Category Archives: Birth Defects/Urinary Tract Abnormalities

My brother was diagnosed with complete kidney failure at 18 yrs old (Hypertension/Jaundice). At that time, 1980, his diagnosis was multi-cystic kidney disease, and after two transplants he died at 25 in 1983. I was told his disease was not hereditary. My son born in 1990, had no left kidney. Enlarged right functioning kidney. Like my brother he was born with a undescended left testicle. He is 28 now with recent ureterocele dx/repair. Should he consider genetic testing prior to having children of his own?

The syndromes that you are describing are generally known as Congenital Abnormalities of the Kidneys and Urinary Tract (CAKUT) and are generally thought of as genetic disorder or disorders that are thought to be hereditary. I do not think there … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing

I can’t pee. How do I know if stopped making urine?

I suggest that you consult with your physician.  If you have not been able to produce urine in over 24 hours, this must be evaluated urgently by your physician.    

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing

My son is 12 and evidently was born with a blockage to one kidney, which is now only functioning 3%. He had one UTI when he was 6, which was treated with antibiotics, but other than an annual urinalysis at check-ups, no tests were ever done to detect the problem. He felt good up until a year ago, when he started having a lot of headaches and nausea a couple of times a week. His pediatrician misdiagnosed him with migraines in January and no testing was done until he ended up in the e.r. several weeks ago and they (thankfully) ran many tests on him. What would be considered to be “standard” care for a 6 year old boy with a UTI that seems to respond to antibiotics but he has no other symptoms? Would a renal ultrasound be considered to be “standard?” Or for a 12 year old boy with migraine- like symptoms and a history of 1 UTI? For the time being he’s stable with the help of blood pressure meds. as we wait for his surgery and he’s actually feeling better than he has in a year. His other kidney is thankfully “fantastic,” according to the two specialists who read his scans. They are very well-respected and I trust their judgement. My son has to have a laparoscopic nephrectomy. What is the typical recovery from a laparoscopic nephrectomy like? I’ve been told there’s a 4 day recovery but that it will take quite a while after that for him to get back to 100%. I’m trying to figure out how much support he might need from his school after his surgery. Will he be able to walk from class to class? Carry a backpack?

The questions that you ask are surgical questions that come under the expertise of a pediatric urologist.  I am a nephrologist and do not see children.  Hence, the questions that you ask need to be addressed by a urologist and … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects, Treatments

My three year old son is in remission with Stage II WILMS FH. He had a left radical nephrectomy. He is currently being followed by oncology. Recent test have shown that his GFR was a 38, according to the pediatric calculator. His BUN was 13 and Creatinine ranged from .40 to .45. The pediatrician and oncologist do not seem to be worried. We would like to be seen by a nephrologist but they do not seem to think it is necessary. What is your thoughts?

Wilm’s tumors are treated by a urologist.  Removing one kidney should cause a reduction in the overall kidney function.  That is an expected result from removing one kidney.  I suggest that your son continue to consult with his pediatrician.  Referral … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Pregnancy / Kids, Symptoms and Side Effects, Treatments

My son, now 5 years old was diagnosed with Hydronephrosis in both kidneys before birth. He was monitored for 2 years and was released of urology and nephrologist but the past few weeks he’s showed high blood pressure, very metallic smelling hair and breath. He has been wetting his bed at night and cannot seem to stop sweating and drinking excessive water. Should I get a lab work up?

I suggest that you consult with your son’s pediatrician for an examination.  Laboratory testing may be needed but a good examination by his pediatrician will be important to make sure the proper tests are performed. For more information on children’s … Continue reading

Posted in Ask the Doctor, Bed-Wetting, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects, Treatments

Hi, My daughter postnatally was picked up to have dilated kidneys (both) She had surgery on both of these at 6 months and then 12 months (JJ Stints) the right one has been successful with it now looking normal. The left one is now stretched and still shows signs of dilation. She is 7 years old the right one measures 9.46cm and the left is 11.24cm. She has recently had an MRI and this showed the right one draining ideally the left one did drain however it was slower. The consultant has advised that we will follow up in 6 months with another scan as the left one may just be bigger and it might just be the way it looks now. My question is, with your experience would you have expected the left one to stabilise by now? They gave her a medication to reduce the time of the scan however would this have adjusted the results? (It took an additional 5 minutes for the larger kidney to drain under the medication so does this mean without it, is the urine sitting then and not draining or it does drain just a lot slower? If so is this of concern) Any advice on the long term management to avoid future problems would be appreciated. We have all images available and notes if required.

