Daily Archives: January 9, 2019

My question concerns the use of creatinine, measured in the blood, as an indicator of kidney disease. My understanding is the normal range for the general population is between .8 to 1.2 as regards creatinine in the blood. Is the range different for body builders? Specifically, people who eat a great deal of protein daily, carry more muscle than most people, and work out heavily several times a week. I read that certain individual factors bump the range higher for people who have more muscle, people who eat a lot of protien, people who work out frequently (therefore likely worked out an hour or two prior to the blood test).

Yes, the serum creatinine has an inverse correlation with kidney function (the higher the serum creatinine, the lower the estimated glomerular filtration rate). There is a direct correlation of the serum creatinine with muscle mass (the greater the muscle mass, … Continue reading

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

I am a 64 year old Canadian male, no diabetes, with well controlled hypetension 117/70-75 with Losartan and Norvasc. 14 years ago, my kidney function went from 62-64 to 56-57. My PCP said no problem but I insisted on a nephrologist consult. All bloodwork, urinalysis, and ultrasound were deemed normal. Since that time my GFR fluctuated between 57 and 64. Last year, my GFR suddenly showed a decline to the 53-58 range. Again, my PCP said normal aging (as aging is a component of the GFR calculation and GFR declines with age) but again I asked for a nephrologist consult. My 24 hour urine and urinalysis and a detailed bloodwork analysis were again deemed normal for protein, electrophoresis, etc. My nephrologist said my PCP was right. The decline can correctly be referred to as aging decline. She noted that in the last fourteen years my creatinine varies between 114 and 126 umol/L and this is reflected in the GFR fluctuation. I asked her if this is classified as CKD and she said by the strict KDIGO guidelines, that would be true. I follow a strict low salt diet, similar to DASH. I monitor my BP bi-weekly and ensure I don’t overeat. I don’t smoke and have the rare glass of wine. I maintain my body weight carefully (I am 5 foot 5 inches and weight 132lbs). My question, is it normal for creatinine to fluctuate in such a range? Can my GFR decline correctly be referred to as caused by aging?

The estimated glomerular filtration rate (eGFR) is used to classify the Stage of chronic kidney disease (CKD) but it cannot make a specific diagnosis as to the cause of CKD. In your case, you would technically be at Stage 3a … Continue reading

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

On 11-27-18 I had an MRI done to check the soft tissue damage in my lower back. Partially visualized on scout imaging is a T2 hyperintense lesion in upper pole of the left kidney measuring 2cm. Also partially visualized on scouting imaging is a T2 hyperintense lesion in the lower pole of the left kidney measuring 2.3cm. How critical are these? Will they continue to grow and how fast. Will they harm the kidney? If they need to be removed, is it risky operation? I have yet to talk to a surgeon about, I am looking for information before I do.

I am a nephrologist and have no surgical expertise. I have no expertise in the surgical evaluation of tumors of the kidney. I suggest you consult with a urologist. A urologist is a surgeon who deals with tumors of the … Continue reading

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

My brother-in-law has had a transplanted kidney for 32 years. But it is now failing and must go on dialysis as he waits for another transplant. Since he still has some kidney function left, should he continue to takes his rejection meds so that he can enjoy some kidney function for as long as it lasts? We realize this is a question ultimately for his physician but what is the industry standard practice, so to speak. As an aside, he has been a motivational speaker for NKF conferences.

In most cases, the transplant physicians recommend continuing some anti-rejection medication while awaiting a second transplant. The dose and the types of anti-rejection medication that are continued is often a local recommendation at the discretion of the transplant physician. I … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Medication and Kidney Function, Transplantation, Treatments

Does black pepper have any negative effect on your kidneys?

There are no ill effects on the kidney from black pepper.

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