Monthly Archives: June 2018

I have a question regarding FSGS. Recently a dear person to me told me that she was diagnosed with MCD when she was 6 years old ( biopsy was taken at that time). Few years later she mentioned that another biopsy was taken which showed FSGS. Ever since she was followed up by nephrologists and was on steroids and in 2010 she was on cellcept until she stopped both steroids and cellcept in 2016. She had testing done and her recent test shows only an elevated ACR of 67 which I’m assuming to be subnephrotic range. All her kidney functions and ultrasounds were normal and so for the past 26 years she has had this condition and kidney function seems fine. My question is what are the chances of her going into ESRD and needing dialysis? I know it is difficult to speculate but given a history of what I’m guessing a stable partial remission FSGS what are the likelyhood of needing dialysis down the road? Do all fsgs patients end up on dialysis? Thank you

Focal and segmental glomerulosclerosis (FSGS) has many different courses and many different presentations. There is not just one clinical course for all patients with FSGS. In fact, minimal change disease (MCD) has often been found to evolve into FSGS when … Continue reading

Posted in Ask the Doctor, FSGS, Kidney Biopsy, Kidney-Related Health Questions, Minimal Change Disease

A medical record in my patient portal cites a lab result of 58.33 for “estimated GFR” along with this explanatory note: Units are: mL/min/1.73 meters squared. Staging assumes the associated GFR level has been in effect for at least three months. Stages 1-5 indicate Kidney Disease. GFR = 30-59: With OR without kidney damage = Stage three my Questions: does this information mean I have “stage 3 kidney disease?” and therefore should I be seeing a kidney specialist? My primary care physician did not communicate this result to me and I would not even be aware of it if the hospital’s patient portal had not included lab results. I am also wondering if I need to change doctors since it seems to me this is important information that should have been discussed and seriously compromises my trust in my primary care doctor. Of the 8 common kidney disease symptoms I only have experienced fatigue, and I have had two instances of kidney stones (2004, 2016). I am 66 years old. Thank you.

As mentioned in the results and explanation, chronic kidney disease (CKD) can only be diagnosed if these results remain in the same range for at least three months. There are many things that make the test mildly abnormal from time … Continue reading

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

I need your expertise. I had my physical in March (turned 50). Had the complete exam as well as the entire blood panel (included everything). In March the Serum Creatinine came back at 1.07, all other results in the normal range. Then went back May 1st to get a BMP. Creatinine came back at 1.09 and the eGFR came back at 59 so my doctor sent me in for a Urinalysis and the Urine Creatinine, Urine Albumin and ALB/Creat Ratio all came back normal as did the Kidney Ultrasound. I don’t have Diabetes or High Blood Pressure (all normal) so would like to get your thoughts on the results. I was taking birth control and stopped taking it on May 1st. I don’t have any symptoms of any kind nor do I take any medication. I don’t even take aspirin. I exercise daily (strength training/cardio). I drink plenty of water and green tea. Rarely eat red meat either. Looking forward to hearing back from you. I submitted a question earlier today and am still waiting for his response. I wanted to give him another blood result #. Back in March my creatinine came back at 1.07 and my eGFR was at 61. In April my creatinine was 1.09 and my eGFR was at 59. According to my ranges the creatinine was in the normal range but the eGFR was not. All other tests have come back normal (i.e. urinalysis no protein in urine and kidney ultrasound nothing found, kidneys in good shape). I have no symptoms and feel great! I workout daily and have quite a bit of muscle but am not a bodybuilder. I do not take any supplements, vitamins or medications. I do not even take aspirin. I stopped taking my birth control (Gianvi) on May 1st. Please advise. Thank you!!!

