Category Archives: Anemia

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

I am an 83 year old man. I have dropped to late stage 3 ckd over the past 20 years. I do not have heart disease or diabetes. My creatinine is 1.73 and gfr 38. Recently I have been diagnosed with anemia due to a decrease in hemoglobin red cells level to 11.1 because my bone marrow is not producing enough erythropioetin hormone and when it drops to 9.5, I will have to get injections of synthetic epo. My question is do you think my good creatinine and gfr levels will also drop sharply. I am hoping that the injections will keep my hemoglobin levels around 11.1 and my good creatinine and gfr levels will not drop drastically because of this hemoglobin problem and that I will be able to avoid dialysis for a couple of years more.

I am not able to provide a prognosis without performing a complete history and physical examination.  Each person progresses with chronic kidney disease (CKD) at a unique pace.  The pace of deterioration of your kidney function is best judged by … Continue reading

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

The anemia that your father manifests could clearly be a result of his chronic kidney disease (CKD).  CKD is commonly associated with anemia.  Your father also has iron deficiency anemia based on the testing that you describe.  Iron deficiency anemia … Continue reading

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

I just had a colonoscopy, hip replacement, hernia strangulation surgery all with in a week and an half span. Recently I was in hospital for bowel obstruction twice. I was just informed that I am anemic. I am in end stage renal failure. My level is at 12 right now. It bobs back and forth between 10 and 12. What should I do? I am waiting for a call from a nurse. But I am sick. I have all the classic anemic signs.

In patients with End Stage Kidney Disease, we strive for a hemoglobin between 10 and 11 grams per deciliter (g/dl).  If your hemoglobin is normally 12, then you are very fortunate.  I suggest that you consult with your nephrologist. For … Continue reading

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

Dr, My father has been a diabetic patient for over 25 years and now he has developed diabetic Nephropathy. He was on medicines till recently and underwent one hemodialysis last month. Now he is experiencing severe anemia and has to undergo blood transfusion every week. Is there a cause and treatment for the anemia. His hemoglobin levels drops suddenly and even after the blood transfusion its lasting for only a week. He had his intestines checked for bleeding which came out negative. What else can we try?

Anemia is very common in advanced chronic kidney disease (CKD).  The kidney is responsible for producing erythropoietin (EPO) that is a hormone that promotes the growth and production of red blood cells.  In patients with advanced CKD and who are … Continue reading

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

My uncle is suffering from kidney disease. He does dialysis three X a week, but hemoglobin is very low 6. Doctors give blood bags ….but blood level does not increase What will we do?

I suggest that your uncle be tested for iron deficiency and if present, iron deficiency should be treated with intravenous iron therapy.  If iron levels are normal, your uncle should then be treated with erythropoietin (EPO) therapy.  This is an … Continue reading

Posted in Anemia, Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Symptoms and Side Effects