Monthly Archives: September 2019

In June, I was diagnosed with Stage 3 Chronic Kidney Disease and in July it became Stage 4. My creatinine level has jumped from 3.27 to 7.2 in a little over a month. What do you think could be causing this jump?

I am unable to make a specific diagnosis without performing a complete history and physical examination.  This is rapidly progressive kidney disease and likely requires urgent evaluation.  You may need to be hospitalized and have further testing performed.    

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I have had kidney failure/insufficiency 3 times this year. I always have hyperkalemia when this happens. I am restricted to 32 ounces of liquid; however, they always say I am dehydrated. What am I doing wrong? Will this keep happening or is there something I can do? I am a diabetic.

I am unable to make a specific diagnosis based on the information that you present.  I can only suggest that you visit with your nephrologist and ask for a specific diagnosis at to your kidney disease.  A specific diagnosis is … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Symptoms and Side Effects

I had a nephrectomy done on 1 kidney 3 years ago and just found out that there is fluid that has built up in the area where the kidney was removed. What does this mean and will I have to have another surgery to drain the fluid?

I am a nephrologist and not a surgeon.  I have no surgical expertise. A urologist is a surgeon and deals with surgical management of the kidney and urinary tract disease.  I suggest you consult with a urologist.    

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

Hi, Doctor. I have a collapsed hip and took one ibuprofen a day for more than a year (I take no other medications). Last spring a blood test showed kidney problems. I stopped the ibuprofen and had a subsequent blood test a month later. The two tests showed BUN going from 17 to 20, Bun-Creatinine ratio from 19.1 to 21.5; eGFR going from 67 to 63. Now latest test in September showed BUN at 10, BUN-creatinine at 12.7, and eGFR at 77. That’s good, right? However, now I have hip surgery scheduled and was told I would have to take two 81 mg aspirin 2x a day for a month to prevent blood clots. Are my kidneys sufficiently recovered to do this? Or should I delay surgery for six months (which would not be a problem, timing was more for the weather)? Thanks for your thoughts.

The information that you provide suggests that your kidney function is normal and has remained normal.  The normal for an estimated glomerular filtration rate (eGFR) is greater than 60 milliliters per minute per 1.73 meters squared.  It is likely true … Continue reading

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

I had been receiving 2 liters of .9 saline solution over 2 hours for hydration three times a week. Doctor now has changed it to over 4 hours. Is there any benefit to receiving it over 2 hours vs. 4 hours? CKD 4 with one kidney and creatinine base approximately 3.1.

I do not think there would be any difference between 2 versus 4 hour hydration.  Fluid challenge over 2 hours sometimes can result in some shortness of breath in patients with kidney disease and heart disease.  If there is no … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Treatments

I am panicked as was told yesterday I have 3rd stage kidney issue. My cholesterol 235, my hdl 153 high, deficient in B12, not pre-diabetic but at high end of normal, obese with gum disease. I can’t fix as no $$$! I don’t know what to eat or avoid or how much water to drink. All if this occurred after years of statin drugs that I stopped 6 months ago as bad side effects including cataracts. Statins ruined my health! High blood 160-185 pressure also despite taking 50 mg pill. Feel like a walking time bomb as had myocardial infarction years ago. Age 77 (Nov.) and have to wait one month to see doctor. (In tears alone in world, poor $$, scared). Went to Urgent Care and they did zero just said eat moderately and drink water. Help, in tears. Please advise!!!!

Stage 3 chronic kidney disease (CKD) suggests that your estimated glomerular filtration rate (eGFR) is between 30 and 59 milliliters per minute per 1.73 meters squared.  This is still early stage CKD and does not indicate urgent need for intervention. … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I had my left kidney removed due to a cancerous mass on July 11,2019. My pathology report came back clean. No sign of cancer. My right kidney is healthy. I have never had any trouble with my kidneys until this happened. I have a follow up CT on November 8, 2019. I have been to my primary doctor for a routine check up and he did some blood tests. My results for kidney function were not normal. My GFR was 30. Is that because my right kidney is adjusting to the change? Is there anything to worry about at this point? Thanks for your response

After removal of one kidney, the expected estimated glomerular filtration rate (eGFR) should be in the range of 50 to 70 milliliters per minute per 1.73 meters squared.  Hence, the value you report seems a bit lower than I would … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Nephrologist, Symptoms and Side Effects

Dear Dr I am having hypertension and hypothyroidism detected in 2006. I have taken several BP medications in past including Telmisartan plus Ramipril Telmisartan plus Amlodipine plus hctz and now I am on telmisartan 80mg plus hctz plus CLINIDIPINE 20mg a day. My creatinine for last 14 yrs varies between 1.2 till 1.7mg/do. I am 41 years old. My GFR is 75. I am also taking Hormone replacement therapy for hypothyroidism 100mcg. I want to ask you are the medications correct? Does Telmisartan and CLINIDIPINE also increase creatinine and decrease GFR? What should change the medications or are medicines correct? My current creatinine is 1.45mg/dl. BUN AND URIC ACID NORMAL..SUGAR Negative..Cholesterol normal..Kindly reply asap. Thank you and Regards

I am unable to recommend medical treatment or comment on medical therapy without performing a complete history and physical examination.  The goal of therapy is to keep your blood pressure less than 130/80.  If these medications are achieving this goal … Continue reading

Posted in Ask the Doctor, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist

Does the pregnancy cause the cysts of ADPKD to burst? Thanks

  I have not experienced this in my practice.  In patients with very large kidney cysts, I can see cyst hemorrhage as plausible during a pregnancy but I do not think this is a common event.  

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Pregnancy / Kids

My 14 yo grandson is a 2-time cancer survivor. Wilms stage 4 at age 3; came back in peritoneum at age 5. He has one deformed partially functioning kidney. A year ago they found he had reflux to kidney, deformed bladder with scarring. Bladder was repaired. So he was just tested and there is no longer any reflux, his bladder while large has returned to normal shape and scarring in bladder is much diminished. He has no sensation to urinate, so he voids his bladder every three hours to keep it empty. His creatinine is at 1 and his cystatin is at 1.25. He swims and plays basketball, going through puberty, and growing tall (very thin though). Question: his urologist is insisting that he self-catheterize for at least six months to see if cystatin number will drop—and if not then he should self cath for life. My grandson is devastated and none of us understand how self cath will help his kidney when his bladder empties fully when he voids. Should we get second opinions from nephrologist. He has been through so much and so many surgeries, 2 last year to repair ureter and bladder. Help!?

I am a nephrologist and I would have no expertise in bladder management.  Management of bladder issues is within the field of expertise for a urologist and not a nephrologist. You mention that the bladder is large and if this … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects, Treatments, Urological Issues