Monthly Archives: January 2019

I had a kidney transplant 5 years ago. I saw a cardiologist today that wants to do a nuclear stress test. I thought radioactive dye was bad after a kidney transplant?

A nuclear cardiac stress test does not have any kidney toxicity and should be safe for a person with a kidney transplant. Iodine containing contrast used for cardiac catheterization can be toxic to the kidney, so if the stress test … Continue reading

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

I am a healthy, normal weight, non-diabetic, 31 year old Caucasian female. I have had bloodwork done 3 different times over the course of 2 years and my creatinine is consistently over 1.2 mg/dL and my eGFR is consistently under 60 mL/min/1.73m2. I was recently told the reason could be that I am on the oral contraceptive Ocella, which contains the hormone Drospirenone which has antimineralocorticoid activity and can act as a diuretic. However, the person who told me this, is not a physician. Is it possible for consistent abnormal lab work to be caused by Drospirenone or is that unlikely?

I am not aware of any diuretic activity for drospirenone. Drospirenone is a progestin-like compound and can have some anti-mineralocorticoid activity, but this would cause fluid retention and not diuresis. I am not able to provide any other diagnosis based … Continue reading

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

I am 52. Recently told I was stage 5 last week. Total shock. Started dialysis. I notice first week only urinated 1 time a day in the morning. Yesterday three one morning, then evening and late last night, and about 3 in morning. Can your kidney cells improve? Doctor, can I live on dialysis for a long time? I just want someone to be honest. Not sure what to do.

Urine output is not a good measure of kidney function. Hence, your listing of the number of times you pass urine is not reflective of a return of kidney function. Most patients continue to have urine output despite being on … Continue reading

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

My father 68 lost consciousness during dialysis. He is in ICU intubated but at minimum support attached; his vitals are stable all Neural tests are normal. GSC score is low but he responds to pain. He is not in coma or brain dead. Please help.

I am unable to provide a diagnosis or treatment recommendations without performing a complete history and physical examination. You should discuss this with the physicians who are caring for your father.

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

Hi Dr., I am presenting with low urine output, severe abdominal swelling, difficulty concentrating, high BP, extreme fatigue, muscle weakness/soreness. All of my labs have been normal, have a background in nutrition with excellent health habits. Echo/Heart MRI perfect, A1C 5.1. Have been managing Lipedema/ Lyphedema very well no progression, still having abdominal swelling in spite of Manual Lymph Drainage and Pump. Doctor said it is more than Lymphatic Failure. I could use your help with any suggestions you may have. I have been looking into Lysosomal/ Mitrochondrial/Metabolic Disorders. Thank you so much. My family history is Tinnitus, AFIB, Lipedema, Lymphedema.

I am unable make a specific diagnosis based on the information that you present. I do not identify a kidney disease based on the symptoms and information that you present.

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

Can a diabetic patient with CKD take fish oil/omega-3 supplements? Are there any supplements that are good for them and which are bad? Thank you.

Fish oil and omega-3 supplements are commonly used in patients with chronic kidney disease (CKD). Patients with CKD often have elevated triglycerides and treatment with fish oil and omega-3 supplements are commonly recommended. I do not know of any specific … Continue reading

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

Hello! I am a 28 year old male and relatively healthy but I was born with one kidney and I’ve always been curious as to whether or not it effects my adrenal functions. Since technically, I only have one adrenal gland and all, will it effect my hormones level? Such as my cortisol, catecholamines, and adrenal androgens? Thanks!

You only need one adrenal gland to have full functioning of your adrenal axis. It is also possible that you could have an adrenal gland, even if you were born without a kidney on one side. It is likely that … Continue reading

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

I recently had some labs done. My BUN was 20, which was slightly higher than its usual 14 or 16. My creatinine level was .67, which also was a fraction lower than a year ago at .71. Those were all within the lab’s normal range. However, my bun-creatinine ratio was 30 and the lab’s normal range tops out at 28. The ratio is higher than it was last year when it was 20. Should I see a doctor? Is the ratio meaningless if the numbers themselves are within normal range, even though they have changed since my last test. My GFR is 95. My A/G ratio is 1.8, which is also in the normal range. I have not had any kidney issues other than kidney stones 20 years ago. I do have primary biliary cholangitis but take medication for that. I have been trying to eat more protein and likely had no liquid other than coffee and a small glass of water on the day of my test. Thank you very much.

A high protein diet will cause a elevated blood urea nitrogen (BUN). This may be the cause of the elevated BUN that you describe. Otherwise, I am unable to make a diagnosis of kidney disease based on the information that … Continue reading

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

I am trying to understand the way CKD is staged but it is confusing. eGFR of 60 and above is set as the normal level but kidney function also declines with age at about 1% a year. So individuals with a eGFR of 65-70 are called normal. But due to aging decline does this mean that in 5-10 years their eGFR will fall below 60 and will then be classified as having CKD? How is it possible to go from normal to stage 3 of a disease?

The Stages of chronic kidney disease require two pieces of information. What is the the estimated glomerular filtration rate (eGFR)?  And what is the urine testing that includes blood, protein and infection in the urine? These two pieces of information … Continue reading

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

My daughter recently saw a nephrologist who was stumped as to why her erythropoietin is at 6 (expected to be close to 100 with a hematocrit of 30 and hemoglobin about 9.5) yet kidney function studies are all within range such as creatinine .5, BUN 12, etc. What might account for an epo-deficiency without obvious CKD? As we pursue further evaluation, any lab recommendations?

I am unable to make a specific diagnosis based on the information that you present. In the absence of kidney disease, a deficiency of erythropoietin would suggest a failure of the kidney to make erythropoietin or an autoimmune reaction against … Continue reading

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