Category Archives: Acute Kidney Injury

Dr. Spry, My father suffered a kidney failure, apparently resulting from a UTI this past March. Though he is a long-term diabetic (over 27 years), his medical records state his condition as AKI rather than CKD. He is now dialysis-dependent, but his doctor seems to believe his kidneys could recover sufficient functionality for him to go off dialysis, though it’s been nearly 8 months since the diagnosis. What indicators would a doctor use to identify AKI vs CKD in a less obvious scenario where the UTI or the Diabetes could be the root cause, unlike an actual physical injury or nephropathy in the absence of a pathogen beyond diabetes, where I presume it would be easier to classify as AKI or CKD, respectively. How would the doctor determine if there is a possibility for some kidney function to return? From what I can tell of his creatinine, potassium, urea, albumin levels, there doesn’t appear to be a consistent improvement in any metric that would allow a quantitative assessment of kidney recovery. Is there a qualitative method to assess the viability of a kidney? Short of a biopsy is there another quantitative method outside the typical blood work to judge how much kidney function is just dormant vs. how much has been lost permanently? Apologies for the multiple questions! My father is being treated at the top hospital in his city, one well-known for international medical tourism (though he’s a local). His doctor appears to be a very competent and straightforward professional. Unfortunately, doctors in India are extremely reluctant to share technical patient information and I’m relegated to scouring the internet to help my dad navigate his condition. Thank you for any information you can share on the subject!

Acute kidney injury (AKI) means that the tubules of the kidney have been injured but the filters of the kidney (glomeruli) remain intact. If there is tubular injury, then the kidney is capable of repairing this injury and then the … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis

My father-in-law was recently admitted to a hospital with increased Potassium and Creatinine levels and diagnosed with Stage 3 Kidney Disease. However, upon a follow up appointment with his Internist he was told that his diagnosis of Stage 3 Kidney Disease was a temporary issue. Can Stage 3 Kidney Disease be a temporary phenomena?

We differentiate between acute kidney injury (AKI), where kidney disease is a reversible reduction in the estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), where the kidney disease is present and stable for at least three months.  If … Continue reading

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

Sir, acute kidney disease can be recover through dialysis? How many days does it take?

It is true that the kidneys can recover after an episode of acute kidney injury.  I am unable to give any time frame because each case of acute kidney injury is unique and the duration of recovery can vary significantly. … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Kidney-Related Health Questions, Treatments

Hello sir, my ckd test are decreasing with every dialysis, that contain urea, nitrogen, sodium and creatinine value. So is my kidney is going to a better side? Is it working?

Hemodialysis does decrease the values of potassium, creatinine and urea nitrogen, but this does not heal the kidneys.  Dialysis is a replacement for kidney function, but in no way heals the kidneys.  If you came to dialysis with chronic kidney … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

Hi Doctor, About 4 months ago, I had vomiting, constipation and pain in lower back abdomen due to pushing and gas. I went to the doctor and he wrote few tests. My urine tests showed protein, traces of blood and my CBC blood test had WBC and NEU higher than normal. He wrote another test for creatinine and blood urea and it was 3.3 and 55. He referred me to a nephrologist. The next day, I couldn’t see nephrologist because he was out of town. I felt so much thirsty on that day and drank alot of water. The nephrologist wrote same tests again and this time my urine has no traces of blood or protein, my CBC was normal except Hematocrit little less and my creatinine was dropped to 2 while BUN was 43. My ultrasound report showed no back pressure, normal size kidney, high echogenicity suggested. The nephrologist said it is temporary and said to go for tests again after 15 days. The test are normal since then. No traces of blood in urine, no protein since 4 months now. I have done 4 more tests. I am concern if I have CKD or is there any chance of CKD and what my ultrasound report mean by high echogenicity suggested?

I am unable to make a specific diagnosis based on the information that you present.  You could have acute kidney injury that is in the process of recovery or you could have chronic kidney disease (CKD) with acute kidney injury … Continue reading

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

My creatinine level is 1.8. What does it mean and treatment?

An elevated creatinine can mean either acute or chronic kidney disease (CKD). I am unable to make any other specific diagnosis based on the information that you present.  I suggest that you contact your physician and discuss this result with … Continue reading

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

My wife is 51 years old. Her creatinine level was always below 0.97. On 18 April, her creatinine level rose at 1.41 and gfr was at 51. On 25 May her creatinine level was 137.6 umol/L and gfr went down to 37. In the 1st investigation period she was having fever and in the 2nd investigation period she had coughing. Now her creatinine level is 1.55 even though she is on 30gm protein level diet plan. What is the cause of quick drop of her gfr?

I am unable to make a specific diagnosis based on the information that you present.  This appears to be something that is causing acute kidney injury.  I recommend consultation with your physician and further testing as to why she is … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects

I have a concern in regards to protein supplements in tube feeding. I have a cousin on tube feeding due to cardiogenic shock and acute kidney injury. Hemodialysis (daily once) since yesterday. He is put on Nepro high protein supplement every hour with 30cc. Question: post dialysis should he be put on low protein and only during dialysis on high protein or until daily hemodialysis, should he be on Nepro high protein?

Nepro is the brand name for a high protein and low potassium with low phosphorus tube feeding supplement.  It is designed for patients who are acutely ill.  During acute illness, there should be encouragement (rather than limitation) of protein intake. … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions

Can we increase the GFR level if it is less than 15?

That depends on the cause.  It may be possible to improve kidney function, if the cause is acute kidney injury (AKI).  If the cause is chronic kidney disease (CKD), then improvement is less likely.  The kidney has the capacity to … Continue reading

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

My Husband has CKD stage 4. Last May 2016, he had a UTI and was prescribed trimethoprim. After 4 days he was admitted to hospital with hyperkalemia (6.4) and an acute on chronic kidney injury. He is now on a diet to keep his potassium levels satisfactory. Today his local GP has diagnosed that he has a chest infection and has prescribed amoxicillin 500mg capsules for 7 days. Is this a suitable prescription for a patient with CKD stage 4. Would it be necessary or a worthwhile procedure to have a blood test taken when he has completed the 7-day course to identify if his potassium levels have been affected? What symptoms should one look out for or what tests should be done to check if he is diabetic.

Trimethoprim is known to cause high blood potassium because it interferes with the kidney elimination of potassium.  Penicillins such as amoxicillin do not usually cause potassium problems.  Your husband’s physician should be able to determine if he is a diabetic … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis