Category Archives: Diabetes

I am a diabetic, since 2000, and I have problems sleeping at night. I also urinate 3-5 times at night. I take Metformin/Glibencamide 3x daily, as prescribed by my doctor. Grateful for your response at your convenience. Regards.

Passing urine during the night can be a sign of kidney disease or your diabetes not being well controlled. I suggest that you discuss your concerns with your primary care physician (PCP) and ask for further testing. This is a … Continue reading

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

Dr. Spry, My father suffered a kidney failure, apparently resulting from a UTI this past March. Though he is a long-term diabetic (over 27 years), his medical records state his condition as AKI rather than CKD. He is now dialysis-dependent, but his doctor seems to believe his kidneys could recover sufficient functionality for him to go off dialysis, though it’s been nearly 8 months since the diagnosis. What indicators would a doctor use to identify AKI vs CKD in a less obvious scenario where the UTI or the Diabetes could be the root cause, unlike an actual physical injury or nephropathy in the absence of a pathogen beyond diabetes, where I presume it would be easier to classify as AKI or CKD, respectively. How would the doctor determine if there is a possibility for some kidney function to return? From what I can tell of his creatinine, potassium, urea, albumin levels, there doesn’t appear to be a consistent improvement in any metric that would allow a quantitative assessment of kidney recovery. Is there a qualitative method to assess the viability of a kidney? Short of a biopsy is there another quantitative method outside the typical blood work to judge how much kidney function is just dormant vs. how much has been lost permanently? Apologies for the multiple questions! My father is being treated at the top hospital in his city, one well-known for international medical tourism (though he’s a local). His doctor appears to be a very competent and straightforward professional. Unfortunately, doctors in India are extremely reluctant to share technical patient information and I’m relegated to scouring the internet to help my dad navigate his condition. Thank you for any information you can share on the subject!

Acute kidney injury (AKI) means that the tubules of the kidney have been injured but the filters of the kidney (glomeruli) remain intact. If there is tubular injury, then the kidney is capable of repairing this injury and then the … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis

I have been a type 1 diabetic for 37 yrs. My eGDR has been decreasing over the years. My new endocrinologist told me that since I have no history of spilling protein, the lowered kidney function is not diabetes related. Is that correct?

In general, diabetic kidney disease is most commonly associated with albumin or protein in the urine. If you are a diabetic and have no protein in the urine, then diabetic kidney disease is less likely. It is still possible to … Continue reading

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

I am 44 yrs. 3+ yrs diabetic HGBA1C 5-5.8 over years. BP varies from 135-150/80-100 taking medicine. Cholestrol/trigliceride a bit borderline high. Recently I got Protein 1+ and ACR showed three reading over 4 days one in normal range, 2 in mid range (Arithmetical mean Urine creatinine 50 mg/dl Mic Alb 40 mg/l). No swelling feet, Creat 1.23, BUN, Haemoglobin OK, Uric acid 9.2 and 7 days later 6.5. USG fatty liver II, Cystitis, Kidney normal. Egfr (equation used not known) 64. Please advise on risk and next step forward?

I recommend that you consult with your primary care physician (PCP). You have diabetes, high blood pressure and excess albumin in the urine. In most cases, I believe you should be treated with an ACE-inhibitor or an ARB agent for … Continue reading

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

What are the first symptoms that can be observed in a person with chronic renal failure?

Most people have no symptoms when they have chronic kidney disease (CKD). The only way you know if you have CKD is to be tested. If you have a family history of CKD, if you have heart disease, diabetes or … 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

I am 70 and have diabetes and kidney disease. I go to VA in Chaleston SC (Wonderful Caring facility). The disease is the result as exposure to agent orange in Vietnam. I am 74 inches tall & 250 lbs. My kidney function is at 21% (has been going down for 6 years) In preparation for a transplant, cardiology found two blockages in my heart that require stents. Problem is that the dye used in heart stents will probably kill my kidneys. I understand that the iodine in the contrast may kill my kidneys. What is the name of the non iodine contrast that maybe less destructive to my kidneys? Any other suggestions you have would be welcome. I am not on dialysis yet. With a three year wait for a transplant killing my kidneys to fix my heart is a tough decision. Thank you.

There are no safe contrast agents that can be used for delivering a heart stent to a coronary artery. The problem that you describe is commonly encountered by patients with advanced chronic kidney disease (CKD).  It is a risk that … Continue reading

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

My question is regarding my boyfriend, who is a type 1 diabetic and has kidney disease. In May of this year, his GFR was 80 and now today his GFR is at 18. His kidney doctor is speaking of dialysis and saying he needs to find a treatment center before his appointment in a month. He is supposed to limit potassium and phosphorus in his diet, and drink a quart and a half of fluid per day. My question is, he seems to be doing worse everyday and his face is a little swollen more and more each day. Are there any remedies that can help his kidneys function a little better such as natural remedies that he may take or drink? What do I do to help him make it until next month?

If dialysis is indicated, there are no herbal or dietary supplements that will help someone with advanced kidney disease. If he is having increasing symptoms, I suggest that your boyfriend contact his nephrologist for advice.

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, GFR, Herbal Supplements in Kidney Disease/Failure, Kidney Failure, Kidney-Related Health Questions, Nephrologist

My mom, who is 52 year old and diabetic also has creatinine serum is .93 mg/dl but should be in the range of .5-.8 mg/dl. Is this the symptoms of any kidney disease?

I am unable to make a specific diagnosis based on the information that you present.  I suggest that your mother have urine testing for blood, protein and infection.  I also suggest that your mother discuss the creatinine result with her … Continue reading

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

Hi doctor, My dad had a CABG 10 days ago, and since that time he is in the ICU suffering from polyuria. His daily output about 17 liters, creatinine 1.1, blood urea 16, osmolality in urine 24 hrs is 280, serum sodium 134, specific gravity 1010. The doctors are really confused, is this diabetes insipidus or AKI? What’s the suitable treatment? I should tell that my dad had taken Desmopressin for 2 days, the urinary output decreased to 14 liters only. Thanks in advance.

I am unable to make a specific diagnosis based on the information that you present. The urine osmolality does not suggest diabetes insipidus. The urine specific gravity also does not suggest diabetes insipidus. The serum sodium is low and diabetes … Continue reading

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

I am Level 5 CKD/ESRD, trying to eat correctly. Is honey okay to use? I have purchased Renal Cookbooks and also buying a crock pot and blender to use with books.

Honey is safe for patients with chronic kidney disease (CKD) and should not pose a risk for kidneys.  If you have diabetes, honey is a very concentrated form of sugar and may pose a problem for your diabetes.  If you … Continue reading

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