Daily Archives: May 15, 2018

My husband had a mitral valve repair 2004. Now age 64. His valve is failing but he is also peeing red brown urine – hemolysis and we are trying to figure out why. The urine is clear red brown a few times per week . I’m worried about damage to his kidneys. He is otherwise healthy with no DM.

Hemolysis (breakage of red blood cells) is a common complication of failing heart valves. Hemolysis can also cause kidney injury. I recommend that you review your concerns with your cardiologist and heart surgeon. Your husband may need to see a … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Kidney-Related Health Questions, Nephrologist

I have stage 3 ckd egfr is 50. What should my limit for sodium per day be?

I recommend that you limit your sodium intake to 2300 milligrams per day.  This should be part of the DASH diet.  You can review the DASH diet at: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

Posted in Ask the Doctor, Kidney-Related Health Questions

Good Day Dr. I am 76 year old Male white. Since I am 40 years old, I check yearly. The last lab show a slight rise in Creatinine 1.18 with GFR of 60 (MDRD) and I have Hypertension but under control. My fasting blood sugar 101, no Protein in the Urine. What your advice to me? Dr. Thank you.

I am unable to make a specific diagnosis based on the information that you present.  I am not sure if you have chronic kidney disease (CKD).  It is important that your blood pressure be controlled to less than 130/80.  You … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions

GFR 23 range for last 2 years. Watch protein intake, no dairy, exercise daily (well almost), salt intake range 1500 a day. Looking at Dr. McDougalls plant based diet. Curious as he suggests potatoes & other vegetables that are high in phospahates or potassium. Do the benefits of the plant based diet out weight the concern for potatoes etc.? My counts at this time are phosporus 4.7 mg BUN 45mg & creatinine 2.13 I’m not fond of vegetables so Dr. McDougalls diet – focused on starch as your main course – looks appealing. with bread & potatoes & think I could stay on plant based but not sure safe for CKD.

I have always encouraged a balanced diet and never focusing on a narrow list of foods. The most important part of the diet is to restrict sodium or salt intake. I suggest a limit of 2300 milligrams of sodium intake … Continue reading

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

Hi. I’ve been having a lot pain in both kidneys and I have stones in both. My left kidney is also significantly smaller than my right one which has hydronephrosis but the doctors won’t do anything to help unless they see it as life threatening or an emergency. What can I do? I’ve had referrals made to doctors but have yet to hear anything even after calling and I’m in so much pain. I’m at my wits end. Any advice would be extremely appreciated. I have every symptom except for the fever and blood in urine. Thank you

The problem that you describe is a urological problem having to do with recurrent kidney stones and back pain. I am a nephrologist and have no surgical expertise. A nephrologist tries to figure out why someone has recurrent kidney stones … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Urological Issues

I have kidney stones during pregnancy (only when pregnant) in which require stents repeatedly through out pregnancy until lithotripsy can be done. I have had a total of 12 stents and 4 lithotripsy all on the same side, can this have caused permanent damage and pain? My urologist says no but I have frequent pain in the same area. Just wondering if there is anything else I should be aware of or if this is a side effect from circumstance. Thank you.

I am a nephrologist and I do not have any surgical expertise. The question that you ask is appropriately addressed to a urologist  A urologist is a surgeon. I suggest that you continue to consult with your urologist.

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Urological Issues

Can I receive kidney from a donor who is AB positive group and I am O positive and we are not relatives? What are the percentage of chances?

The circumstances that you describe would result in an ABO incompatible transplant. This would be a difficult high risk transplant and require a specialized transplant center to perform. The chances of success are much lower than a cadaver donor and … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

I have stage 3 CKD (Creatinine 1.6 – 1.8) but keeping blood pressure down has been difficult. First of all, recent ultrasound shows Left Renal Artery blood flow is very good, left Kidney is 11 Cm size. Right renal artery plugged and dried up since April 2016. Right kidney now still operating from 2 small arteries and Vascular surgeons opinion is doing maybe 5% of load. It has reduced in size to 5.1 Cm. Question is: How much effect does atrophy hormone have in keeping blood pressure higher. And how long should it take for right kidney to atrophy down to it’s ultimate size as determined by blood supply to it. Average daily pressure is 140 / 80 with pulse about 60 -70. I am taking 100 Mg Metoprolol, 12.5 mg HCTZ, 2MG Doxazosin, and 12.5 mg Spironolactone (1/2 – 25 mg pill) Any medication changes suggested?

The small right kidney can certainly make blood pressure more difficult to control. The kidney that is getting very little blood flow produces a hormone called “renin” that causes the blood pressure to be higher and can injure your remaining … Continue reading

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

Unfortunately, I had a poor nephrologist who was not on top of things. After seeking a second opinion because of feeling so awful, I am now in full blown kidney failure, with a GFR of 13. We are to see the dialysis nurse next week to discuss options for treatment. I am leaning toward hemodialysis, with a fistula, rather than a graft. However, after researching, it appears the fistula takes up to four months to heal before dialysis can begin. Can both a graft and fistula be done at the same time, so that the graft can be used initially and the fistula used, once healed? Thanks.

A fistula should be your first choice. It would be hazardous to place both a fistula and a graft. I suggest you try for the fistula, if possible, and place a graft if the fistula is unsuccessful. Your nephrologist and … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Nephrologist

My cousin is mid 30’s and does not have either kidney. She is cleared to have a live donor. I would like to write something up to provide statistics on her scenario for people to understand medically what a rare situation this is. Can you advise on statistics of: 1) About how many people are living now with out either kidney? 2) What is the average age of a person in this situation? 3) What other statistics and information would be helpful for others to understand what it means to donate a kidney. I think I found about how many live transplants are done a year. Also the risk to someone that donates. It did not hit me how rare this scenario is until I went into the ICU with her a few years ago to visit and I heard the nurses say in shock that she had neither and they did not know it was possible to live with out them. My point is asking for information to motivate others to become a living donor. Thank you!

I am not familiar with any statistics about how many people are living on dialysis without any kidneys being present. This data is not compiled by any entity that I am aware of. We have a section on our web … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, organ donation