Category Archives: Blood/Urine Testing For Kidney Disease

I am 62 year old Type 1 diabetic with Stage 4 CKD. My eGFR is currently 23. I am an amputee and have a hex of CHF, sepsis, ARDS, acute renal injury x’s 3. I was on an ACE inhibitor but was taken off of it by my new nephrologist. From what I have read, an ACEi is standard treatment. Your thoughts?

Drugs such as Angiotensin Converting Enzyme Inhibitors (ACE-I) and Angiotensin Receptor Blockers (ARB) agents are used to try and preserve kidney function in diabetics with protein in the urine. In your case, your nephrologist may have evaluated the risks or … Continue reading

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

Hi~ I am a male, 43, do not drink (never had a problem with any substances). I recently had an attack in my side that lasted for over an hour. I went to a doctor and was misdiagnosed with diverticulitis (no tests were performed to validate even after I inquired) and was prescribed Augmentin. Dosage was one pill every 12 hours. By the third pill I had formed such a severe headache, that I stopped the medication and contacted my doctor. My blood pressure went through the roof (189/115), and after three weeks is still high. My BP before that (130/80) was in the moderate range. I went to the emergency room and the tests the first doctor should have performed, were finally completed. (Blood, Urine, EKG, CT w/contrast). Everything was normal except the CT showed something on my kidney but nothing more. I had an ultrasound yesterday of both kidneys and learned today that I have fibrosis in both kidneys. Would Augmentin cause this fibrosis to happen? Is the scarring reversible? I do not have any other medical conditions that I am aware of at this time. Thank you for your time.

Fibrosis (scarring) of the kidney is not a process that can be accomplished in a couple of days. This process likely takes weeks or months to develop. I am not sure that you can make a diagnosis of “fibrosis” purely … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine

This is being written just having been diagnosed with Chronic Kidney Disease Stage 3 Glomerular Filtration Rate. I have gas coming from my vagina for several months. At the time I first noticed it, I just discounted it. I have just gotten Internet this past month and started to look up ’gas in urine’ and was surprised to learn this is for real. I also have yeast infection. On that note, I had been well since before July 2018. Unusual amounts of rain flooded my basement this past year. Mold/fungi developed and air quality tests showed aspergillus and basidispores very prevalent in my house. I needed to move out but five months too late. Remediation has taken place where I lived before. Health issues developed skin, rash, watery eyes, and much more. This was the time when urinating bubbles/foam appeared in the toilet. This recent diagnosis CKD Stage 3 needs health care. I need advise as to who knows how to treat this and also the provider be aware of the fungi that I breathed for 5 months. Thank you for this opportunity to express myself on this matter.

Your primary care physician (PCP) should be the first person to review your history and provide a complete examination. You should also have a urinalysis performed to confirm if this is air coming out in the urine or are the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine, Urological Issues

Assuming the average person doesn’t weight train, I am led to believe that we lose muscle mass with aging. Does this mean that blood creatinine levels also decline as we age? As GFR is calculated from serum creatinine and is inversely proportional to serum creatinine, does this mean that as we age and creatinine declines our GFR slowly increase? Or since kidney function also declines with age, the two effectively cancel each other out and GFR essentially stays in a narrow range as we age? I assume the CKD- epi equation is configured to reflect this? Are the rates of decline in kidney function and creatinine levels similar or is one faster than the other? Will GFR keep declining with age even with declining serum creatinine levels?

You are correct that as we age, our muscle mass decreases and hence our ability to generate creatinine is also  decreased as you age. We usually say that your creatinine generation rate declines with aging and hence the total amount … Continue reading

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

My GFR goes between 27 to 29, so I know I have stage 4 kidney disease (for a short time it even went up to 32). I have three questions. Why don’t I swell much in my feet and legs with stage 4? I have just a bit of swelling if my feet are down. Also, about how long does it take to progress to stage 5 if I don’t take any precautions? Are low grade fever and stomach bloating symptoms of kidney failure? Thank you.

