Category Archives: Diabetes

I from Nigeria. My father is sick. According to the doctor, he was diagnosed with diabetes but according to what I read from your article I thought it may be more than that because his feet and stomach swell up and his body is getting smaller. So I want know if this is a case of diabetes or kidney problem?

I am unable to make a specific diagnosis based on the information that you present.  Your father should be seen by a physician for a specific diagnosis.  Diabetes and kidney disease can both occur in the same person. For more … Continue reading

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

How do you treat CKD patients with atherosclerotic disease of the left common carotid artery? What medications do you give to treat the atherosclerotic disease?

Hardening of the arteries (atherosclerosis) is a disease of blood vessels associated with high blood pressure and elevated blood cholesterol levels.  It is also passed down in families and is thought to be related to genetics.  The treatment in patients … Continue reading

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

I am a 74 year old female and have hypertension and borderline diabetes. My A1C was 6.0 in Nov. 2016. I had a kidney stone and treated with Lithotripsy in May 2016. I made a return visit to my urologist last week with L. flank pain and had a CT Scan done. While the scan did not show a stone on the left side, it did reveal swelling in the tube below my right kidney. My urologist said I should have a procedure done with contrast so he can determine the cause of the swelling. My concern are the risks involved and if its a necessity to have this procedure done? Any idea as to what causes swelling in the tubes? Thank you in advance for your input.

I am unable to make a specific diagnosis based on the information that you present.  If your kidney function is otherwise normal, the risk of contrast is very low.  I suggest that you follow the advice of your urologist. For … Continue reading

Posted in Ask the Doctor, Diabetes, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease

Hi, I was diagnosed with chronic kidney disease in July. My gfr was 57. I’ve had diabetes for years and keep it under control. The doctor said the diabetes caused the kidney disease. In October, the gfr was still 57. I went to a dietitian and changed my eating habits & I’m exercising. I’ve went from 178 to 155. My cholesterol glucose, & a1c have all dropped. This time when I went my gfr was 51 but all my other numbers went down again. The doctor wasn’t concerned and said he’d watch it. He said drink lots of water before my lab work but I did this time because they have trouble finding my veins. I know the gfr can go up and down but is this much normal (from 57 to 51 in 3 months)? I’m concerned because all my other numbers went down. My doctor has done no other tests he is just assuming the diabetes caused this. Should I get a 2nd opinion? Also should I be seeing a kidney specialist at this stage? My doctor says no he’ll just tell me to do what I’m doing. Thanks for your time.

There is always some laboratory variability to any blood test and the estimated glomerular filtration rate (eGFR) may vary from time to time.  The variance that you see is not unusual.  You should also have urine testing for protein in … Continue reading

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

My father is a new dialysis patient – only 1 month in. He is 77, diabetic, suffers from peaks of high blood pressure and is now on dialysis. It has been a very hard transition for him to make. His fistula failed so an emergency port was placed in his chest. He has had surgery just this week to implant a fistula graft in his arm. He is currently residing in a rehab facility in a nursing home. I’m sending this because I feel like I cannot get answers from local doctors and treatment facility. This last Monday was the first time his dialysis team was able to get his dialysis up to 400 (Fresenius facility). On Tuesday morning he called me at 6:00am in a panic. He felt like he was having a low blood sugar with sweating and confusion. He was seeing things that weren’t there. His BG was 245 which isn’t that odd for him, so that was ruled out. The nursing home was sure he was going to pass out and were ready to send him to the ER. After he ate and drank something, it started to pass and by evening he was back to his normal self. He was VERY angry at the Monday treatment and so we figured it was a manifestation of his mood. My other instinct is his electrolytes were out of balance. I’ve taken care of my dad for the last four years and in the past when he would get in a similar mood, a gatorade or juice helped ease the confusion. I know gatorade is not good due to the high levels of all the things a dialysis patient shouldn’t have. But he acted like that was what he needed. It got better as the morning went, so everyone moved on. Wednesday night, dialysis again. He was in a much better emotional place than the previous treatment. However, at 4:00am the next morning, he had the same issue. Confusion, seeing things that weren’t there, worry, anxiety. He described it like a nightmare. Then after a meal and a few hours it passed. The nursing home staff have no answers except to refer him for an eval with a psych doctor. We cannot find anything online on any kidney or dialysis sites that relates to dysphoria (nurses said it was a type of dysphoria he was displaying.) The only link to what my dad is experiencing and information is related to dialysis disequilibrium syndrome and all research I’ve found says that is not a common condition anymore with modern treatments. He acts like he’s anemic and his electrolytes are out of balance. We keep getting told that blood tests are done once a month and that would be able to tell us more. The nursing home staff really aren’t doing much to find a solution. The nephrologist NP he sees is out of town till the end of next week. The staff at the dialysis center say its not related. Nothing really online. I’m scared and no one will talk to us about this problem and just want to send us off to someone else. Dialysis wasn’t even on our radar. We knew it might be something in the future but my dads kidney function has maintained for two years between 15 and 20%. No training. No counseling. Nothing. Then he goes to the hospital with what we thought was a heart attack. Very aggressive blood pressure treatment took his kidney function from 14% to 6% in three days. It wasn’t until the third day that his other blood indicators said yes, his kidneys were failing. And, he didn’t have a heart attack. The week leading up to his first treatment, he swore he would not do it no matter the end result. The next morning, he was OK with it, had the emergency port put in and had dialysis three hours later. Now, one month later we are only a little wiser about dialysis and only because we sit with him for each treatment and ask questions of the nurses. Since this dementia behavior has surfaced, we know even less. No one will give us a straight answer, check his blood, do any scans, something…anything that can give us a clear idea of what is going on. My father has a PhD in Mechanical Engineering. My mother was an RN. Four of the eight children and husbands in our family are educators. We are intelligent people seeking intelligent answers. Reaching out to you is a long shot I know, but it is all I know how to do right now. Any advice. Any thoughts. Any history. Any suggestions are greatly appreciated.

