Daily Archives: April 2, 2019

Hello Dr. Spry, First, I’d like to thank you for taking time to reply to our question. We appreciate it. I am writing on behalf of my mother. Background: Female, 80 years old, eGFR = 22, creatinine = typically 1.99-2.20 mg/dL, Bun=55mg/dL. She has to do mitral valve surgery. We know you are a nephrologist and not a cardiologist, but want to know if you have a point of view on the below. We are trying to assess risk for further kidney damage from cardio surgery and explore options based on some reading we have done. – Is avoiding heart/lung machine (aka going “off pump”) better for the kidneys? – If one must go on the heart/lung machine, what are methods/ways (pre, during, and post-surgery) to potentially minimize kidney damage? For example, more kidney hydration during surgery? Extra saline IV pre-during-post surgery? – Are there any potential Rx or OTC or herbal solutions to minimize further kidney damage if one must do cardio surgery? – Are there other potential solutions you could suggest that we inquire about? We understand it is difficult to provide definitive advisement without seeing the patient. We are simply seeking some smart questions and potential hypothesis to consider for exploration. Thank you so much for your insight.

Kidney injury during cardiac surgery is very common, especially during heart valve surgery. In general, limiting the exposure to the “heart-lung machine” or bypass pump is important, however, the heart surgeon is well aware of this and the anesthesiologist and … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Hypertension/High Blood Pressure, Kidney-Related Health Questions

My nephrologist recently recommended I limit my daily fluid intake to 40 to 60 ounces. I have been trying to limit my daily intake to 60 ounces, but I find it difficult. I have Stage 4 CKD (eGFR at 23). I am 75 years old, weigh 175 pounds, and I’m 5′ 11′ tall. I play golf 4 times per week and I work out at a Fitness Club 3 times per week. I have read some articles where 3 Liters were recommended for men with CKD, but not sure they have Stage 4 CKD. I would like your opinion on the appropriate daily fluid intake for me. Thank you for your support.

Even with Stage 4 chronic kidney disease (CKD), I do not know of a specific recommendation for fluid intake. This is a difficult question to answer because hydration or fluid intake is unique to each person, each medical problem and … Continue reading

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

I am having problems finding proper nutrition counseling for stage 3 CKD. I am going to Davita’s website and sometimes get contracting advise. Specifically, what foods should I totally avoid?

I don’t think there are any foods that have to totally be avoided for Stage 3 chronic kidney disease (CKD). I do recommend limiting salt intake to less than 2300 milligrams per day. I am a strong proponent for the … Continue reading

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