Category Archives: Diabetes

Over the last three months I have seen my creatinine levels increase and Gfr decrease. I raised my concern to my urologist. He said I should not be concerned but ordered a renal ultrasound. He added that if something was found he would refer me to a kidney expert. The ultrasound results indicated normal, no abnormalities. I discussed results with my urologist and he said there was no need for concern and he would see me in six months. I have no symptoms (ankle swelling etc.) However, I have read that in most cases of kidney problems there are no symptoms. One symptom is bubbly urine. I do not want to wait until it’s too late. Current creatinine level is 1.44 and Gfr is 52. I am 83 years old.

I recommend that you have urine testing for blood, protein and infection. If these results are abnormal, then consulting with your primary care physician (PCP) or a nephrologist may be indicated. The estimated glomerular filtration rate (eGFR) that you quote … Continue reading

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

Hi Doctor, I know you answered this question already. That CKD is not reversible. I understand that it is generally irreversible when the damage is too extensive, i.e., later stages of CKD. However, at early stages, the damage is not widespread. If the kidney function is still normal and proteinuria is in remission, why is it impossible to reverse the damage? There is evidence that hardening of the artery walls in heart disease patients can be reversed when the patients are put on a healthy diet. If proteinuria is gone and a healthy diet is adopted, there is no more injury to the kidney. Why then damaged nephrons (just a bunch of blood vessels) can not be repaired or reversed in the same way heart arteries can be repaired? What makes our kidneys so special?

Once the small filters of the kidney (glomeruli) and tubules (nephrons) of the kidney have been destroyed, the kidney has no capacity to replace those destroyed glomeruli and nephrons.  It is true that the glomeruli are blood vessels but they … Continue reading

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

I am an Indian. My father has CKD. His present serum creatinine is 1.73 & ACR is 135. His blood pressure 120/80, fbs- 95 & pp- 320. Presently I am in touch with a reputed nephrologist. According to my doctor there is no medication for CKD. He said we only have to control blood sugar & pressure. Please give me your valuable opinion to improve my father’s health.

For patients with  chronic kidney disease (CKD) related to high blood pressure and diabetes, the treatment is to carefully control both diseases. Hence, your doctor is correct. It is important that your father not smoke, limit consumption of alcohol, exercise … Continue reading

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

I’m male, 48 y/o, weight 139 kg, height 195cm. Creatinine 1.1, eGFR 53.3 Cystatin C test 139, blood pressure 149/100 (pulse 100), sugar blood 182, cholesterol 203, triglyceride 375, uric acid 6.1. I am taking medicine: Twynsta 80/10 (each a day) Gemfibrozyl (each a day) Glucosamine 1500mg/day, fish oil 1 capsule/day. Question: How do I take care of my kidneys? Is it really serious? I have a serious pain in my waist, and always feel too tired. I’m an alcoholic, but after doctors told me I have serious kidney problem, now I only consume 200cc whiskey/day. Thank you.

You have chronic kidney disease and need to follow your doctor’s recommendations. You should stop drinking alcohol, lose some weight, and eat a healthy diet that is low is salt. I recommend the DASH diet. You can review the DASH … Continue reading

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

My husband was diagnosed with type 2 diabetes a week ago. He was in ketoacidosis which is what caused us to go to the ER. Since he’s been released from the hospital he’s developed an ammonia smell to his breath. What test should we ask for? He hasn’t had his post hospitalization appointment yet.

An ammonia odor to the breath can mean many things, including a recurrence of the ketoacidosis. I suggest that your husband call and visit his primary care physician (PCP) for evaluation and diagnosis of his current status.

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

I am a 67 year old lady who lives in Canada and have Type 2 diabetes (insulin dependent). I just recently was diagnosed with CKD and then nothing from doctors. I did all the blood tests and have to go for the ultrasound on my kidneys soon but I feel as if I am floundering as the doctors have not even contacted me as to the next step for me to take. I don’t know what to eat and what not to eat. I don’t know what phosphates are or how protein is very important for me. I am going crazy without answers. Can you help please? Yours truly.

First of all, it is most important to make a specific diagnosis as to the cause of your chronic kidney disease (CKD). If you are still undergoing testing, then your physicians are still exploring tests and this should lead to … Continue reading

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

Dear Doctor, My serum creatinine is 0.71 mg/dl, CPK 74 u/l, HbA1C 6.72, microalbumin (spot) 86. Can you help diagnose the problem?

Based on the testing that you present, you appear to have diabetes mellitus.  Your Hemoglobin A1c is 6.72% which would be in the diabetic range. I am unable to comment on the rest of the testing as these results are … Continue reading

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

I was diagnosed with CKD Stage 3a in 2016 for a number of months gfr 58, 49, 55, monthly then 56, 55, at 6 monthly intervals all with ACR at A1 although there was some with blood in urine. Then after rigidly sticking to a healthier diet, the GFR went up 65 and I was told I no longer had CKD. However my GFR has now come in at 62 but I have an albumin/cretinine ratio of 4.4 (ACR at A2). I have to return in a months time for retests. What I want to know is, if you are diagnosed with CKD do you no longer have it if GFR rises above 60? I thought once you had it, you always would have it. I am having the same problem with getting a diagnosis for Diabetes because I only ever get one result over the 48 line on HgbA1c yet I go back and forth over the borderline and have been told by retinal screening I have diabetic maculopathy in one of my eyes. I find this bizzarre when I can’t get a confirmed diagnosis. I find it most confusing. Can you help?

The line for the diagnosis of chronic kidney disease (CKD) is somewhat arbitrary and has been set at 60 milliliters per minute per 1.73 meters squared and it must be present for at least 3 months. You appear to be … Continue reading

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

Hi Dr. I just want to ask, my mom was diagnosed with Stage 4 kidney failure last February first week and she has history of diabetes and hypertension also. She was all ready for dialysis doctor said, but since we are poor people, we can’t afford it. Now she is here at home. Her two feet are big already, her skin gets black like it was burned. Her urine is regular but she can’t poop. What do you advise me to do aside from dialysis? And what food is she allowed to eat and drink too please? Thank You.

I am unable to provide a specific diagnosis or treatment based on the information that you present. There are many cause of kidney failure, including high blood pressure and diabetes. I am not able to suggest a diet that would … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Hypertension/High Blood Pressure, Kidney Failure, Kidney-Related Health Questions

I am 38 and have hypertension and type II diabetes as well as RA. My latest bloodwork showed a creatinine urine of 229 and microalbumin urine of 5.2, but the ratio was normal, I’m assuming because both are proportionally high. Is this something that would require a nephrologist? My endo was the one who ordered the tests but I don’t see her again for a while. I’m concerned also because my grandfather passed from kidney failure, my aunt on that side has had 3 kidney transplants and my mom, who donated a kidney to my aunt, has FSGS, so kidney disease is, very prevalent on that side of my family.

The concentration of creatinine and microalbumin in the urine are only relevant if the ratio is greater than 30 milligrams per gram (mg/gm) of creatinine. I am unable to establish a diagnosis of chronic kidney disease (CKD) based on the … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Hypertension/High Blood Pressure, Serum Creatinine