Daily Archives: November 2, 2018

Hi, I just had recent blood work done and my GFR was 32. What does this mean?

The estimated glomerular filtration rate (eGFR) is a rough estimation of kidney function that is approximately the same as a percentage of normal kidney function. An eGFR of 32 milliliters per minute per 1.73 meters squared is approximately 32% kidney … Continue reading

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

Good Morning Doc, I am a 48 yo white female, I have a congenital solitary, hypertrophic kidney. It has a large renal pelvis and low grade reflux that has, thus far, only given me trouble once. About 10 years ago when I had a bad infection which put me in the hospital with septicemia. Luckily it was an isolated incident. I work in healthcare as a surgical tech so I’ve always remained very conscience of what I take, medication-wise and try not to “tax” my kidney any more than I have to. I’ve experienced left plantar foot radicuopathy for the past year due to a herniated L5-S1 disc and have refused pain meds. I don’t take NSAID’s. I have had 2 epidurals which have given me some temporary relief. But I still have some burning and tingling in my foot that just won’t go away. The doctors want to put me on Cymbalta for nerve pain. Which at this point is considered chronic pain. I classify it as “annoying” and “quality of life” more than pain and am very frustrated so I’m considering it because I don’t believe surgery is necessary at this point. My question is this: What are the long term affects of Cymbalta on the kidney? I can’t find any information, no one has any answers. Are there any studies? How long is “too long” to take a drug like Cymbalta when the kidney is concerned? Also, my plan if I decide to take it, is to have blood tests every 3 months. What do you recommend I test for?

Cymbalta (duloxetine) is Serotonin-Norepinephrine Reuptake inhibitor (SNRI) similar to other antidepressant drugs that are on the market. It has more properties that are pain relieving and has been particularly useful in the treatment of chronic pain. I do not believe … Continue reading

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

My 18 year old son was diagnosed with Alport Syndrome in February. He is now on med’s to maintain kidney function. I was recently identified as the carrier. I have had level 1/2 kidney disease forever (I’m 50 now). My question is: Can we eat keto (& intermittent fast)? I have been doing keto & intermittent fasting (8 PM to 12 PM) for 2 months, lost needed weight & feel good. I have read that keto & fasting has been beneficial for diabetic & dialysis patients. There are a lot of high potassium foods that are typically on keto lists such as avocado, nuts, dairy. What high fat foods can I eat that are not high in potassium? Thank you in advance for any insight.

I am not an expert in diet. I do not recommend high protein keto diets for patients with chronic kidney disease (CKD). High protein diets have been shown to hasten kidney disease. I suggest that you consult with a dietitian … Continue reading

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

My son, who is 4, has been told that his right kidney had shrunk since last Friday. What could be the cause of that?

I do not believe that a kidney can shrink in a very short time. I am an adult nephrologist and do not see children. In most cases, I would guess that a small kidney in a 4 year old would … Continue reading

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

Hello Dr. Spry, my 5 yo daughter has mild hydronephrosis (right kidney) and vomiting episodes where she quickly becomes acidotic. Her urologist ordered a Mag3 test to be completed soon to find out more. The urologist as well as the hematologist weren’t sure if the hydronephrosis could be contributing to my daughter’s unexplained ongoing normochromic/normocytic anemia, so I wanted to reach out to get your thoughts to see if the two could be possibly connected. Her erythropoietin level was at 8 which was lower than expected for a hemoglobin of 9. Thanks.

I do not know of any association between blockage of the kidney (hydronephrosis) and anemia. If the kidney damage was present in both kidneys and there was associated kidney failure, then anemia related to kidney failure could be present. The … Continue reading

Posted in Anemia, Ask the Doctor, Chronic Kidney Disease, Hydronephrosis and Hydroureter, Kidney Failure, Kidney-Related Health Questions, Pediatric Issues

How does an ileostomy factor (short gut & Malabsorption) in equations, formulas, etc affect the rates, normal ranges etc used to indicate a need for dialysis?

An ileostomy with malabsorption can lead to malnutrition. This can make estimating equations very difficult to interpret. In some cases a 24 hour urine collection must be done in order to make better estimates of underlying kidney function and the … Continue reading

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

Dear Dr, my 6 year old daughter has constant nose bleeds and swelling near the ankles. I took her to the Pediatrician and he sent for some lab work. Her BUN/CREAT ratio is 60. Is this high level common? He cannot see her until a few days. Thanks.

The Blood Urea Nitrogen to creatinine ratio (BUN/CREAT ratio) is not commonly used to estimate kidney function. An elevated ratio can suggest dehydration. An elevated BUN/CREAT ratio can also suggest that there is bleeding that is occurring and getting into … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues

What is the baseline GFR to start dialysis? When other renal panel results are close to or normal with the exception of BUN 66ml/dl; Creatine 4.44mg/dl and co2 @21 mmol/L, last GFR was 12ml/min/1.73m2.

Dialysis is not started on the basis of the glomerular filtration rate (eGFR) test. This test tells us that you have low kidney function, but the decision to start dialysis is made between you and your nephrologist. You and your … Continue reading

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

Dear sir, my sister, Sonali, had a successful kidney transplant in 2016. Her current situation is last month her creatinine level was 1.7 and her current blood creatinine is 3.2. Please guide me. How does she control her creatinine level and how to care daily?

Your sister must be seen and examined by a transplant physician. I am not able to give a specific diagnosis based on the information that you present. Further testing will be required and perhaps a kidney biopsy will be needed. … Continue reading

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

I was diagnosed with hemolytic uremic syndrome in 1991 and was placed on dialysis after acute renal failure. I was three years old at the time. Eventually I was released from the hospital and after follow up care the doctors told my parents that my issue had been resolved. I am now 30. Other than monitoring my creatinine and GFR from time to time, are there any other additional considerations I should watch for or get tested for? How would I know how the injury to my kidneys had a long term effect on my nephrons. Do I have weaker kidneys by default having had the disease? Unfortunately, I was too young when I was being reviewed by experts and most physicians brush the old ailment off as if I recovered from a cold. Just trying to take preventative steps to ensure my kidney health will remain intact. Last GFR estimate for me was 111.

It appears that your estimated glomerular filtration rate (eGFR) is now normal and that you did, indeed, recover totally from your episode of hemolytic uremic syndrome (HUS). I would also recommend that you have annual testing of your urine for … Continue reading

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