Category Archives: Diabetes

I am a 79 year old white male with Type 2 diabetes. My left kidney was removed 28 years ago due to a tumor. Fasting levels are in the 96-110 range. eGFR is 49 (up from 43 two months ago.) Serum creatinine 1.53; Potassium 5.4; BUN 29. Recent 24hr UA: UA Protein (calc) 80. Total Protein is 4.3. I feel my PCP is not taking enough action or giving me enough information about my lab results. His notes indicate that everything is normal with my lab results. My BP runs 120/78. My meds include 10mg of dextrostat and Lisinopril HCTZ 20/12.5 Does the dextrostat or (the supplement L-thinine 200mg) have a negative affect on my kidney function?

Dextrostat (dextroamphetamine) is a very potent stimulant and can cause elevation in your blood pressure.  I am not aware of the drug L-thinine.  This is not a compound with which I am familiar.  Since you only have a single kidney, … Continue reading

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

For the last 7 months my GFR level has decreased from 71 to 54. I am a 55 year old white female with diabetes. Should I be concerned?

Yes.  A decline of kidney function by nearly 20 milliliters per minute per 1.73 meters squared in less that a year would be a source for concern.  I suggest that you also have urine testing for blood, protein and infection … Continue reading

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

A 82 year old frisky male has had reasonably well controlled DM and Hypertension for decades was diagnosed with CKD a year ago. He also has increasing microalbuminuria and stable retinopathy (of unknown causation). If all other possible causes of CKD can be excluded, can it be determined whether his CKD was caused by DM or hypertension?

High blood pressure (hypertension) and diabetes are the two most common causes of chronic kidney disease (CKD).  It is most likely that both hypertension and diabetes are the cause of his kidney disease.  The presence of the retinopathy and microalbuminuria … Continue reading

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

I have a good family doctor, Today I received my 3 month blood test report. My creatinine serum was 1.18. They told me it was a little elevated but nothing to be concerned about. Everything else was wonderful. I am diabetic and have taken Metformin for many years and go every three months for a blood test. Do you agree with them and that I just should watch it to see if it continues to raise.

The creatinine result that you quote is mildly elevated.  I recommend that you continue to follow your doctor’s advice.    

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

Can acute kidney failure cause thyroid problems?

There is no direct connection from kidney disease and thyroid disease.  Both can and do occur in the same patient.  Thyroid illness, diabetes and kidney disease are all commonly seen together but kidney disease does not cause diabetes or thyroid … Continue reading

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

Hello and sorry to bother you. I am a type 1 diabetic with a blood creatinine level of 3.54 and a urine creatinine level of 918. I have been an a low purine, low carb diet for the past 3 weeks or so. I have managed to keep my blood glucose generally under control for the past 3 weeks as well. But over the past 3 weeks my creatinine has gone from 3.11 to 3.54. I am scared and don’t know what to do? Or at what stage my kidneys are or if they failing me completely? My doctor has given me Adalat which I take unless my blood pressure is normal to low. Also my uric acid is at 6.6 and my urea is at 88. What am I doing wrong?

Once diabetes has injured the kidneys, the disease is irreversible and will cause continued destruction of the kidney function.  Short term control of diabetes and high blood pressure will not have much effect on the kidney function. I suggest that … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

Hello Doctor, One of my uncle is recently detected with CKD. His creatinine level is 5.19 (reduced from 5.46 a week ago) and Phosphate is 5.50. He is a diabetic since last 15 years. Doctors are advising him to get the A V Fistula surgery done as he may get dialysis done at any time. But somehow he is not willing to do so and asking if he will control his Blood Sugar, Food and BP, is it possible to stay healthy and of course with monitoring of creatinine level. When do you think? When dialysis becomes a must or at which creatinine level, he must go for dialysis? Is there any medications for reducing creatinine level in blood?

There is no specific level of serum creatinine or level of kidney function that requires one to start dialysis. Dialysis is started to relieve symptoms that start to occur as a result of kidney failure.  Hence, the decision to start … Continue reading

Posted in Ask the Doctor, AV Fistula, Diabetes, Dialysis, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects

I recently was told by my new Doctor that I needed to see a nephrologist. My last blood work indicated that my urea nitrogen was 27 mg/dL. My creatinine is 1.95 mg/dL and my eGFR is 27mL/min/1.73m2. I can not get into see the nephrologist until Sept. 21, 2017. I have been trying to set this up since the beginning of June. They said they put me on the top of the cancellation list. My question is what do I do in the meantime to help myself out?

In the meantime, you can monitor your blood pressure to make sure that your blood pressure is less than 130/80.  If you have diabetes, your diabetes should be very carefully controlled.  You should follow a low salt diet with less … Continue reading

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

Hi. So there was a 70 male patient who was having dialysis. The patient was well before dialysis with bp 120/70. After 2 hours of dialysis he went into hypoglycemia but soon glucose level stabilized with IV ddextrose. However, he went into a deep sleep with loud snores. We tried to wake him up but unsuccessful. Even the doctors did not know what to do. The patient died in his sleep latter in the evening. But why did he go into such deep sleep? Was it due to hypoglycemia? Past medical history: diabetes mellitus.

I am unable to make a specific diagnosis based on the information that you present.  I can only suggest that you discuss your concerns with the physician who has cared for this person prior to his death.  Hypoglycemia is usually … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, End of Life Issues, Kidney Failure, Kidney-Related Health Questions, Treatments

My father-in-law, white age 89, has a microalbumin/creatinine ratio of 720. He has recently been diagnosed with type 2 diabetes and it is controlled with Actose and Metformin. He also takes Amlodipine Besylate for high blood pressure. A1C is 5.7. He has been diagnosed with Chronic kidney disease, Stage 3 moderate and told to avoid Advil and Aleve. He is experiencing swelling in his ankles. He self caths and has had a severe uti. I am very concerned about his kidney function. His family doctor says there is no need for concern. Should my father-in-law see a Nephrologist for further treatment?

Most primary care physicians (PCP’s) are very well able to manage patients with Stage 3 chronic kidney disease (CKD).  I commonly recommend referral for to a nephrologist when the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per … Continue reading

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