The swelling that is experienced in kidney disease can have many causes. These include a high salt diet, the nephrotic syndrome (spilling large amounts of protein into the urine) and heart disease, just to name a few. I am unable … Continue reading

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

A girl after pregnancy diagnosed with both kidney failure. Suggestion please?

It is certainly possible that someone could develop kidney failure after pregnancy. There are a number of kidney diseases that can complicate pregnancy including systemic lupus erythematosis, scleroderma, post partum kidney failure, and other forms of nephritis. In some cases, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney Biopsy, Kidney Failure, Kidney-Related Health Questions, Pregnancy / Kids

I have medullary sponge kidneys. Two big surgeries, cystoscopes, lithotripsies. I have pain when the stones are in the kidneys, none in ureter or urethras. Thanks.

Medullary Sponge Kidney can be associated with a deficiency of citrate production by the kidney. You should be evaluated by a nephrologist and have 24 hour urine testing to see if there are possible treatments for your kidney stone disease. … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions, Medullary Sponge Kidney, Nephrologist

My question concerns the use of creatinine, measured in the blood, as an indicator of kidney disease. My understanding is the normal range for the general population is between .8 to 1.2 as regards creatinine in the blood. Is the range different for body builders? Specifically, people who eat a great deal of protein daily, carry more muscle than most people, and work out heavily several times a week. I read that certain individual factors bump the range higher for people who have more muscle, people who eat a lot of protien, people who work out frequently (therefore likely worked out an hour or two prior to the blood test).

Yes, the serum creatinine has an inverse correlation with kidney function (the higher the serum creatinine, the lower the estimated glomerular filtration rate). There is a direct correlation of the serum creatinine with muscle mass (the greater the muscle mass, … Continue reading

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

I am a 64 year old Canadian male, no diabetes, with well controlled hypetension 117/70-75 with Losartan and Norvasc. 14 years ago, my kidney function went from 62-64 to 56-57. My PCP said no problem but I insisted on a nephrologist consult. All bloodwork, urinalysis, and ultrasound were deemed normal. Since that time my GFR fluctuated between 57 and 64. Last year, my GFR suddenly showed a decline to the 53-58 range. Again, my PCP said normal aging (as aging is a component of the GFR calculation and GFR declines with age) but again I asked for a nephrologist consult. My 24 hour urine and urinalysis and a detailed bloodwork analysis were again deemed normal for protein, electrophoresis, etc. My nephrologist said my PCP was right. The decline can correctly be referred to as aging decline. She noted that in the last fourteen years my creatinine varies between 114 and 126 umol/L and this is reflected in the GFR fluctuation. I asked her if this is classified as CKD and she said by the strict KDIGO guidelines, that would be true. I follow a strict low salt diet, similar to DASH. I monitor my BP bi-weekly and ensure I don’t overeat. I don’t smoke and have the rare glass of wine. I maintain my body weight carefully (I am 5 foot 5 inches and weight 132lbs). My question, is it normal for creatinine to fluctuate in such a range? Can my GFR decline correctly be referred to as caused by aging?

The estimated glomerular filtration rate (eGFR) is used to classify the Stage of chronic kidney disease (CKD) but it cannot make a specific diagnosis as to the cause of CKD. In your case, you would technically be at Stage 3a … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions

Hi, Dear Dr, I am 64 years old male living in Sri Lanka (Asian). I have been using Diamacrone SR 30 mg daily (Gliclazide) more than 5 years. My HbA1c is 5.1.%. My serum creatinine = 0.90 mg/dl, eGFR=89.94 ml/min/1.73sqm, Urine microalbumin/Creatinine =11.88 mg of Al/ g Creatinine. Please be kind enough to see this and let me know whether there is any signs of CKD?

The laboratory results that you describe are within the normal range and would not suggest chronic kidney disease (CKD).

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