Category Archives: Anemia

When you have CKD does your red blood cell count increase or decrease? Explain why?

The kidney produces a hormone known as erythropoietin as called EPO. That hormone helps to produce red blood cells. When someone develops chronic kidney disease (CKD), the kidney produces less of that hormone and anemia or low red blood cell … Continue reading

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

I was started on weekly Aranesp injections about a month ago. I read an article that said taking Aranesp can double your risk of having a stroke and can increase the risk of cancer. What are other treatment options for anemia in dialysis patients?

Aranesp (darbepoietin) is a drug known as an erythropoiesis stimulating agent (ESA). It is used to treat anemia in dialysis patients. There are other ESA’s available but all of them have some risks of stroke, heart disease and may make … Continue reading

Posted in Anemia, Ask the Doctor, Dialysis, Kidney-Related Health Questions, Medication and Kidney Disease, Nephrologist

At night I get pains in legs anywhere from feet up to and including my thighs. Sometimes it is very painful and on a few occasions I have not been able to walk on my leg while the pain has been intense. It feels as if it could be muscle spasm or vascular spasms. I have to get out of bed when this happens and walk around until the pain subsides before I get back into bed. Could you please tell me what is causing this to happen and if there is anything I can do to stop this happening?

The cause of muscle cramps is often very difficult to diagnose with precision and can be very difficult to treat.  It is important that you see your physician and have testing for the common causes of muscular spasms including blood … Continue reading

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

I have been diagnosed with stage 4 CKD. Back in late September I had a stroke, and it affected my left which has slowly gotten better. I also have IC of the bladder, low blood pressure which in times that I’m active it raises just a little, then when I rest it drops. When I had the stroke my BP was 72/54. I have to take potassium daily for kidney stones. I also have a tumor in my left kidney, a hole in my heart, and a blockage. I take meds for high cholesterol and high triglycerides. My protein level is low, I have a very bad B12 deficiency, precarious anemia, I also have GERD and IBS. At this time I’m down to only getting the B12 shot, but it will be a lifetime short my body doesn’t absorb B12 from foods I eat. I’m supposed to be on a no processed, low sodium diet, but it is hard to find food that has not been processed.  I see a cardiologist and a neurologist on a monthly basis. So, I was just wondering how all of this works together. If you could give me some insight into how all of this will affect each other. 

You describe a very complex mixture of medical issues.  In cases such as you describe, it is best to have a primary care physician (PCP) who is able to sort out all of the recommendations of the specialists that you … Continue reading

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

My metabolic panel shows Urine Urobilinogen to be greater than 2.0 MG/DL. Is this cause for concern? The lab shows a Reference Range as 0-1 MG/DL as being normal.

The urine urobilinogen is a measurement of liver disease or byproducts of red blood cells in the urine. It may mean that the urine is very concentrated or that there might be liver disease or complications of anemia. I suggest … Continue reading

Posted in Anemia, Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing

I have Stage 3 moderate kidney disease Egfr in mid 40’s. No change in last 5 years. No protein in urine. Blood good for last 5 years. Occasionally, I wake up with leg cramps in right leg. Cramps in thigh very painful. In calf or ankle not too bad. Quinine recommended by some. Is quinine bad for kidneys?

Quinine does not have any ill effects on kidneys, but Quinine used for cramps was removed from the market by the Food and Drug Administration (FDA). Quinine is available for use in malaria, but no longer available for use in … Continue reading

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

Hi. I have some questions about chronic kidney disease patients. 1.Are there any boundaries to taking tetracycline, doxycycline, pirprofen, aminopterin, ibuprofen and amiodarone in this people and why? 3. If there aren’t any boundaries, how much of these drug doses are usually used? 2. Is there any document that proves these drugs increase erythropoietin level in blood?

