Daily Archives: June 17, 2019

SGL2 related sugar, most of time in urine as a permanent thing; can this damage the kidneys in the long run?

I will assume you are asking about Sodium Glucose Cotransport 2 (SGLT2) inhibitors as a treatment for Type 2 diabetes mellitus. These drugs decrease the re-absorption of glucose by the kidney tubules and result in the loss of glucose out … Continue reading

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function

I had a kidney transplant in 1994 and it worked great for almost 20 years. I had to start dialysis again, and yet I still had the transplanted kidney. I was still taking my anti-rejection medication and I never had any issues with infection or rejection. I was incarcerated in 2014 and spent over a year in prison, I was still on dialysis at the time. At the end of 2015 a nephrologist working at the prison took me off of my immunosuppressant medicine; stating that since the transplanted kidney was not working any more there was no need to take the medicine anymore. I eventually rejected the kidney and had to have a nephrectomy. My only question, is this a common thing to be done with these circumstances I have mentioned?

There is no universally accepted treatment guidance in this regard. Whether to continue immunosuppression after a return to dialysis is handled differently from location to location. In most cases, the immunosuppression is tapered off one drug at a time in … Continue reading

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

I live in New Zealand. Can I donate a kidney to a non blood family member in Canada?

The person in Canada would have to get on a list in Canada to be accepted as a kidney transplant recipient and then you could offer to donate at that kidney transplant center in Canada. Hence, your non blood family … Continue reading

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

On my annual physical yesterday, my general practitioner told me my GFR is 58 and that indicates stage 3 CKD. She didn’t recommend a nephrology consult. Just follow up in one year. Is that appropriate care?

In most cases, primary care physicians (PCP) are able to manage chronic kidney disease (CKD) in the early stages. Stage 3 CKD requires that your estimated glomerular filtration rate (eGFR) be less than 60 milliliters per minute per 1.73 meters … Continue reading

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

Is it okay to have a Cardiac Nuclear test 2 & 1/2 years after a kidney transplant? Would it be safe for the new kidney?

Yes. The nuclear testing done for heart disease does not have any ill effects on the kidney or a kidney transplant. If, however, a cardiac catheterization with contrast dye is done at a later date, this will require preparation and … Continue reading

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

Hi, I was diagnosed with idiopathic hypoparathyroidism over 10 years ago. My last ultrasound revealed diffuse nephrocalcinosis with mildly increased parenchymal echogenicity and cortical thinning with normal kidney size and shape. I am currently spilling 400 mg in my 24 hour calcium urine and my last creatinine was 1.1 and BUN was 13 but had creatinine go as high as 1.4 through the years. I am a 27 year old male and am worried long term for my kidneys. Is it possible to stop the progression of nephrocalcinosis and will it lead to end stage renal failure?

I am not able to make a specific diagnosis based on the information that you present. I am not able to link the idiopathic hypoparathyroidism to your nephrocalcinosis. Nephrocalcinosis can progress to end stage kidney disease with time. Since you … Continue reading

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

Dear Sir, Last month, 2 times, I tested my Urine-Creatinine ratio in urine. The first result was 0.37 and second result was 0.9, which is normal. Why did this happen? During my first test, the previous day, I consumed more salt and soda. Will this affect my results?

I am not familiar with the test “Urine Creatinine Ratio”. In order to be a ratio, it must be compared to some other factor in the urine such as protein, sodium, potassium, calcium or phosphate. A protein to creatinine ratio … Continue reading

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

What OTC anti-inflammatory meds are safe and can be used instead of NSAIDs with 3rd stage CKD? Thank you!

Tylenol (acetaminophen) in doses less than 3000 milligrams per day is safe for patients with chronic kidney disease (CKD). I also encourage the use of topical pain rubs and sports creams to relieve pain. Low doses of aspirin can also … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Function

I was diagnosed with Stage 5 failure in August, 2018. Since then (10 months), I have only consumed about 100mg of calcium a day. My PTH IS 347 and my calcium is 9.0 I’ve begun a low dose of Calcitriol (.25mg, twice a week). I have ten more days until my bloodwork is done again. My understanding (from scouring the internet) is that your parathyroids are constantly monitoring your calcium level. If calcium levels are insufficient, the parathyroids release PTH which causes calcium to be released from your bones (among other things). My PTH could be high because my calcium absorption is low (because my kidneys aren’t converting vitamin D to its active form) – hence the Calcitriol – or my PTH could be high because my dietary calcium is low (because many of the foods I avoid for potassium/phosphorus reasons are also prime sources of calcium). Or, it could be a combination of both. Wouldn’t it make sense to test Active Vitamin D levels before beginning Calcitriol – rather than assuming that a high PTH is due solely to absorption issues? I feel that I likely should be on a calcium supplement but my nephrologist points to my calcium level of 9.0 – which, if I’m understanding correctly, could be the result of calcium being leeched from my bones. When is it appropriate to begin calcium supplements? I just sent a question regarding calcium/calcitriol/PTH but forgot to mention that I’ve maintained a GFR of 12 in the ten months since diagnosis and have not had to begin dialysis. Thank you.

You are dealing with a very complex issue called secondary hyperparathyroidism. This is an area of kidney disease that remains very poorly understood and can be very frustrating to treat. First of all, in patients with chronic kidney disease (CKD) … Continue reading

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

I have CKD and suffer from shortness of breath on slightest exertion?

Episodes of shortness of breath on exertion (also call dyspnea on exertion or DOE), are always of concern and should be brought to the attention of your primary care physician (PCP) or your nephrologist. Since you have chronic kidney disease … Continue reading

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