Daily Archives: November 28, 2018

Dear Doctor, I have done (ureterscopy+ djstenting) for 9mm stone in upper ureter on 28 Feb 2018 in India. After 20 days, the stent became infected and I used antibiotics for 20 days. The stent removed 2 months after operation. Now after three months, there is still minimal to moderate hydronephrosis on my right kidney. One month ago, some pains comes and goes and I used pain killers sometimes, but it is about three weeks that the pain is reducing day by day. Here in Afghanistan, the doctors say that this is a complication from the operation. It will become normal after a few months. Now sometimes I have pain. Thank you!

The problem that you describe is a urological problem and must be addressed to a urologist. I am a nephrologist and I have no surgical expertise. A urologist is a surgeon and deals with surgery of the urological tract including … Continue reading

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

I’ve been sick for 9 days with what was assumed to be the flu. They gave me Tamiflu and since I don’t have a spleen due to congenital oval spherocytosis, they also gave me a Z-pack and then added in Augmentin. I became very nauseated and had to go off of those meds before finishing them. After 72 hours he gave me Cipro. Today I went to urgent care because the nausea has been chronic for 9 days. I have pneumonia and my creatinine was at 1.7. I’ve been alternating Motrin and Tylenol all week too for the fever that lasted 7 days. The urgent care Doctor was very concerned about the creatinine level, but when my physician got the results, he wasn’t concerned. He said it could be that I was just dehydrated. I’ve been drinking fluids and my urine was very clear when tested. Should I be concerned? I’m 64 years old and have mild high blood pressure, which I take one medication for. I’m not on any other regular meds. Thank you

I am unable to make a specific diagnosis without performing a complete history and physical examination. A single creatinine blood test that is abnormal is difficult to interpret. There are many reasons why your creatinine test could be abnormal including … Continue reading

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

Hi. My name is John and I’m having lower back problems with changes in my pee. It‘s less than usual and my bladder hurts a bit followed by my thighs swelling. My creatinine level is 0.87.

I am unable to make a specific diagnosis without performing a complete history and physical examination. I am unable to diagnose a kidney disease based on the information that you provide. You need to see your physician and have an … Continue reading

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

My partner was born with a birth defect where his one and only kidney formed in his groin area and was scarred. My partner has since had a successful kidney transplant in May 2018 after starting dialysis in December 2016. His amazing kidney kept him alive until he was 36 years old and finally its function was below 7% in December 2016. We are now pregnant after trying for 3 years :). Are his genetics likely to cause my baby problems in the same way? We have come off some of the medication that can cause issues to my partner’s sperm in preparation for this pregnancy 2 months before we conceived. I am, however, in full health. Would appreciate your advise. Thanks.

Your partner likely had a syndrome that is generally referred to as “Congenital Abnormalities of the Kidney and Urinary  Tract” (CAKUT). This syndrome is likely related to genetic abnormalities but the genetics are very complex. It is difficult to know, … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Pregnancy / Kids

I wanted to ask your opinion on the supplements acetyl l carnitine and alpha lipoic acid used for pain control in those with neuropathy. I have IGA neuropathy and my last GFR (Oct. 2018) was 51.

Carnitine has been studied in the treatment of anemia associated with dialysis patients. Alpha lipoic acid has been advocated for the treatment of painful neuropathy associated with diabetes. I am not aware of any studies done with either of these … Continue reading

Posted in Anemia, Ask the Doctor, Diabetes, Dialysis, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions

My very stubborn friend has soapy urine, frequent urination, muscle weakness, and is extremely thirsty. I told him to go to the ER, but he’s not listening. What could be causing his symptoms?