There are many considerations when dosing drugs in patients with chronic kidney disease (CKD). Physicians are trained to know how drugs are eliminated by the body. Most drugs have some clearance through the kidneys. Hence, the level of kidney function … Continue reading

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

I am writing about my mom, 79 yrs young. She still hauled grain to the elevators this summer in the grain trucks. As of late, the GP has had some concern of anemia, and some leg swelling. A few months ago she had emergency gall bladder removal surgery, and several days later kidney function declined significantly, gfr was down to 15. After a few days and testing, the situation corrected itself to gfr of 51 The GP sent her to nephrologist. He did a battery of tests. CBC RBC 3.69, Hemoglobin 11.3, Hematocrit 34.5, ESR elevated to 55, Iron, IBC and Ferrtin, in normal ranges, IFE and PE are within normal vales, no M spike observed. LD normal range. Bun 29, creat 1.0, albumin 2.9, BUN/Cret 27.9, UA protein 71.1 mg/dl, UA creat 133.7 md/dl, UA protein/creat ration 0.532, Uric acid 8.2 mg/dl, Free Kappa Lt Chains 63.4 (H) mg/L (3.3-19.4), Free Lambda Lt chains 78.3 (H) MG/L (5.7- 26.3) But Kappa/Lambda radio is 0.81 (.26-1.65) which I was told was good. Blood smear was unremarkable, reds and whites of normal size and shape and appearance. Doctors unsure. Nephrologist was not concerned, and didn’t think kidney disease would progress (stated stage 3a ckd) so no special instruction or diet, other than avoid NSAID. GP thought Iron problem, but iron test show otherwise. Endocrinologist not sure, happy with A1C 7.0, using Lantus and R on sliding scale. Only other meds are Sotalol antiarrhythmic for a. fib, and a statin. The only thing that was not run was an EPO level, with the comment made that the kidney disease was not severe enough to cause a problem with EPO causing the anemia. Reading, many of the above could be explained by chronic kidney disease. Any ideas or impressions ? Thank you

I am not able to make a specific diagnosis based on the information that you present. Since she has diabetes, heart disease with atrial fibrillation, and a recent episode of acute kidney injury, she does have significant risk factors for … Continue reading

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

I am a 68 y.o. white female. I have one kidney (not sure how long the other one was atrophied, as it was noticed incidentally on a sonogram) and there is a mass on it thought to be benign because it has shrunk in the past. My GFR was 49 in April, 49 in June, 41 in August and now 49 in September. My BUN was 19, 19, 31 and 24 , Creatinine 1.15, 1.10, 1.30 and 1.12. These tests were performed by my hematologist who is following me for this, as well as anemia. My hemoglobin in now up to 11 (no meds). My BP is well controlled averaging 120/70 (on Avapro and Amlodipine). I am not overweight (5’6, 136 lbs.). I did take Nexium in the past for about 10 yrs and am now trying to control acid reflux with Zantac prn. I have had idiopathic peripheral neuropathy (lower legs and feet) for about 18 yrs. I am not diabetic. My Hematologist and Internist both agree that this is nothing to be concerned about and that I just need to recheck this in about 3 months. I am told that my GFR is low partly because of my age. I’d like your opinion of this assessments, as I want to do all that I can to keep my kidney function normal. Thank you.

You appear to have early Stage 3 chronic kidney disease (CKD) based on the testing that you provide. I cannot tell why you have CKD. The creatinine testing and estimated glomerular filtration rates (eGFR’s) that you describe are probably not … Continue reading

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

I have had Stage 3 kidney disease for 5 years and recently was able to donate blood and I did it twice within the allowed time frame. I seen my PCP today for some weight gain that was fluctuating past 3 weeks of up to 3 or 4 pounds overnight. I donated last 4 weeks ago. I had a full exam and no solid answers as to the gain, barely any edema, rings tight but mainly abdomen bloated and full feeling. I told my PCP I had donated twice recently and he stated that was probably the reason for the gain. He explained that the fluid shifts would not be normal for me with the kidney disease. He offered to repeat my kidney labs but I just had that done last month and seen my Doctor also and all was stable. I then did some research and some places said those with kidney disease should not donate and it can change your stage of disease. I am now wondering if I should have my labs rechecked. Any thoughts?

The reason for not donating blood for patients with chronic kidney disease (CKD) is related to the anemia that is commonly seen in patients with late Stage 3 or Stage 4 CKD. If you are not anemic, then donating blood … Continue reading

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