Monthly Archives: January 2019

I had a partial nephrectomy on Nov 12. Since then I feel like I am about 4 months pregnant, but only on the left side. My doctor tells me this is normal and I should be patient; which is probably true. But what exactly is happening? Is it swollen organs (from being assaulted during the surgery), is it a kind of lymphedema? Is there anything that will reduce the swelling as in hot or cold compresses, massage or is the only solution the “tincture of time”? I find that when I start to walk my daily route the swelling gets more pronounced and “harder”…in the morning it is soft. If I sit at my desk it also gets harder. I am going for an ultrasound in 3 weeks which will be the 3 month mark. AND I went through airport security to pick up my grandchildren from a plane at Christmas and the body scan showed a big yellow box where the swelling is, so they gave me an intense pat down; looking for contraband I suppose. Have you heard of that before?

I am a nephrologist do not have any surgical expertise. I’m not sure if you had an open partial nephrectomy or a laparoscopic partial nephrectomy. The edema after surgery can take several months to completely resolve and the muscular injury … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrectomy / One kidney, Nephrologist

My mother, (age 93) has a slow growing tumor on her right kidney. She has had this condition since 2016. She is on medication for high blood pressure and takes 500mg of Tylenol 3 times a day for chronic pain. She is now seeing blood in her urine and her GFR is now down to the lowest reading we’ve seen for her, 39. She is not African-American. I was wondering if all the Tylenol she takes (and has been taking for at least 10 years) could be a factor for the CKD. What are your thoughts?

This dose (1500 milligrams per day) of acetaminophen (Tylenol) should not be a factor in her kidney disease. The kidney tumor could be causing the blood in her urine. At age 93, it would likely not be a good idea … Continue reading

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

Hello Doctor… my creatinine is 3.2 and my BUN is 35, but, all my other numbers are well within normal parameters (glucose, phosphorous, potassium, sodium, etc) …can there be some other answer as to why only my protein numbers are elevated but all the other numbers are low to normal?

I am not able to provide a specific diagnosis based on the information that you present. I would suggest consultation with a nephrologist to provide a specific diagnosis. You should also have a urine test for blood, protein and and … Continue reading

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

I am 36 years old and have been diagnosed with CKD Stage 3 (1.9 Creatanine, 40 GFR). Keeping myself physically fit has always been a huge priority of mine. How can I still do what I enjoy (weightlifting) and put on muscle mass if I am restricted with protein intake? Last I checked, a healthy dose of protein and resistance training were required for muscle protein synthesis and hypertrophy. Please help… thank you.

Protein supplementation is not healthy in chronic kidney disease (CKD). I would suggest that you limit your protein intake to less than 1.2 grams of protein per kilogram of body weight per day. Exercise is not a problem in CKD … Continue reading

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

Dear Dr Spry, I am very worried about my dear wife. She was diagnosed with lung cancer in Sept 17 and she has been on a very bad journey since. She has been on Chemo: Cisplatin only 3 cycles/ Permexetred every 21 days, for 10 months, disease is now stable BUT when she went for her 13th cycle she was told that her renal blood tests were not good enough to allow the cycle to go ahead, and come back in 21 days to see how her bloods are then. Apparently, her renal readings have been gradually getting worse throughout the 10 months (which we were not aware of). I am now concerned that they are now too low for any alternative treatments. Her creatinine is 127, you may be confused by this figure but that’s what it says on the print off, unless there is a conversion for it. eGFR 3, Gamma GT is 83, LDH 261, Cholesterol 5.8, C Reactive Protein 8.0. I have seen that CHICOSAN supplements can lower creatinine levels and cholesterol. Is this correct please? And should she not be be treated for the renal problem please? Best Regards.

I am not familiar with CHICOSAN supplements and do not think they would be of any value in the treatment of chemotherapy induced kidney disease. Cisplatin is known to cause kidney injury that may not be reversible. I suggest that … Continue reading

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

66 year old male who had nephrectomy in May 2018. Papillary carcinoma. Since been diagnosis with autoimmune IGG4 elevations effecting my lungs, sinus, and pseudotumor left eye. Treated with Steroids. Adult onset asthma since 2015. No smoking hx. Most likely related to IGG4. Exercise was running 2 miles. Limited now but continue to eat healthy and exercise. Questions? It has been suggested I take supplement of Calcium 500mg D3 twice day. What ramifications with my one kidney? Fear of kidney damage and stones.

If you have a history of kidney stones, I generally do not recommend calcium supplementation. However, if you have no history of stones or gravel in the urine, calcium with vitamin D supplementation can be appropriate. I generally recommend between … Continue reading

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

The ultrasound said “Right kidney: Measures 9.2 x 3.5 x 3.9 cm. Normal contour. No cysts. Mild right pelviectasis is present. No masses, stones, or frank hydronephrosis identified. Renal cortical thickness appears normal.” I don’t have any back pain or anything. The ultrasound was actually for my intestines but they went ahead and checked all my organs. Everything came back healthy besides this right kidney. I also had blood work done and kidney function was normal. My BUN/Creatinine ratio was 9. I did have a bad UTI infection that kept coming back in 2016. I took an antibiotic that I had an allergic reaction to. When I initially took the antibiotic it took care of the infection but it came back when I stopped because of the allergic reaction. The doctor put me on another antibiotic but I had to take it for a month before the UTI went away. Could that have caused permanent damage? I haven’t had an infection since. I have no pain or anything but I do notice in the last couple years I pee more…especially when drinking water. I’m a 5’7″ male that’s 28 years old. My weight 155lbs.

The ultrasound report suggests that your right kidney is somewhat small. A normal length for a man should be at least 11 centimeters (cm). Your right kidney measures 9.2 cm in length. I am unable to tell you why this … Continue reading

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

My eGFR is 66.66. Is it alright?

The normal for an estimated glomerular filtration rate (eGFR) is greater than 60 milliliters per minute per 1.73 meters squared. Hence, the value you provide appears to be normal.

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

What foods should I eat when I have diarrhea?

In general, we commonly recommend a BRAT diet. This consists of Bananas, Rice, Applesauce and Toast. If you have kidney disease, the bananas could be problematic. You should review this with your physician. I also commonly recommend hydrating with Sport … Continue reading

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

Hello, I am 63 years old and have stage 3A CKD where my creatinine fluctuates between 1.4 – 1.6. I have high uric acid (8.6) and every now and then I get some pretty horrific gout attacks. Are any of the medications to lower uric acid safe to take? I currently take 80mg Telmisartan. I understand that Losartan can lower uric acid levels. Does it make sense to switch to Losartan? Thanks.

You are correct that Losartan does have some uric acid lowering properties and may be used in patients with gout and elevated serum uric acid. I suggest that you review this information with your physician and see if Losartan would … Continue reading

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