Daily Archives: November 11, 2019

my question is about my stage 4 chronic kidney disease, doctor when I breathe I feel a strong pain in the under the lungs is how a very hard squeeze. Doctor I do not have fluid retention, I do not have hypertension the pth is in 263.90 with very small kidneys less than half of the normal of an adult, I am not on dialysis or pre-dialysis what can I test can you recommend to see what is affecting my Kidneys, my nephrologist does not recommend a biopsy because the kidneys are very small and can bleed. I don’t know what is causing my kidney disease. Can you give me a concept Doctor a hug and blessings.

I am not able to make a specific diagnosis based on the information that you present.  Your symptoms could be consistent with chronic kidney disease (CKD) but you indicate that you do not have fluid overload.  Your blood pressure should … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

When should I see a kidney Doctor? I am a white female 70, non smoker or drinker for the last ten years. My eGFR 40, creatinine 322. The only thing I have been told is I have Stage 3 ckd and should drink more water. My GFR has been in this range since 2016.

In most cases, primary care physicians are trained to care for patients with chronic kidney disease (CKD).  I have generally suggested consultation with a nephrologist if the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per … Continue reading

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

I was involved in a rear-end collision, where I was sitting still and a person hit my vehicle at over 30 mph. I had tremendous back pain and was diagnosed with a kidney stone (4mm x 6mm) 3 days after the accident. I am looking for any documentation to support my claim, as I required shockwave treatment to remove the stone. I am fighting with the other person’s insurance to pay for the procedure. I had read an earlier post regarding a similar subject and would appreciate any guidance. Thank you

I am not aware of any published information that says that automobile accidents are associated with kidney stones. I have had several inquiries from questioners on this blog mentioning the same story as you report. I do not have any … Continue reading

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

Can you explain to me about fluid overload for CKD patient when they on dialysis?

As kidneys fail, they often retain fluid.  Fluid retention is the kidneys retaining salt and water.  When someone is on dialysis, urine output commonly falls but it is rarely zero.  Hence, as you take liquid and salt in the diet, … Continue reading

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

After ordering a CT scan for another issue, my dad was given the CT radiology report, as well as, paperwork that was a health history with the urologist he’s seen for years. I’m always the person who is “primary care giver” within family. As I was reading the reports, I was shocked to see they had dx’d him with stage 3 CKD (no differentiation for stage 3 a or b). There is also a surprisingly large cyst on one of his kidneys. In speaking with him, he’d never been told of these two things. Granted he has little to no symptoms. Yet it still triggered my protective button & led me to diving head first into research, learning all I can, etc. There’s one issue that worries me more than anything. It was the description of how someone who’s ckd worsens, they can begin to have mental health symptoms. My family has a long past of issues with mental health issues, so I’m familiar with how those symptoms can go from very tame to crisis and everything in between.This puts 2 things in my sights… him still being able to drive and then the fact that he owns multiple handguns, long guns and shotgun. His personality is one where he wouldn’t give up either unless he felt 1,000% he was a danger. Can you describe any of the symptoms to use as a flag that issues are beginning from CKD, within the mind? The urologist is not treating him in any aspect for the CKD. He is being treated for high blood pressure, diabetes mellitus, & high cholesterol. And in case it matters, he’s a 69 year old white male, low activity, drinks alcohol, no smoking, no illegal substances, 5’10” to 5’11” @ 275-325 pounds. Any info/suggestions would be greatly appreciated.

Patients who have chronic kidney disease (CKD), do not typically exhibit symptoms of aggression or hostility. The mental status symptoms most commonly associated with CKD are loss of focus, fatigue, lassitude, and lethargy. Confusion and delirium are very late findings … Continue reading

Posted in Ask the Doctor, Kidney Cysts, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Urological Issues

How does alcohol effect CKD?

Excessive use of alcohol can lead to liver damage that can cause worsening kidney disease. Alcohol in excess also causes worsening of high blood pressure and can lead to an acceleration of kidney disease. Excessive alcohol is more than two … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Risk factors

I have biopsied IgA Nephropathy. My recent blood and urine tests show that among other out of range values my BUN has increased to over 30. In addition, I show small reductions in my red blood count and hematocrit which are now out of range. I have been on Coumadin for 10 years and wonder if it has contributed to these recent developments. There has been a recent study which shows that all of the various blood thinners contribute to worsening kidney function if one already has impaired function. My current gfr is 42 whereas a year ago it was 49.

Coumadin (warfarin) can cause episodes of acute kidney injury (AKI) in patients with underlying chronic kidney disease (CKD). This happens when the dose of Coumadin is excessive and the blood become too thin.  I am not aware of any studies … Continue reading

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

The criteria for determining CKD is very confusing to me. As you know, the Merck Manual lists 5 stages of CKD. From reading some of your past posts it appears that you consider eGFR 60 or above to be normal. I have read that one of the following must be present for > or = three months to be CKD: GFR 29, or other markers of kidney damage. According to this criteria, it appears to me that stages 1 & 2 of CKD as defined in the Merck Manuel are completely ignored. Please explain.The other question I have is that the National Kidney Foundation website states that 37, 000, 000 adults have CKD in the US. There is no explanation as to what that number includes. That seems to be a lot of people to be in stages 3,4, & 5 so does that number include stages 1 & 2?

There are 5 Stages of chronic kidney disease (CKD) that have been proposed by the National Kidney Foundation (NKF). The estimating equation that we use to calculate the estimated glomerular filtration rate (eGFR) is most accurate and consistent when the … Continue reading

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


The laboratory testing that you report shows an elevated LDL or bad cholesterol and an elevated blood glucose.  I do not identify any kidney disease although I cannot interpret the meaning of the 3+ bacteria noted in the urine testing. … Continue reading

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