The problem that you describe is a urological problem.  I am a nephrologist and have no surgical experience with childhood obstructive kidney disease.  This problem is best handled by a urologist and not a nephrologist.  I suggest that you continue … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Chronic Kidney Disease, Kidney-Related Health Questions, Symptoms and Side Effects

Hello, My 9 year old son recently had an renal ultrasound to look for kidney stones, etc. We don’t follow up with the nephrologist for over a month, and I’m curious about ultrasound report. The nurse told me on the phone that he didn’t have kidney stones, and this is what the report actually says: 1. Mild right pelviectasis in the prone position only (7 mm). 2. Otherwise normal sonographic appearance of the kidneys. No definite calcifications are seen. In the prone position only, there is mild right pelviectasis (SFU grade 1 bordering on 2) with AP diameter of the pelvis measuring 7 mm. I assume the pelviectasis isn’t serious since the nurse didn’t bring it up on the phone, but never having heard the term before, I tried to research it. The only references I can find refer to fetal pelviectasis, and I can’t find anything about this condition in a 9 year old child. I’m also curious about it only being seen in the prone position. Does this point to the possibility of some sort of blockage, or is it likely just a physiological finding? Is it unusual in a child his age?

Pelviectasis (also called pelvocaliectasis) merely means a separation of the collecting system or pelvis of the kidney detected by the ultrasound device.  It does not suggest any disease, unless there are symptoms or signs of blockage and none are described. … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Pediatric Issues, Pregnancy / Kids

For the past year, my 9 year old daughter has been getting regular immoglobulin treatments (Gammumex)which are responsible for a miraculous improvement in her mobility, since she has Chronic Inflammatory Demyelating Polyneuropathy. For almost a year she got the treatments at 2 week intervals and more recently at three week intervals. These IVIG treatments, necessary as they are, are hard on the liver and kidneys, but do you know just how toxic these IVIG treatments can be to a child’s kidneys over time? Have you heard of this type of treatment ever damaging the kidneys? She doesn’t get an especially high dose, just average, and her neurologist says any irregular reading on the kidney and liver test we took should be disregarded because that’s just due to the IVIG’s. But because this is a rare disease, most of the frequency/dose of the treatment still involves guesswork and experimentation, so I remain watchful for signs of stress on her body. In the last several months she is getting bladder infections now and then that she didn’t get before. So far they just go away with cranberry juice. Then in the last 6-7 weeks I usually have to push her to eat because she frequently gets stomach pain. She was never a big eater to begin with so I worry about her getting enough protein and losing alot of weight again, which she did when she was initially misdiagnosed, wasn’t getting these treatments, and lost most of her mobility. What scares me most is that I read everywhere about how there are no symptoms of kidney disease until it’s advanced. So should I be proactive/concerned, then? If you say yes, my next step would be to show the readings we have to pediatric kidney doctor in our hospital system, to see if a more detailed kidney/liver test should be taken The test the neurologist ordered wasn’t, I was told, but that’s because her neurologist is unconcerned. The reason I feel the need to check with a third party at times is because he was the one who misdiagnosed her, so I had to go to another doctor and then go back and convince him to give her these IVIG treatments, which I think saved her life.

I would recommend blood and urine testing for kidney disease at least every three months to monitor kidney function.  This should include a serum creatinine and an estimated glomerular filtration rate (eGFR).  Urine testing should be for blood, protein and … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects, Treatments

I just read an old report of a blood test. The Doctor never said anything to me, but I had high protein in my urine and a few other things. They wrote possible kidney renal problems. This was taken at 52, I’m now going to be 54. I have had alot of bladder infections and one with my blood when i was younger. I had a scope of my bladder and I see a urologist for infections due to intercourse. They once said I had blood coming from my kidneys. No followup. I take prescription for infections when needed. I also don’t urinate all day then when I lay down I urinate alot. I do have marks on my legs from my socks and impression of fingers of swelling when you press on my legs. Should I be concerned? Get more tests? Sugar is good, actually I have low blood pressure.

I suggest that you have a urine test for blood, protein and infection sometime when an infection is not present and you should also have blood testing for creatinine testing and estimating your glomerular filtration rate (eGFR).  These tests will … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

My 9 year old son has had a very bright white, chalk-like residue in his underwear for several months. It is usually dried when I find it, and when I flake it off, it becomes powdery. It is definitely not a “discharge” from infection or seminal fluid. When I first saw it I thought it was paint, or white-out. When I examined it my first thought was that it looked like calcium (Tums) or some sort of mineral. He has had this once every week or so for 4-5 months, and I am now noticing that on days when he has it he often has an episode of stomach pain, which he describes as hurting fairly badly. He has never before complained of stomach pain so this made me pay attention and I noticed the correlation. It has not been accompanied by any pain or burning with urination until just the other day. That day he called me in to the bathroom to see a white, wet but powdery discharge, almost like wet chalk clumps. It was on his penis as well, and that time he said the opening in his penis hurt when he urinated. I was able to scrape a bit of the substance, which is like a hard flake, though very small. His doctor is having me take it to the lab to be tested. I’m curious if you’ve every heard of something like this, and what it might indicate? He is not dehydrated, and his urine is almost always a light straw color. Incidentally, the last week or so he has been waking with mildly to moderately puffy eyes.

I am unable to provide a specific diagnosis based on the information that you describe.  This is a finding that I have never seen before.  I suggest that you continue to work with your pediatrician and seek consultation based on … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects