Category Archives: Diabetes

I am 62 year old Type 1 diabetic with Stage 4 CKD. My eGFR is currently 23. I am an amputee and have a hex of CHF, sepsis, ARDS, acute renal injury x’s 3. I was on an ACE inhibitor but was taken off of it by my new nephrologist. From what I have read, an ACEi is standard treatment. Your thoughts?

Drugs such as Angiotensin Converting Enzyme Inhibitors (ACE-I) and Angiotensin Receptor Blockers (ARB) agents are used to try and preserve kidney function in diabetics with protein in the urine. In your case, your nephrologist may have evaluated the risks or … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, Kidney-Related Health Questions, Nephrologist, Treatments

Hi Doctor. I am a 56 year old male who works out with weights 3-4 days a week and do not smoke or drink. I have been on a high protein, low carb diet for years. I also took Sudafed for headaches and sinus pressure almost daily for many months which probably did not help my blood pressure. I was recently diagnosed with high blood pressure and CKD. My last labs in June 2017 showed a 60 GFR. This past December 2018 it was 45. I immediately modified my high protein diet and began taking blood pressure medication as prescribed. (Losartan 25Mg) A week later my blood pressure was normal and GFR increased a point to 46. I am trying to get in to see a nephrologist but he is booked up for a couple weeks. Is it possible through diet and blood pressure control to raise GFR to get me up into a stage 2 or better yet a stage 1 condition? Please let me know? Also is taking the supplement creatinine harmful to kidneys? I had been taking it to build muscle mass but discontinued immediately upon my diagnosis. I still have to take the 24 hour urine test and also to schedule a kidney ultrasound as recommended by my GP. This is scary stuff! I appreciate you answering my questions and hope this diagnosis can be reversed! Thank You! Sincerely.

High blood pressure is the most common cause of kidney disease in the world today, followed by diabetes. Untreated high blood pressure results in damage to the kidney that usually cannot be reversed. Hence, the goal is to avoid further … Continue reading

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

My dad was diagnosed with diabetic kidney disease 8 years ago with creatinine of 1.6 something and it has been increasing since then (it remained less than 4). Since last 2 weeks, it increased from 4.3 to 4.5 then 5.5 then 6.5 and now 8.3 along with increased blood pressure going as high as 180/90 or 180/110. His blood sugar was increased too but it remained around 210-220. My father is reluctant to go for dialysis, so his doctor advised him to get AV Fistula surgery done in case the emergency arise. Now my question is, is it necessary to get it done? Is this the last resort?

I am unable to make a specific diagnosis and treatment plan without performing a complete history and physical examination. Your father appears to have a more rapid progression of his diabetic kidney disease than is commonly seen. I suggest that … Continue reading

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

I’m 67 yrs old and have type 2 diabetes. My general practitioner did a test to check my kidneys then sent me to a kidney specialist. My kidney function is at 40%. Can you tell me what this means? I’m scheduled for some test after Christmas, so my Dr. only knows the function percent; I don’t know that either. Any answers from you explaining what this means will help me so much! Thank you.

Diabetes and high blood pressure are the two most common causes of kidney disease in the United States. Your physician is concerned about your kidney function. It is not clear from the information that you provide as to whether this … Continue reading

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

I have had high creatine levels for three months and low GFR levels between 41 and 51 for 3 months in a row. Also have had urine testing which is negative. I do not have an appointment with my PCP until January at which time he will explain what to do next. I feel that he’s very unconcerned about these numbers. I am 68, have diabetes, lung disease and an immune deficiency which I do 3 IGg infusions a week. I am quite concerned. Should I be?

You may have early Stage 3 chronic kidney disease (CKD) based on the level of you estimated glomerular filtration rate (eGFR). Diabetes is a very common cause of CKD. I suggest that you wait and consult with your primary care … Continue reading

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

Lab results are: MicAlb 7.8. alb/cr 121.0, urcreat 64.4. I am Type two diabetic and have high blood pressure. Should I be concerned with these values? Thank you.

The normal for a urine microalbumin to creatinine ratio (alb/cr) is less than 30 milligrams per gram of serum creatinine. The value you report may be elevated but you do not mention the units. I suggest that you review this … Continue reading

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

My GFR has dropped from 28 to 17 in a matter of 6 months but my diet has changed for the better, potassium went from 6.1 to 5.1 using Veltassa, staying well hydrated but nobody can explain the quick drop in GFR. My question is my primary care doctor has me on Actos and Glyburide for Type 2 diabetes and my last A1C was 6.8%. I am hearing and reading that I should not be taking Actos but my primary care doctor and 3 different nephrologists say its OK. Please help.

Actos (pioglitazone) in a diabetic drug that can cause fluid retention in patients with chronic kidney disease (CKD), but if you are tolerating the medication well and your diabetes is well controlled based on your HgbA1c, I don’t see a … Continue reading

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

What is the advice for one healthy kidney patient? In the case of one right side kidney being absent?

Many people lead a normal life with only a single kidney. It is important to protect your single kidney and not inure your only kidney. You should not smoke. You should avoid non-steroidal anti-inflammatory drugs (NSAID’s) such as Motrin, Ibuprofen, … Continue reading

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

I’m CKD stage 2. DTPA renogram done shows adequate function with GFR 78. My question is that how can I arrest ckd for further progression. What medicine should be taken to improve kidney function?

There are no medications that specifically increase kidney function. Instead, the treatment of kidney disease is to avoid those things that make kidney function worse or potentially injure the kidneys. You should not smoke. You should avoid non-steroidal anti-inflammatory drugs … Continue reading

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

Hello Dr. I have a question regarding erectile dysfunction. I’m asking for a friend, who is diabetic, and is currently on dialysis. He is unable to become erect. Is it safe to take any form of viagra?

Viagra (sildenafil) is a medication that is used to treat erectile dysfunction but there are a number of medications and contraindications that must be considered before prescribing Viagra. In patients who have diabetes and are on dialysis, there are a … Continue reading

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