Every month, the dialysis team gets together for something called a multidisciplinary conference to discuss the patients in the dialysis unit.  I suggest that you talk with the social worker who is responsible for your father and ask to be … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Hypertension/High Blood Pressure, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments

Hi doctor My mother is 72 years old and highly diabetic. Now her creatinine is 3.Please advice for a better treatment.

Your mother should see a nephrologist and have testing of protein in the urine and testing for remaining kidney function.  The nephrologist can then recommend proper treatment for her chronic kidney disease (CKD). For more information on Diabetes click here:

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

I have Type 2 diabetes with stage three kidney disease and am scheduled for a colonoscopy. The prep includes taking Gavillyte c pre-exam one gallon total. Does this med cause further kidney problems and if so what precautions should I take? Please advise.

Gavilyte contain polyethylene glycol (PEG) with electrolytes and is safe for patients with chronic kidney disease (CKD).  It is important to drink plenty of clear liquids including water while drinking this preparation.  

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Treatments

I was informed today that the Transplant Team has denied me being able to donate a kidney to my brother. The reason they gave was that I had an elevated fasting blood sugar of 114 along with my family history of diabetes. I am the only one in my family who doesn’t have diabetes. My question is, why can’t I have the choice to donate a kidney? What happens if my brother never gets a kidney due to how long the list of recipients is? Shouldn’t it be my choice? Couldn’t stress be a big factor that causes my sugars to be elevated all of a sudden? Can I at least ask to be retested?

Each transplant center determines who will and who will not be a kidney donor. There are no nationwide accepted guidelines for transplant centers to follow.  It is generally felt that if someone has a risk of developing diabetes, there are … Continue reading

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

To whom it may concern: I am writing this letter to ask you a question about my mother who has IgA nephropathy problem which has been continued for 8 years. Although, the rate of proteinuria raised nearly 3450 mg/24hrs last year and her Dr. prescribed prednisolone 50 at first. As a result, rate of proteinuria has decreased to 194 mg/24 hrs. On order to her Doctor was able to decline prednisolone to 12.5 mg/day. Despite decreasing of protein rate in urine, the amount of proteinuria has raised again to 1710 mg/24hrs! So her Doctor raised prednisolone to 15 mg/day. In addition, she uses Calcitriol in their medication as well. I want to know that it is important to follow treatment by using of prednisolone after one year so as to use constantly? I really worry about the side effect of using this drug extra for my Mother!

The goal of treating IgA Nephropathy is to lower the protein in the urine and improve kidney function.  It sounds like your mother is being treated appropriately.  Your mother’s physician should be monitoring the side effects of prednisolone.  The side … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diabetes, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Nephrologist, Symptoms and Side Effects, Treatments

My husband is 68 and has genetic cardiomyopathy. Recently he has been diagnosed with blood sugar. Earlier he had a borderline blood glucose level but within normal range. Currently his readings are 194 fasting and 220 PP. His HBA1C level for past 3 months is 9. The doctor prescribed an ARC test and a spot urine ARC revealed Urinary Microalbumin in spot urine: 44.51 mg/dl; Urinary Creatinine in spot urine: 157.4 mg/dl; and Urinary Microalbumin: Urinary Creatinine 282.78 mcg/mg. My question is how advanced the stage is and can further deterioration of kidneys be stopped if not reversed? Also what kind of diet should he consume and how much water intake is allowed? I’m worried about his health. Please advice.

Your husband appears to have an excess of albumin in his urine and this is likely due to his diabetes.  A normal albumin to creatinine ratio is less than 30 and the number you provide is 283.  His diabetes is … Continue reading

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