Category Archives: Chronic Kidney Disease

Will abandoning my NSAID help my kidney function? Background: I am a 59-year-old woman, thin, low to normal BP, no drinking, no smoking ever. Diagnosed with autoimmune ankylosing spondylitis in 1989–full blown. History of back problems in teens. Have been on relatively high dose NSAIDs since 1989, which is credited for my decent range of motion despite entheses in various places. My creatinine has been gradually going up and my GFR is now 54, Creatinine 93. Is this to be expected of someone my age? Is it too late to make a difference, to stop the NSAID?

The long term use of high dose non-steroidal anti-inflammatory drugs (NSAID’s) is associated with progressive chronic kidney disease (CKD). This is especially true when combined with acetaminophen (Tylenol) or phenacetin (analgesic powders). If you are seeing a decline in your … Continue reading

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

I am a 65 year old female with one kidney. The second kidney was removed due to a car accident when I was 16. Prior to 2016, my GFR has been stable and in stage 4. From January 2016 through July 2017, the GFR on my remaining kidney dropped 6 points from 63 to 56. In July, after getting this information, I went on a low sodium, low potassium, low protein diet. In October 2017 my blood work was re-checked and my cholesterol jumped from 206 to 284 my BUN was 25, Creatinine was 1.1 and my GFR had dropped another 6 points to 50 which is stage 3. I am stunned at my readings and at a loss as to why my GFR has dropped 13 points in less than a year when they have been stable. My doctor is an internist and I wonder if these kind of changes would warrant a visit to a specialist or a renal dietitian. Thank you.

I am unable to suggest a reason why your kidney function would decline. I do not recommend a low potassium diet or a low protein diet. I recommend the DASH diet. The DASH diet is a high potassium and low … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions

I am a diabetic, since 2000, and I have problems sleeping at night. I also urinate 3-5 times at night. I take Metformin/Glibencamide 3x daily, as prescribed by my doctor. Grateful for your response at your convenience. Regards.

Passing urine during the night can be a sign of kidney disease or your diabetes not being well controlled. I suggest that you discuss your concerns with your primary care physician (PCP) and ask for further testing. This is a … Continue reading

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

I am suffering from essential hypertension for more than 20 yrs (BP not more than 140/95 mmhg at first) and taking drugs for lowering BP like Dytide, Natrilix etc. I am taking Losartan potassium + Hydrochlorothiazide for last 15 years and BP is now more or less 130/85 mmhg, taking thyroxine sodium 75 mcg for last 6 months. I am suffering from Gilbert’s syndrome from very beginning. My Creatinine is over 1 mg/dl for last 10 years. At last it is 1.25 mg/dl (now I am 46 yrs old) Indian, wt.69 kgs.FBS 89 PPBS 133 HbA1C is 6.1, Ca+ 10 mg/dL PO4 4 mg/dL, no protein, sugar, ketone bodies found in urine R/E. Potassium 4 mg/dL, Total cholesterol 195mg, LDL 110 mg, HDL 54 mg, SGPT 74 mg, SGOT 45 mg, Uric Acid 6.64 . GFR calculator shows eGFR is 62-74% which is type II CKD. But my Doctors of Kolkata, India say that no medicine is available for this stage, and continue all medicines as previous. Is it really CKD? May it rise further? What is latest medicine to roll back creatinine level to below 1mg/dL or to rise eGFR to above 90%? Please advise.

I agree with your physicians in India. There are no medications which cause a decrease in the serum creatinine or an increase in the estimated glomerular filtration rate (eGFR) that is sustained and beneficial to the kidney in the long … Continue reading

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

Is it necessary to weigh yourself daily in the early stages of CKD?

I do not have my patients weigh themselves daily. I do think that taking your blood pressure and recording your weight once every week or two can be very informative when you visit your physician. Hence, if you want to … Continue reading

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

Hi, do you have any website about having natural diet with kidney disease, especially juice treatment or herbal?? Thanks in advance.

I am not aware of any juice diet or herbal supplements that will benefit anyone with chronic kidney disease (CKD). In the early stages of CKD, Stages 1, 2, and 3, I am a strong advocate for the DASH diet. … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions

I have thin basement membrane disease. I found out in 2014. My GFR is 61. I have read most people with this disease have normal kidney funtion. What could be causing my kidney function to decrease? It took 14 years of blood in my urine to discover disease, that’s because of GFR 61%. Urologist told me in 2000. Some people have blood in their urine. My age 57. Thanks.

Thin basement membrane disease is typically not associated with any reduction in the estimated glomerular filtration rate (eGFR). The eGFR that you mention is 61 milliliters per minute per 1.73 meters squared. This would be in the range of Stage … Continue reading

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

Test Report Beta-2 Microglobulin (ß2M) has been identified as the light chain of the HLA-A, -B, and -C major histocompatibility complex antigens, 100 amino acids in length and noncovalently associated with the heavy chain. ß2M occurs on the surface of nucleated cells- abundantly on lymphocytes and monocytes- and on many tumor cell lines. Its function is unknown, but it may control the expression and on the cell surface. Elevated serum concentrations in the presence of a normal glomerular filtration rate suggest increased ß2M production or release. What does this test report of myeloma panel mean? This is the report of patient suffering from chronic kidney disease.

Beta-2-microglobulin can be elevated in patients with chronic kidney disease (CKD) and is often elevated in patients with multiple myeloma. It be elevated in some patients with lymphoma and leukemias. For interpretation, you will have to consult with the physician … Continue reading

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

Can lactated Ringers be used in renal patients in an interventional radiology suite? Minimal amounts are administered per patient per procedure. Procedures lasting approximately 30 minutes – 1.5 hours.

In general, I avoid lactated Ringer’s solution in patient with advanced kidney disease because it contains potassium. The amount of potassium is relatively small, but even small amounts of potassium in some patients can be associated with a rise in … Continue reading

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

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