Monthly Archives: March 2019

I have one kidney that is in stage four kidney failure. I take a 20 MEQ SA TAB of Potassium a day. How does potassium affect my kidney function?

The kidneys are responsible for balancing the amount of potassium in your body and specifically regulating the level of potassium in your blood. Taking a potassium supplement can cause a high blood potassium level if you have advanced chronic kidney … Continue reading

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

Hi Doc, You have answered a ton of my questions lately and I truly appreciate it. You said from my results you felt there was no CKD present and the kidney function was normal. 1.4 creatinine and 136.6 creatinine clearance. I feel good but I am still anxious. Should I have my doctor check my Cystatin C levels to make sure everything is okay since I am a bodybuilder with high mass. I know I have good creatinine clearance but I’ve seen that can overestimate and my serum creatinine is still high showing a low GFR for me at such a young age. Thank you.

A Cystatin C test would not change my opinion that you have a normal creatinine clearance. The Cystatin C test is yet another test that is used to estimate the glomerular filtration rate (eGFR) and has it’s own limitations. I … Continue reading

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

I have had a creatinine level of 0.8 for the last year or so. Every time I go to the rest room sometimes my urine is completely clear when I have not drank any water at all, other times is a very light pale yellow. I am not sure what to do. When I had urine dip stick test run back in December of 2018 it showed no protein, bilirubin or ketones or glucose in my urine. My GRF at the local emergency room for that same visit was 87. Using the calculator online it says it should be 96. Sometimes also my creatinine dips to 0.7 then back up to 0.8. I am at a loss of words as to what to do. My doctor will not send me to a nephrologist because he does not think there is any problem. All of 2007 my creatinine was 0.7 then in 2018 went up 0.8 then comes back down to 0.7. Would you be able to think of any possible problems that could be causing the clear urine without drinking lots of water?

The normal variation in the serum creatinine from day to day in laboratory testing is plus or minus 0.2 milligrams per deciliter (mg/dl). Hence, the numbers that you quote are not significantly different from each other and are in the … Continue reading

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

My 13 year old daughter has high amounts of protein in urine, discovered during a routine physical. Here are some findings from recent urinalysis as well as an ultrasound: PROTEIN, URINE, CONC. 71 NOT ESTAB MG/DL Final CPL Reference interval for random urine samples has not been established. CREATININE, URINE, CONC. 38.9 NOT ESTAB MG/DL Final CPL Reference interval for random urine samples has not been established. CALC PROTEIN/CREATININE 1825 SEE BELOW MG/G CREAT Final CPL ***** INTERPRETIVE INFORMATION ***** NKF ADULT AND CHILD NORMAL RANGE . . . . .. MG/G CREAT 2-3,000 NKF NORMAL RANGES PREFERRED FOR FIRST MORNING VOID, BUT NON-FIRST MORNING SPECIMENS ARE ACCEPTABLE. FOR ASSESSMENT OF NON-FIRST MORNING SPECIMENS, ADDITIONAL INTERPRETIVE INFORMATION PROVIDED BELOW: AGE MALE FEMALE (MG/G CREAT) (MG/G CREAT) 7-9

The information that you provide suggests that you daughter has an excessive amount of protein in the urine. The normal range for a young female should be less than 150 milligrams per gram of creatinine. The number that you quote … Continue reading

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

Hello, my mom is a 65 year old African American End Stage Renal Disease, Diabetes, Hypertension, dialysis 3 x week since 10/2014. Ulcer developed on her left heel 11/2018. Since then things have gone from bad to worse. The Vascular Surgeon did several tests to ensure good circulation. According to him the ulcer was not due to poor circulation. Then a blister formed on her left lower leg calf area. She had two toes on her right foot amputated on 2/27/19. Now she has two large infected ulcers, one on each leg calf area. Both heels are infected as well. The pain is extremely excruciating and it seems like the pain meds are not helping. She takes Norco, Tramadol, and Gabapentin not sure of the dosages. The Vascular Surgeon suspects that she has Calciphylaxis. If this is true will the ulcers ever heal? What should we being doing? How can we advocate for her?

I am unable to make a specific diagnosis based on the information that you present. I typically see calciphylaxis beginning in the upper thigh area or on the lower abdominal area in the fat pad (panniculus). The findings that you … Continue reading

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

What is the difference between GFR NON AFRICAN AMERICAN and GFR AFRICAN AMERICAN and why are those GFR values always so different? Also, why are they both included in your lab work report and do you follow one or the other based on a person’s race or ethnicity and disregard the race GFR value that you don’t pertain to?

The estimating equation for the glomerular filtration rate (eGFR) uses a different correcting factor for black African American individuals and individuals who are of other races (non-African American). This is based on different muscle masses between different races. For any … Continue reading

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

Hi Dr. Spry, I am a type 1 diabetic 34 and have been a diabetic for 22 years. I am in pretty good shape but I have noticed increases in the amount of protein in my urinalysis. My endocrinologist mentioned using a statin to protect my kidneys at some point. I wanted to know if there where some guidelines for the different levels of albumin and creatine? When should an individual include a statin to protect their kidneys from further damage? Thanks.

The American Diabetes Association recommends that all diabetics be treated with a statin to prevent atherosclerotic heart disease. Statins have also been shown to slow progression of kidney disease in diabetics as well. In the case of the albumin to … Continue reading

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

My 17 year old grandson has protein total urine excretion 417, creatinine clearance 50, creatinine clearance BSA corrected 46, creatinine serum/plasma 1.20, creatinine time urine 29.1, blood urea nitrogen 28, blood urea nitrogen 28. They can’t get him into a local nephrologist until June. Should I take him to the big city. What is going on?

The normal for 24 hour protein excretion into the urine is less than 150 milligrams per 24 hours. His creatinine clearance is also low. The normal for a creatinine clearance in a 17 year old boy should be greater than … Continue reading

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

My sister has kidney problems. Report says plasma glucose is 55.8 mg/DL and serum urea is 125 mg/DL. What should I do, sir?

I recommend that your sister consult with her physician for interpretation of her blood tests. I am unable to interpret tests without performing a complete history and physical examination. Your sister needs to be seen and examined by her physician.

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

My wife has Stage 3 CKD & is in the hospital battling colitis & they are giving her antibiotics. They told me today that her kidneys are getting worse. Is there anything that can slow the damage down or is possible to heal some of the damage after she heals from the colitis? Thank You.

The kidneys are likely suffering from acute kidney injury (AKI) as a result of the infection. In patients with pre-existing chronic kidney disease (CKD) this AKI can sometimes be reversed but this is not always predictable because of the different … Continue reading

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