Daily Archives: June 13, 2019

I have just found out today that my 14 year old son has a dilated renal pelvis and dilated ureter. The Mag-3 study suggests no VUR and it reads as if the kidney has cleared the isotope spontaneously but, says slow perfusion. The previous ultrasound only showed dilated distal ureter. Can you tell me how urgently I should expect to see a pediatric nephrologist? I am worried delay will cause more damage. His left kidney is already scarred and significantly impaired. I just don’t want to sit and wait weeks if its something requiring more urgent care. I hope you can provide some guidance.

The problem that you describe is a urological problem and must be addressed to a urologist. I am an adult nephrologist and I have no expertise in obstructive disease of the urinary tract and no expertise in the surgical management … Continue reading

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

Hello, I have had chronic kidney stone disease since about age 23. I’m 48 yrs old now. I have had reoccurring UTIs, hydronephrosis, and/or pyelonephritis about every year or two at most, since my late teens. My family has a very high incidence of renal failure on my paternal side, while the kidney stone disease is very prevalent on my maternal side. I frequently have protein detected in my urine as long as I can remember. I sometimes have very dark bloody to brown urine, very frequently cloudy, and on/off pale foamy urine. I worry that most of this is being passed off as side effects from my kidney stones. I also have hyperparathyroidism secondary to vit D deficiency and I have a genetic Connective Tissue Disease called Ehlers-Danlos Syndrome Hypermobility Type(hEDS) with some overwhelming of Classic Type, Delta Granule Storage Pool Deficiency Platelet Dysfunction, POTS, MCAD, and multiple other Autoimmune Disorders … I’ve seen what used to be called Bright’s Disease show up on numerous family death certificates while compiling our family’s genealogy, so I am concerned that my Urologist hasn’t followed up with more specific testing to evaluate my actual kidney function aside from BMP, CMP, U/A with the frequent culture sent for analysisa. I am concerned especially with my right kidney because it drops a bit low and doesn’t drain well with the ureter arched a bit higher anatomically. I’ve had about 6 ESWL procedures, a Percutaneous Lithotomy( due to high stone volume, 30+ Ranging 1mm-9mm and some high density type stones) with a temp nephrostomy drain/bag, and most recently a Ureteroscopy with laser Lithotripsy and stent placement x 1 1/2 wk(I couldn’t have tolerated the stent any longer), all of these have been about UA showed something new for me that upset, a rare budding yeast which also showed up in a 2nd clean catch sample several days later. I am worried more so because both of my children have hEDS also, they both inherited my Platelet Dysfunction. My son, the younger at 23 yrs, has started passing kidney stones at the same age that I did. My daughter has had a few bad infections also. I can no longer take sulfonamide antibiotics or Nitro furan Antibacterials, due to an allergy to them. Since my last infection and procedure, I have been so tired, bruising, more than usual, with notable Petechia that I don’t recall occurring so much before, itching intensely,(especially at night) and notable increased swelling of my feet, ankles, and sometimes hands. I made an appt with a nephrologist, but have a fairly long wait of a few more weeks until I can get in to see them. I am just concerned and interested in your thoughts. I do have HTN, have had intermittently since my 20’s, was treated in my 30’s with a hydrachlorithiazide until no longer required after significant weight loss with gastric bypass, I have since been treating with a beta blocker in mid 40’s which also treats my POTS …keeping my HR in control. I take sublingual B12 to treat anemia also. I take a lot of medications for my various conditions.

Your medical condition sounds very complex and I am unable to make a specific diagnosis based on the information that you present. Most of the problems that you describe for your kidneys are urological problems and should be addressed by … Continue reading

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

After receiving my latest blood results, I went back and looked at my results from my previous two labs. After seeing an increasing trend for 6 months, I informed my neurologist who told me to inform my primary care doctor. I receive 150g of IVIGs every other week and I am concerned that it might be doing something to my kidneys. Don’t you think that looking at the below that I should see a nephrologist? My primary care did make an appointment but I had to convince her. CREATININE 1.08 mg/dL (High), MARCH WAS 1.18, MAY WAS 1.3 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: 0.51 mg/dL – 0.95 mg/dL Est. GFR Non-African American 53 mL/min/1.73_m2 (Low), MARCH WAS 48, MAY WAS 47 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: > 59 mL/min/1.73_m2 Total Protein 8.8 g/dL (High), MARCH WAS 9.0, MAY WAS 9.4 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: 6.6 g/dL – 8.3 g/dL Thank you!

The serum creatinine can vary from day to day based on normal laboratory variation. The variation can be 0.2 milligrams per deciliter (mg/dl) up or down from day to day. Hence, the numbers that you quote are not statistically different … Continue reading

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