Daily Archives: October 7, 2019

Hello Dr. Spry I’m 36 years old , I underwent pre-emptive kidney transplant on 17/4/2019. I was diagnosed with medullary sponge kidney since 2005 ( as congenital case ) My GFR was 55 ml/Min at Cr 2.0 mg/DL The progression of my case took almost 14 years until Feb, 2019 where my GFR dropped to 15ml/Min at Cr 6.6 mg/DL My brother donated his kidney and the transplant was successful. I was discharged to ICU then to my room after 24 hours at Cr of 1.1 I started with immunosuppressive agents immediately Prograf ( Tacrolimus) 7 mg daily Cellcept ( mycophenolate mofetil) 500mg *4 Prednisolone 15 mg daily By August ,2019 creatinine jumped to 1.5 My nephrologist asked for U/S and it was normal Then he asked for biopsy that showed BK virus infection. In parallel , I was suffering from severe diraheaa caused by Mycophenolate ( cellcept) And I was admitted to hospital for 48 hrs where I underwent biopsy and colonoscopy since my weight decreased significantly. During my stay in the hospital,, I was connected to normal saline IV Creatinine dropped to 1.3 Accordingly , nephrology team suggested that I suffered from dehydration due to diraheaa . So they lowered the mycophenolate dose and raised the steroid and Tacrolimus. My weight started to increase . Diraheaa immediately stopped and creatinine remained 1.3 and my overall health improved. Last week Creatinine jumped to 1.6 Prograf level 8.6 ng/dl Hb 13 My nephrologist informed me that he had no significant illustration to this case. He asked me to repeat the Cr and prograf level next week , if it remained 1.6 or more He will ask for U/S and if it was normal he will go to second biopsy. By next week I will finish 6 months ( post transplant). On the other hand,, my brother ( Donor) was discharged at Creatinine 1.3 One month later it was 1.5 , and since that date it remained 1.5 He is not suffering from any illness and his overall health is perfect He is 50 years old ( non diabetic , non HTN) His medications are : Aspirin every other day Crestor 10 mg daily My questions are : 1. are these complications post transplant normal ? Especially I never undergo dialysis? HLA 70% , lymphocytotoxicity ( negative) 2. is it normal or accepted to go for second biopsy? 3. What is your assessment to my case , and your recommendations? 4. What is your assessment to my brother case , and your recommendations? Thanks a lot for your efforts , waiting for your kind reply. Regards.

I am unable to give medical advice without performing a complete history and physical examination.  The course that you describe for you post transplant events are not uncommon.  The first six months after a transplant are generally the most unpredictable … Continue reading

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

Hello I have a cousin she is donating her kidney to her father in law. I would like to know if there is anything that will help in her healing at home after surgery? I don’t live near her so was gonna do gift cards to restaurant but thought if there was something I could send to help her after? Thank you so much!

I am sure that any support that you provide will be beneficial to your cousin.  Healing takes time and nutrition so your support with gift cards seems appropriate.  I have also heard of family members providing transportation support.  Since you … Continue reading

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

In 1996 I had total organ failure from alcoholism that caused acute ascites. I went from 215lbs to 305 Lbs in 2 weeks and turned yellow. A tap was placed in the abdominal space and 65lbs of fluid was drained in 5 days. That resulted in metabolic shock and total system failure. Heart, kidneys, liver all shut down. Initial blood readings were Creatine 11.5, Bun 145, and SGOT/SGPT/GGtall well over 150. I had terrific docs and the benefit of being 29 years old. My Nephrologist did not start dialysis as most may have, instead as long as the readings improved daily no dialysis. I spent 6 months in the ICU. Recovered after 1 year and have had no issues since. My blood Creatine reading ranges between 1.9-2.9. Has been consistent for the last 23 years. 8-10 years ago in my early 40, I struggled with gout and spent 6/8 years on allopurinol once daily. Also, blood pressure was high with systemic changes to the cardiac muscle. However, as I aged, I better disciplined myself and I am now 168lbs at 70.5” and I usually eat only one meal a day with some sort of high protein snack to tied me over. Now I have been off the allopurinol for 2 years and off my blood pressure meds for two years. I feel good and at 52 my blood glucose was 80 last labs. I know if I do anything to further damage my weakened kidneys such as drink again or take NSAIDS I could cause premature kidney failure. However, if I do not damage them by bad habits or too many OTC pain killers what is the potential for my kidneys to never be an issue until I live a normal 70-80 year lifespan? If they have not worsened in the last 23 years, baring me doing damage or developing type II diabetes, can they not last another 23 years and not fail prematurely? Several doctors have limited my life to 60-65 years due to the alcoholism and the resulting multi-organ failure. Most don’t expect me to live a normal life span. I understand that if I still drank or if I was 275 lbs again with gout every 2 weeks. Yet I haven’t had those issues for several years. I know the diabetes could change everything. Yet, my blood glucose has always been 75-85. BP is now consistently 118/76 or better with pulse at 80 or below. I am a male and 52 years old. I am 5’10.5” weight consistently between 165-175. I take a baby aspirin now and that is all. The system failure occurred in 1996 at the age of 29. After a year I had all normal organ blood level readings except for the Creatine of 1.9. At 170 LBS it stays 2.0or below. When I would gain up to 275 lbs the Creatine would increase to 2.9-3.0. I have been sub 180 since I turned 50, and Creatine has been 1.75-1.9. I have had no treatment of any kind since I left the hospital in 1996. What does the future hold for my kidneys if I don’t ruin them by drink or drug? How devastating would diabetes be to someone like me? I have no pre diabetes now and since age 46 I have had blood glucose tested every 6 months with my Creatine. It has been 80 average for 6 years. Can I expect my kidneys to continue to work without a hiccup or are those many doctors correct who pegged my life span at 65 not that of an average man? Thanks doctor!

Your story is certainly an extraordinary account of severe illness that seems to have stabilized and you have adopted a remarkable change to your lifestyle. I don’t know that anyone can forecast the future with that degree of precision.  In … Continue reading

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

My mother’s present creatinine level is 2.7. Can we use some Indian herbs for her kidney disease???

I have no knowledge of Indian herbs or supplements.  I am not aware of any studies that has examined the use of Indian herbs or supplements in patients with chronic kidney disease (CKD).  

Posted in Ask the Doctor, Chronic Kidney Disease, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Treatments

Are certain blood pressure meds hard on kidneys such as Lisinopril or carvedilol?

Lisinopril is an Angiotensin Converting Enzyme Inhibitor (ACE-I) and does cause some decrease in the blood flow to the kidney filters (glomeruli).  Hence, Lisinopril may cause a slight increase in the serum creatinine.  However, studies have shown that ACE-I can … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments

I only have 1 kidney….no kidney disease. Is it OK to take 600 mg of calcium and 1000 units of Vit D daily? This would be for osteoporosis

Yes.  I commonly recommend extra calcium for my female patients with and without kidney disease.  1000 units of Vitamin D is also recommended on a daily basis.  

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Nephrectomy / One kidney, Treatments

Renal failure for roughly 3yrs. Got headache and sore tonsils. Feeling cold then hot. Coughing up crap. Taken pain killers. Got cough sweats. What else can I do? This is day 3.

I am not able to make a specific diagnosis based on the information that you present.  There are many possibilities including pneumonia, influenza, and viral syndromes.  I suggest you contact your primary care physician (PCP) and ask to be seen … Continue reading

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