Category Archives: Diabetes

I am a 73 yrs old female. Have early stage 3a kidney disease. Have chronic sinus inflammation. Can I take short does of prednisone? Thank you so very much.

Short courses of prednisone should not cause any concern for chronic kidney disease (CKD). If you have diabetes, this could make your diabetes more difficult to control in the short term. You should also monitor your blood pressure while you … Continue reading

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

Hi Dr. My question is should I be consulting a nephrologist at this point or am I getting ahead of myself? I am a 53 year old female. Brief medical history 10 yrs. + metastatic melanoma survivor, one year Interferon. Coronary & Carotid Disease as well as PVD. Type 2 Diabetes but maintain no higher than 6.5 A1c. COPD, pulmonary nodules. Many long term prescriptions, omeprazole, metoprolol, amlodipine, losartan, clopidogrel, rosuvastatin, zetia, metformin and baby asprin. This week I had a urine ACR of 120.4 and it came back from lab flagged as high. For the last few years, my eGFR is 60. My right renal artery also is 50% stenosed. I’ve also been experiencing lower back pain. My question is this: is it too soon to be worrying about my kidney function or are these numbers acceptable? My primary and cardiologist do not seem concerned and in fact wish to increase metformin from 500 to 750. Your opinion would be greatly appreciated regarding my need to see a kidney doctor at this point in time (I’d rather catch anything early than late for a change:) Thank you in advance!

I am unable to make a specific diagnosis based on the information that you present. We do see elevated albumin to creatinine ratios (ACR’s) in patients with heart disease, high blood pressure and diabetes. Any one of these could be … Continue reading

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

Hello. My eGFR last Dec, was 71. Two months ago it was 44 and now it is 38. How far in months or years do I have before dialysis or when can I expect to meet my creator? What is your take on life expectancy table for people with CKD. I am 62 Y/O Asian. Started modifying my diet. B/P is normal now and A1c is 6.3. Thank you.

High blood pressure and diabetes are the two most common causes of chronic kidney disease (CKD). It sounds like you are better managing your blood pressure and diabetes which should help to slow the progression of CKD. Unfortunately, CKD cannot … Continue reading

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

I am a 48 yo female with a history of Nephrogenic Diabetes Insipidus, which had resolved two years ago by removing the offending medication. Last year, I was started on Methotrexate for RA and my GFR immediately fell to 45. I was started on Norvasc for cardiac reasons and the GFR returned to over 60 but urine specific gravity was consistently less than 1.005. Just removed Norvasc, specific gravity now normal but GFR dropping to 53. The question is…which is the lesser of the two evils?

This is not a question I am able to answer.  There are a number of other blood pressure medications that are available and if you have side effects with one, then there should be another to choose from.  The specific … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

Hi Dr. Spry, Thanks so much for taking time to answer this question. My father has type 1 diabetes and was prescribed ramipril. His creatinine was recently found to be 140, but I think the ramipril prescription came before any revelation of elevated creatinine.He has consistently low pressure and yesterday it was 88 over 40. (He was dizzy) Does ramipril do anything other than lower blood pressure? We are wondering if he needs to be on this medication at all since he has no problems with high blood pressure.

Ramipril is an Angiotensin Converting Enzyme (ACE) inhibitor and is commonly used to treat diabetic kidney disease, even in the absence of high blood pressure.  It should not be used to cause symptomatic low blood pressure and it should not … Continue reading

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

Good afternoon Doctor, I am 37 years old and I live in Colombia I have an unspecified chronic kidney damage, I feel very bad since the nephrologist says that if I have a biopsy I can bleed because my kidneys are small, creatinine It is 2.40 I do not have diabetes or suffer from high blood pressure my bones if they hurt me a lot and there are days that I feel very tired I would like to know a treatment and what can I do Doctor please. Thanks from my heart.

If you have none of the usual risk factors for kidney disease, such as high blood pressure, diabetes, family history, or obesity, then a kidney biopsy may be the only way to tell you what your disease may be. In … Continue reading

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

I was wondering what insulin/diabetic medicines are the most gentle/safe for a person with one kidney? I had one kidney removed last August due to kidney cancer. Trying to keep my other kidney healthy and was told Metformin and so are some insulin products. Any information would be greatly appreciated. Thank You.

Metformin is now acceptable for patients with an estimated glomerular filtration rate (eGFR) greater than 30 milliliters per minute per 1.73 meters squared. Metformin is a safe and effective medication for patients with diabetes and chronic kidney disease (CKD). The … Continue reading

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

My Microalbumin:Creatinine Ratio was 327.24 ug/mg. I have been told I have kidney damage 3 years ago, and just got retested and got these results a few days ago. I don’t know what this means, and I don’t know where to go from here. What does this number mean? Am I in kidney disease at this point? I am a Type 1 diabetic.

A normal microalbumin to creatinine ratio is less than 30 micrograms per milligram of creatinine (ug/mg of creatinine). The result that you mention is over 300, so you have large amounts of protein in your urine and this likely represents … Continue reading

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

I am 80 years old Asian male. My A1c level in August 2018 was 7.5. However, my creatinine level recently increased to 1.59. I am extremely concerned about it. What can I do to reduce this level? I am currently taking tablets for diabetic, blood pressure and Simvastatin. My lipid results are well controlled (Ch, HDL, LDL, triglyceride- all less than the limits).

You may have chronic kidney disease (CKD), but I am unable to make a specific diagnosis based on the information that you present. Diabetes and high blood pressure are the two most common causes of CKD. In the management of … Continue reading

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

Hi Dr. Spry I am a 65 year old female, with controlled type 2 diabetes, controlled blood pressure, 5’4 tall, weight 210, which I’m actively working on losing. Last week I finally activated our hospital patient portal and started to go through my information that was there. I was stunned to read in diagnoses from November of 2017, that it said I had chronic kidney disease with controlled diabetes mellitus, and chronic renal failure stage 2, mild. My eGFR at that time was 57. My creatinine was 1.03, and all other tests for kidneys were a few points into the abnormal range. The doctor never told us this diagnoses, and now, 10 months later I find out this way. I immediately did research to see what I could do to slow down the progress, where I discovered that an eGFR of 57 is 3’rd stage, not 2’nd. These unacceptable issues will be discussed with him at the only available appt they could offer for follow-up, which is October 5, 18. In the meantime I am making an appt with a kidney specialist, and I also started a renal diet 3 days ago. I started a daily exercise program. I have increased water intake, stopped coffee and diet soda. What else can I do to help myself, and based on the lab values I mentioned, how serious is this? I am also confused by the 2 diagnoses. As I don’t know a lot about kidney disease, how could I have both? I thought renal disease and kidney disease were one and the same. Thank you for reading my “book” and any light you may be able to shed on this situation.

Chronic kidney disease (CKD) and chronic renal disease are the same thing. We prefer the term “chronic kidney disease” rather than the latter term. Diabetes and hypertension are the two most common causes of CKD. Stage 2 CKD means that … Continue reading

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