance of developing CKD when your albumin creatinine is 30ug/mg? And diagnosed microhematuria?

The urine protein that you quote is just barely normal. The normal urine albumin to creatinine ratio in the urine is less than 30 micrograms per milligram of creatinine (mcg/mg). If you have blood in the urine (microhematuria) then you … Continue reading

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