I am not able to make any specific diagnosis of kidney disease based on the information that you provide. The laboratory test for serum creatinine has some variability. The two results that you describe are within laboratory error. The serum … Continue reading

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

Hello Dr. Spry, A recent ultrasound had shown that I have some mild kidney damage. I assume from the three times I’ve had exertional rhabdo (3/94, 6/13, 8/13). I requested a Cystatin C test and it came back normal, but both my GP and the nephrologist he referred me to, are disregarding the result. Do you have any idea why they would dismiss this normal result?! Also, I just got back my results from a Creatinine, 24-hr Urine test. Result is listed as “Above high normal” at 2.523 with the normal range listed as “0.6-1.8”. but I have read that males: should be at 955-2936 mg/24 hours and males should have: 13-29 mg/kg of body weight/24 hours. This would make my 2523mg normal at my weight of 90.899911kg. Also, I am 177.165 cm tall. I now have a serum cr of 1.35 (down from 1.53) after taking a month off from lifting weights/exercising before the Creatinine, 24-hr Urine test. I believe this these numbers bring my ClCr into a normal range? Thank you in advance if you find the time to let me know your thoughts on this. Thanks again.

From your discussion and laboratory information that you provide, I suspect you have a much larger muscle mass than the average male. As you mention that you are a body builder and have apparently suffered muscle injury from excessive exercise. … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

Hi doc, I am diabetic patient. My creatinine is 9 and I am also anemic. What would you recommend to reduce creatinine level?

A serum creatinine of 9 milligrams per deciliter (mg/dl) suggests very advanced chronic kidney disease (CKD). There are no medicines that lower the serum creatinine. I recommend that you consult with a nephrologist in your country. These laboratory results suggest … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Serum Creatinine, Transplantation

I am a 63 yo WF with hx of HTN secondary to primary aldosteronism. Also have Diabetes, hypothyroidism, & past hx of 10 cm ovarian cyst. Family hx studded with Diabetes & CV disease. Maternal GF died of kidney failure/Diabetes. Previous Creatinine early this year = 2.3 (Metformin d/c’d) & on 5/7 Creatinine = 1.30, BUN = 26, & GFR = 44. PCP & endocrinologist do not appear not to be concerned with results. Will lab values continue to improve until normal or are we beyond that point (especially with family hx)? What are your thoughts? Thank you very much.

I am unable to determine a prognosis based on the information that you present. It would appear that you have chronic kidney disease (CKD) and this is likely not completely reversible disease. I do recommend that you have regular testing … Continue reading

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

During the night I get up to urinate about 3-4 times, but towards the morning, my left side of the kidney hurts (like throbbing pain). It’s telling me to go to the bathroom. Not much urine is released but it feels a bit better (the pressure). That happens every 1/2 hour about 2-3 times then I need to get out of bed. What could it be?

I am unable to provide a specific diagnosis based on the information that you present. From the description, it sounds more like a bladder than a kidney issue. I suggest that you consult with your primary care physician (PCP). Bladder … Continue reading

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

Hello Doctor, my serum bicarbonate levels are usually coming back low and my uric acid recently came back low as well. I asked my doctor about it and she said that they are used for kidney function but as the egfr came back normal, it must be fine. Is this correct? I am concerned as one of my relatives was diagnosed with mitochondrial myopathy, which can be genetic, and I have been reading this can be associated with kidney issues. Thanks for your time.

If you have a low serum bicarbonate level and a low serum uric acid, this could be suggestive of a kidney disease known as proximal renal tubular acidosis or Fanconi’s syndrome. Certain genetic diseases and rheumatological diseases can be associated … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

My eGFR is 29. What is the prognosis of that percentage? Many Thanks.

I am not able to provide a diagnosis or a prognosis without performing a complete history and physical examination. The estimated glomerular filtration rate (eGFR) merely provides an estimation of your kidney function and does not provide a diagnosis or … Continue reading

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

I am 63 y/o F w/ multiple endocrine problems to include diabetes T2 & strong family history of both diabetes & CV issues. Maternal GF died of kidney failure secondary to diabetes. 11/17 Creat was 2.3 & this past April BUN=26, Creat=1.30, & GFR=44. PCP concerned when Creat=2.3, but does not appear to be worried with April’s results. What are your thoughts & should I be more proactive in pursuing this? Thank you.

The fall in your serum creatinine from 2.3 milligrams per deciliter (mg/dl) to 1.3 represents an improvement in your kidney function. That is certainly a welcome finding. I would also recommend that you have testing of the urine for blood, … Continue reading

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