Daily Archives: March 15, 2019

Are parents always a match for a transplant to their children or are there times when they are not a match?

A biological parent should be at least a 50% match for their child. In commonly describing this, we talk about a three out of six (3 of 6) antigen mismatch. This is the least it can be and then depends … Continue reading

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

Is there a specific protocol or recommendation for casting materials for patient after ACL surgery? Orthopedic wants to use standard cast and our concern is the weight/water retention fluctuation before, during, after dialysis 3x a week.

I have never heard of such a concern. Casting materials are uncommonly used but if needed are at the discretion of the surgeon or physician applying the cast. Swelling after surgery or injury commonly has to be accommodated with the … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions

Why would Serum Creatinine be higher than normal but BUN would be low but still normal on a scale? Causing a low BUN to creatinine ratio. The low BUN caused by malnutrition.

Malnutrition is a possibility. There are some diseases, such as liver disease and metabolic diseases that cause a decreased production of urea by the body. Someone with liver disease could have kidney disease and this will result in an elevated … Continue reading

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

Dear Dr., My Dad is 92 years old and he is in good health in general. He feels well and keeps active. In Sept. last year he had a kidney ultrasound and everything apparently was fine. In a recent Dr. visit, the Dr. requested a Renal Function Panel and a kidney ultrasound. Can you please let me know if the following results are an indication for you of possible kidney problems or any other problems? Calcium levels are normal, glucose is high, 159 but coming down, Albumin is normal, 4.2 and all electrolyte values are normal (Potassium, sodium, chloride and carbon dioxide) From left to right are more recent to older blood results: 03/13/2019, 03/01/2019, 09/2018, 04/2018; 02/2018 Bun/Creatinine ratio : 23 24 22 27 26 Creatinine: 1.69 1.61 1.61 1.31 1.27 eGFR NON- Afr. American: 34 37 37 47 49 BUN 39 38 36 35 33 Thanks in advance for your support. Regards.

Based on the information that you present, your father may have Stage 3b chronic kidney disease (CKD). I cannot provide a specific diagnosis for the CKD, but the low estimated glomerular filtration rates (eGFR) that are in the range of … Continue reading

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

What stage of CKD does protein typically start leaking into urine? Can you have CKD but not have protein leaking into urine? What tests need to align for kidney disease to be diagnosed and confirmed? I am curious on these because EGFR is just an estimate and has been said to not be a good determination of kidney function in someone who is healthy. Ultrasounds can miss things and only see shape, structure, and size. CT scan can only see the same. Urine tests can pick up creatinine clearance, protein, and blood in urine but can also be a inaccurate measure. With all of these potential variables how can you accurately determine someone has CKD if they are relatively young and healthy without symptoms? Because using blood creatinine can show false causes for kidney disease due to factors like muscle mass, diet, prior test fasting, and laboratory sample differences.

Everything that you mention is a concern and that is why, as a nephrologist, I must consider all of these potential confounding factors. Some forms of chronic kidney disease (CKD) do not have protein in the urine and others do. … Continue reading

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

I just found out I have stage 3. I left Doctor’s office w/out telling Dr. I’ve been in a lot of pain in my stomach, under ribs mostly. From what I read, I haven’t heard of anyone having this. Should I be concerned? Doesn’t seem to fit with the CKD.

I am unable to make a specific diagnosis based on the information that you present. I would agree that pain is an uncommon presentation for chronic kidney disease (CKD), but I suggest that you consult with your physician about your … Continue reading

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