I am unable to make a specific diagnosis based on the information that you present. I agree with your suggestion that your friend should be examined by his physician. I do not think that an emergency room visit is warranted. … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

My last 2 years blood work has come back abnormal for the first time in 10 years. High uncontrollable blood pressure from the age of 18 caused by double kidney renal artery stenosis was treated by angioplasty in 2005. I was having extreme unrelenting flank pain prior to angioplasty that only got worse after treatment. The pain went away only after I took 1000 mg Cipro ER for respiratory infection. My high blood pressure did not go away but became controllable with meds and follow up tests show arteries open and had good flow. Still have constant mild flank pain on right side. Yearly checkup in October 2017 normal except platelet count of 80,000. Doctor retired and new doctor had 1 year wait list. I started feeling increasingly tired around Jan 2018. I started B-12 shots to help energy and because I was told I was low in it and it would help platelet count. I have constant mild dull headache with flickers of stabbing pain over my left eye on occasion. Whites of my eyes have dulled and my perfect vision is getting increasingly worse close up. Can still see far away. Ringing in my ears has gotten increasingly louder. Blood work October 2018, RBC 5.73, hemoglobin 16.2, hematocrit 49.1, alkaline phosphatase 108, eFGR 52.8. Creatinine 1.2 mg/dL . BUN 20. Platelet count now 151 10*3/uL, MPV 12.4. Family history of kidney disease on mother and father’s side including kidney cancer. I am 50 yr old female, no smoking or drinking. Eat healthy, exercise riding road bike 25-30 miles 2 to 3 times week, 5’3 130 lbs. A heart echo LVEF of 60-65% impaired LV relaxation with normal filling pressures. No significant valve dysfunction. Insufficient TR jet to asssess RVSP. Trace tricuspid valve regurgitation by color flow Doppler. No estimate for pulmonary pressure due to incomplete TR jet. Pulmonic valve not well visualized. Normal flow velocities. Grade 1 diastolic dysfunction. Normal LV chamber size with normal systolic function and ejection fraction estimated > 55%. Mom died of renal failure and Dad lost kidney to cancer after years of complaining of pain and tests being run and being told nothing was wrong. By the time he got the right scan he had large grapefruit size tumor that cost him kidney and created other lifelong health issues. Doctors group where I live answer to insurance companies and don’t want to run tests necessary to find problem. Where can I go to find doctor that will do what’s necessary to find out why I’m in obvious decline and help restore and preserve my kidney function instead of telling me it’s just what happens when a person gets older? If not one close, can you tell me what tests and scans I should demand doctor run?

I am unable to make a specific diagnosis based on the information that you present. I do suggest that you have a urinalysis to see if there is any blood, protein or infection in your urine. I believe that you … Continue reading

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

Hi Dr, what I want to know is the urine of my husband who is diagnosed with kidney failure stage 4/5. There is still no symptoms and he’s feeling really great. He has bubbles, straw color urine and it smells very strong. Is it good or bad?

I am not able to make any specific diagnosis based on the color or character of your husband’s urine. I suggest that your husband have a urinalysis and see if further testing will lead to a specific diagnosis. Your husband … Continue reading

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

Can the GFR ever increase after it has dropped?

Yes. We need to differentiate between acute kidney injury (AKI), where the estimated glomerular filtration rate (eGFR) can drop suddenly, but the kidney is able to recover and eGFR will then increase. In the other instance, chronic kidney disease (CKD) … Continue reading

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

I will be 62 in a couple of weeks. For years I have been obese, a smoker, and hypertensive (controlled by medication), and oh yeah I have type 2 diabetes controlled by medication and insulin (humalog & lantus). For the past 18 months or so I have been plagued by a reoccurring pain in my left side first diagnosed and strained muscle, but when exercise and stretching did nothing to improve things upon reexamination i began a course of Gabapentin for”nerve” pain associated with my diabetes, first 300 mg then 600 mg and finally 900 mg. I finally told my doctor that the Gabapentin was doing nothing for the pain in my side and he scheduled me for a CT. When the report came in he was quick to call me personally (not normal procedure) so I knew right away it was serious and asked me to come in right away to see him. He had his serious concerned look on his face when he came in. He told me that the CT showed a “suspicious mass” on my left kidney. He thinks it is cancer (so do I). He sent me to a urologist at a better equipped facility for further tests. My first question is, is a 4.0 cm mass very large? The urologist sent me for another CT and a Function & Flow scan from the Nuclear Medicine Department, and then went on vacation until November 26th.

The question that you ask is a urological question. I am a nephrologist and do not have any expertise with masses and growths of the kidney. I also do not perform any surgery. The smallest growths that can be reliably … Continue reading

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