Daily Archives: April 1, 2019

Hello, and thank you for this great service! I wondered – is there any evidence to suggest any benefit in reducing salt intake for a young family with no medical conditions, hypertension or kidney problems? Should I be using salt freely in my home cooking (within reason), or limiting it as much as possible? Many thanks.

Your question is an interesting one, in that for a specific family with no known medical conditions, who are young and lead an otherwise healthy lifestyle, there is no specific evidence that decreasing salt intake will result in any better … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions

In 2013 my scr was .96. In June of 2018 it was 1.02 and most recently in March of 2019 it was 1.1. I’m 35 years old 5’7” and 155 lbs. I don’t have any health conditions. Is this something I should look into further?

The normal laboratory variation for the serum creatinine is plus or minus 0.2 milligrams per deciliter (mg/dl). Hence, the numbers that you provide for your serum creatinine are within the normal laboratory variation from day to day. Screening for chronic … Continue reading

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

Dear Sir, My creatinine level is 2.39, uric acid is 7.2, blood urea is 39. I am undergoing treatment with a nephrologist in UAE. Medicines being taken are DIOVAN 320, Crestor 10, Adenuric 80, and 320 mg sodium bicarbonate tablets. This has been going on for the past 10 years. The creatinine level varies between 1.9 to 2.39. Please advise. Regards.

I am unable to make medical recommendations without performing a complete history and physical examination. The treatment that you describe is a very common treatment for chronic kidney disease (CKD) related to hypertension and gout. I suggest that you continue … Continue reading

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

Dear Doctor, I am a 51 year old male. At 28 I had a spinal cord surgery done to remove a tumor. Post operation I became paraplegic with complete loss of bladder and bowel functions. I have neurogenic bladder and am required to do 4 hourly self-catheterization for urine drainage. My present medical problem is that both of my kidneys have been affected with hydronephrosis. The right kidney being moderate while the left is moderate to severe. My urologist says the condition is untreatable. When I suggested surgery to correct the problem, he said it wouldn’t help much because the root problem for this is the neurogenic bladder itself and that cannot be treated owing to the damage to the spinal cord. Meanwhile he has put me on a drug called Spasmolyt Trospium Chloride by taking 40 grams a day until my next appointment. Doctor, I would greatly appreciate if you could give me a second opinion on the possibility of an alternative treatment to resolving this problem, if possible. Thank you.

The problem that you describe is a urological problem. I am a nephrologist and I have no urological or surgical expertise. You should seek a second opinion from a urologist.

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

Dear Doctor, One year ago during routine checks, we found my son has a protein in the urine. We made a lot of blood and urine tests. We found he has NO protein in the morning, when we collect spot urine before he gets up – before moving or standing. And we found that he has protein in urine 3+ after movement. He has up to 0.43 mg/l for 24 hours urine. All blood tests are normal – creatinine 40 umol/L. He is 10 years now and he is high 151 centimeters and is 32 kilo. He has no symptoms and some of the doctors said it is ortostaic proteinuria but others said maybe it is orthostatic maybe not and recommend ACE inhibitors for any case, also biopsy. I am very worried and I will be very grateful if you could give me your opinion. Also I am kindly asking you; 1. Do you think is orthostatic proteinuria, if he has protein only after movement? 2. Is it necessary to take ACE inhibitors? 3. Please, help me to calculate correctly his GFR and tell me is it normal? And what is the normal range for a 10 year old boy? Some of doctors tell me he has very high GFR which they think is not normal. Thank you so much for your help!!! My best.

Young children, even young boys, may have protein in the urine after exercise and activity but the protein in the urine disappears at night when they sleep and are not active. This is known as “orthostatic proteinuria” or “exercise induced … Continue reading

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

My GFR is 50. I had an ultrasound yesterday that showed both kidneys are normal. Does that mean my kidneys are fine?

Kidney disease may still be present. You will need to have blood and urine testing for kidney disease. This should include a serum creatinine, a calculated estimation of the glomerular filtration rate (eGFR) and a urine test for blood, protein … Continue reading

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

How much protein should I eat after radical nephrectomy?

I am an advocate for the DASH diet for patients with a solitary kidney. I suggest you review the DASH diet at: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan You should also avoid salt in cooking and avoid salt at the table. In general, I recommend … Continue reading

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

Dr. Spry, On behalf of my 80 year old mother, we’re seeking a POV on cardio test contrast for CKD patients with late stage CKD and low GFR/eGFR. e.g., contrasts that are often used for angiograms, stress echos, MRIs. Specifically, are there some that are better than others? We have seen varying points of view on this topic and need some advice. And, if there are certain procedures that can minimize/slow down kidney damage from the contrast (e.g., taking some other Rx or OTC to counteract the contrast, lower doses, or ways to eliminate it from the body faster). Thank you.

All contrast agents used to perform cardiac catheterizations and contrasted angiograms as well as contrasted computerized axial tomograms (CAT) scans may be toxic to the kidney and there are no currently used agents that are any better than others. In … Continue reading

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

Greetings Doctor. I am post renal transplant from January 2008. In last few months, I started getting extreme edema in legs and tummy causing serious issues for me. Also, my creatinine rose to 2.6 again. I was asked for a comprehensive test and from test spot urine creatinine ratio to protein, I was spotted with protein leak 12.5 g. My Doctor raised Deltacotral to 2 tab daily, Cell Cept to 3 tab daily and Sandimum Neurol to 150 g daily. Now I am OK but is this problem reversible or damage is done? Need advice.

I cannot make a specific diagnosis as to the cause of your kidney transplant dysfunction, based on the information that you present. The only way to make a specific diagnosis in this situation would be to perform a transplant kidney … Continue reading

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

My father, age 86 years and has a failure in one of his kidneys. Now he has a 3.00-3.2 creatinine and 68-90 Urea nitrogen and his pressure sometimes is not stable. I ask for your help to know how to protect him and what is the best food program to treat his case. What must he avoid in terms of medications and foods? Best regards.

I am unable to make a specific diagnosis based on the information that you present. Recommendations for diet and medications would require that I perform a complete history and physical examination. Many elderly will have a hard time following a … Continue reading

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