Monthly Archives: October 2019

Dr said I am a 3 with CKD. Can I get better and how?

The goal for treatment of chronic kidney disease (CKD) is usually not to cure the disease but rather to slow progression of the disease.  Hence, the goal is to slow loss off kidney function.  At this time, we have very … Continue reading

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

Will you kindly tell me whether I am developing CKD? What are the steps for me to follow in the future? May I consult a nephrologist?

The information that you present appears normal to me.  In order to screen for chronic kidney disease (CKD), you should also have urine testing for blood, protein, and infection.  

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

Left kidney has angiomyolipoma near urinary tract. Creatinine level 1.10, GFR Non African level 52 ml. Multi benign cysts as well. Next step?

There is no treatment for an angiomyolipoma and all that can be done is to observe for any bleeding.  Benign cysts also do not require any treatment.  Your estimated glomerular filtration rate (eGFR) may indicate early Stage 3a chronic kidney … Continue reading

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

I have just posted my question yesterday and you told me that all the sympstoms I stated seems to be not related with CKD as CKD Stage 3 usually doesn’t have any symptoms yet. He has undergone kidney biopsy last December and we are told by the doctors that he has CKD Stage 3 and only 48% of his kidneys is working. As you have said that it may imply other severe kidney diseases, why is it that the biopsy detected that he has CKD? Thank you.

The kidney biopsy is the definitive way to diagnose chronic kidney disease (CKD) and tells you what disease process is causing the kidney damage.  The Stage of CKD is determined by measurement of a glomerular filtration rate (eGFR) and performance … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney-Related Health Questions, Nephrotic Syndrome, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis, Urological Issues

I have just recovered (I think ) from my 4th Kidney infection . I do not know why I keep getting these. My doctor mentioned that he was going to flush and clean out my bladder but during the follow up he never mentioned it. He said that I had bladder cancer however I read three bladder cancer tests that I took. One was negative but 2 were positive so he said I do not have bladder cancer. My CT exam noted that there is a 3 mm calculus in the right distal ureter just proximal to the ureterovesical junction (5:85). There is a punctate non obstructing right lower pole renal calculus. There is no hydronephrosis. However, I have not passed the stone as far as I can tell. And my doctors office during one visit he said I had two small stones one in each kidney but then the follow up he said he just couldn’t see anything. Could I pass a stone and not realize it? Should I get a second opinion regarding the cancer diagnosis and the reason why I keep getting kidney infections? My urologist has told me at one appointment that I do not empty my bladder. Is there a way to do this or do I need a procedure? Thank you I really appreciate your help this is an excellent resource.

I am a nephrologist and I do not have any surgical expertise.  I do not have any expertise in dealing with the surgical management of kidney stones or bladder disease.  Hence, you will need to consult with a urologist, who … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis, Urological Issues

Hi. I have a heart disease (ascending aorta aneurysm, BVD, mild to moderate AI, trace mitral regurgitation, mild tricuspid regurgitation), I get labs drawn every 6 months. My labs 11 Sept 2018 showed: Urea Nitrogen 22, CO2 23, anion gap 14, creatinine 0.9, and my egfr 76. Labs 19 September 2019 showed; Urea Nitrogen 15, CO2 21, Anion gap 18, creatinine 1, and egfr >60. Now on October 22nd, they were: Urea Nitrogen 20, CO2 22, anion gap 16, creatinine 1.1, and my egfr 56. My question is; is it normal that my egfr would drop that much in a year? Could this be because of my heart? My primary care doctor always brush it off saying I’m likely dehydrated! But, I’m drinking over a gallon of water a day. Should I be concern over these lab results?

The combination of heart disease and chronic kidney disease (CKD) is a difficult situation.  It can be true that heart disease affects the kidney but it can also be true that kidney disease affects the heart.  I can only suggest … Continue reading

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

Hi Dr Spry, thank for your assistance on this website. I am a bit confused with regards to blood serum creatinine and how it relates to GFR. I am a non black Caucasian with a naturally muscular build. I consistently run/walk 14-18 miles per week and have no health issues with the exception of slighly elevated cholestorol which I control with diet and exercise. My height is 66″ with a weight of 185 lbs. In October 2017 I did a blood test and my creatinine levels were 1.39. Since then however I have had 2 blood tests and on both my creatinine levels were 1.05. Is this considered high for my age and body type? My doctor has said after both tests showing creatinine of 1.05 that I do not show any signs of kidney disease. However, when I compute these on the GFR calculator it says my GFR 93. But yet when I apply the body surface adjustment it says my GFR is 104. Since I am not obese which of these results should I regard as accurate?

When we discuss populations of individuals, the normals must be expressed in terms that allow comparison of one individual to the next.  The serum creatinine is inversely proportional to the glomerular filtration rate (GFR) and directly proportional to the muscle … Continue reading

Posted in Ask the Doctor, GFR, Kidney-Related Health Questions, Serum Creatinine

I AM 74. GFR was 25, creatinine 2.64. I was told to increase liquid intake to 2 liters per day. Tested again in 30 days. Results Gfr dropped to 21, creatinine rose to 3.16. Bun level is 35. I have been told to drink more water. Can I be drinking too much?

Drinking too much water would be unlikely to raise the serum creatinine and reduce the estimated glomerular filtration rate (eGFR).  I would suggest that you discuss these results with your physician.

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

Dr. found a size 7mm stone. I don’t know what kind yet. I have to get x-ray. I have a lot of pain in my lower back by my pelvic bone. Is this normal? They also found blood in my urine. Is this a serious problem?

If you have an obstructing stone, you will need to consult with a urologist.  Severe back pain is commonly associated with kidney stone disease.   I am a nephrologist and do not deal with acute stone disease.  A urologist is … Continue reading

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

Hi Dr. Spry My husband is 74 years old has stage five for the past 4 months with no symptoms. He also had 6.00 Aneurysm (AAA). He has been treated for UTI for past 5 months. He had 5 UTI been giving a low dose of Antibiotics for only 10 days. UTI always comes back in 3-4 weeks. Now they put him on high dose of 500mg of Cephalexin twice a day for 45 days so they can clear UTI so they can repair the Aneurysm (AVAR). How bad is to use Antibiotics for that long with GFR 10%? Thank you

The dose of Cephalexin that you quote is the proper dose for patients with chronic kidney disease (CKD).  The duration of treatment depends on the type of bacteria being treated and the underlying condition that is causing the recurring infection. … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis