Category Archives: Diabetes

Have you looked into combining metformin and the HCG diet to help in maintaining the high levels of ketones in the ketogenic diet?

I am not familiar with the “HCG diet”.  As I understand the diet, you take injections of human chorionic gonadotropin (HCG) and then follow a low calorie diet.  I would not be comfortable with using hormone injections to supplement a … Continue reading

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

My Husband has CKD stage 4. Last May 2016, he had a UTI and was prescribed trimethoprim. After 4 days he was admitted to hospital with hyperkalemia (6.4) and an acute on chronic kidney injury. He is now on a diet to keep his potassium levels satisfactory. Today his local GP has diagnosed that he has a chest infection and has prescribed amoxicillin 500mg capsules for 7 days. Is this a suitable prescription for a patient with CKD stage 4. Would it be necessary or a worthwhile procedure to have a blood test taken when he has completed the 7-day course to identify if his potassium levels have been affected? What symptoms should one look out for or what tests should be done to check if he is diabetic.

Trimethoprim is known to cause high blood potassium because it interferes with the kidney elimination of potassium.  Penicillins such as amoxicillin do not usually cause potassium problems.  Your husband’s physician should be able to determine if he is a diabetic … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis

My daddy is 74 yrs. old and almost almost 300 pounds. He has diabetes Type 2, COPD, congestive heart failure and has recently had pneumonia which caused a ton of fluid on his lungs. The Lasix used to help with the fluid is causing kidney failure. Is dialysis reasonable for a quality life?

The decision to start dialysis must be made by your father and a nephrologist based on the his ability to tolerate the treatment and the goals for treatment.  Your father should discuss his desires and wishes with his nephrologist and … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Nephrologist, Treatments

My mother is SLE patient since 92 and also diabetic heart patient since 2011. Recently she was diagnosed with pneumonia , at the moment her lungs are clear. She was brought in hospital in state of emergency. During her stay her creatinine became 3.1 and she was on insulin. After taking med dytor and nephrosave her creatinine is 1.6. Now should she continue with dytor and nephrosave? And also should she continue with insulin or get back to oral med glypizide 1000mg and diamcron 120mg?

I cannot recommend medical treatment without performing a complete history and physical examination.  I suggest that you follow the advice of the doctors who are caring for your mother.  They will have the complete information about her current health and … Continue reading

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

Hello Dr. I am writing to you for my father who is 86 years old. He is diabetic and has a pacemaker implant. Last year, his hemoglobin fell to 8 which was due to bleeding ulcers in the stomach caused due to the blood thinning medicine. However that was brought under control. Over the last 3 months his creatinine has gone up from 2.1 to 4.3, The doctor has suggested that we should now think of a dialysis. I would be greatly thankful if you could advise if a dialysis is required at these creatinine levels with his condition? Thank you and best regards.

I am unable to recommend medical treatment without performing a complete history and physical examination.  Your father has very low kidney function and you should consult with his nephrologist as to the best course of action.  Dialysis in someone who … Continue reading

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

I am a female, age 58, no diabetes, or high blood pressure, recently tested GFR 48, down from GFR 68 twenty days ago. I have fluid retention and a lot of back pain with fever 100 – 102. No UTI (but suprapubic pain). Urinalysis: No protein, Leukocyte (70), hemoglobin small, all other normal. Doctors point at creatinine level (1.17) and believe due to dehydration and other symptoms not related to kidney. No referral to urologist, no diagnosis of kidney disease, no treatment offered for symptoms. Any recommendations to treat symptoms — now can’t work/function. Thanks. (p.s. I know need to push for more tests).

I am unable to make a specific diagnosis based on the information that you present.  I agree that you need further testing.  I suggest that you consult with your primary care physician for further testing or referral.  An ultrasound examination … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis

I have type 2 diabetes. My last blood test shows my GFR is 41. My Doctor recommended that I drink 64 ozs of water daily but I see on different kidney websites that liquids should be limited. Should I follow her advice. She is a general practitioner and not a kidney or endocrine specialist.

I would recommend that you continue to drink water and avoid dehydration.  Water should only be limited if you are on dialysis or have significant problems with heart failure.  I do not recommend limiting your water intake with Stage 3 … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments

Can someone who has had hepatits B and diabetes be a kidney donor?

Each transplant center has the capacity to decide who will and will not be allowed to be a kidney donor.  The diabetes that you mention would likely be denied by most transplant programs.  Hepatitis B might not be an exclusion … Continue reading

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Living Donation, Nephrologist

Hello! I am a 34 year old female. At my last physical my doctor informed me she wants to monitor my kidney functions more & wants me on a diet because my GFR labs were in 2015 or 14 (can’t remember which year she stated) were at 110. My next 6 month checkup my GFR was in the 80’s, my next 6 month checkup the 70’s and now my check up on 3/31/17 my GFR was 63. I do not have high blood pressure but at 5’2″ & 175 lbs I am overweight. I don’t have diabetes although it is in my family history. She plans on seeing me in 6 months as usual and I am dieting & exercising in the meantime, but should my doctor and/or myself be way more concerned with this & see someone about it? My ankles are swollen with pitting edema from the calf down year round without let up. This edema has been since I was 20 and only 124lbs. Any insight you can give me would be greatly appreciated! It seems that my kidneys are functioning at the rate of an elderly person & I am a single,divorced mother of my 3 beautiful children so I really want to stay on top of this.

You physician is doing the proper monitoring.  I would also suggest that you have urine testing for blood, protein and blood.  This should be part of your monitoring in addition to measurement of your estimated glomerular filtration rate (eGFR).  You … Continue reading

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

My father had a kidney transplant 2 years ago. He is suffering from urine infection and BKV virus from long time. Yesterday creatinine report was 3.5 and hemoglobin was 6.5. He is also a path of diabetes and BP. Please help what to do? Why creatinine is increasing ?

Patients who suffer from BK virus infection in the urine often develop chronic transplant glomerulopathy and this can lead to transplant failure.  Treating chronic BK virus infection is very difficult. I can only recommend that your father continue to follow … Continue reading

Posted in Ask the Doctor, BK virus, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diabetes, Kidney Failure, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Risk factors, Symptoms and Side Effects, Transplantation, Treatments