Category Archives: Dialysis

Suffering from ckd 5. Is there any chance to cure the disease without transplant or dialysis?

Chronic kidney disease (CKD) Stage 5 means that there has been a permanent loss of over 85% of kidney filtering capacity. This cannot be replaced or recovered. Hence, for CKD Stage 5 the only ways to manage are dialysis, transplantation … Continue reading

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

My mother is in stage 4 kidney failure and is in fluid overload. Her nephrologist just upped her Lasix to 320mg per day. She has had fluid on her for 6 weeks now and was in the hospital for 1 week. She has been at the local nursing facility for 4 weeks now and the fluid is not going down. Tomorrow will be 72 hours since doctor raised her Lasix dosage yet she seems to not be able to urinate frequently enough to get fluid off of her arms, hands, feet, and legs. Is there any way to help get fluid off of her? Her gfr is 19 to 20. Any suggestions would be greatly appreciated.

Resistance to the effects of diuretics is a common feature of advanced chronic kidney disease (CKD). In some cases, dialysis is the only alternative. In some cases, the diuretics can be delivered directly into the vein so as to increase … Continue reading

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

I am having a colonoscopy and on peritoneal dialysis with night cycler. I took the prep. Should I do a full exchange?

I am not able to give medical advice without performing a complete history and physical examination. It will be important to call your nurse at the dialysis unit to clarify this issue. In some cases, you might be able to … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney-Related Health Questions

I had a kidney transplant in 1994 and it worked great for almost 20 years. I had to start dialysis again, and yet I still had the transplanted kidney. I was still taking my anti-rejection medication and I never had any issues with infection or rejection. I was incarcerated in 2014 and spent over a year in prison, I was still on dialysis at the time. At the end of 2015 a nephrologist working at the prison took me off of my immunosuppressant medicine; stating that since the transplanted kidney was not working any more there was no need to take the medicine anymore. I eventually rejected the kidney and had to have a nephrectomy. My only question, is this a common thing to be done with these circumstances I have mentioned?

There is no universally accepted treatment guidance in this regard. Whether to continue immunosuppression after a return to dialysis is handled differently from location to location. In most cases, the immunosuppression is tapered off one drug at a time in … Continue reading

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

My father is 78 yrs old and has been on dialysis for 8 yrs. He does hemodialysis at home 5 days a week with NxStage Home Hemodialysis machine; his treatments are overseen by a RN. If his BP SYSTOLIC number drops in the 90’s the protocol is stop pulling fluid; filter only if drops in the 80’s then all treatment is stopped. He normally runs lower BP’s and is on Midodrine (3x daily). I was able to take him on a trip and scheduled treatments in center on a regular dialysis K-machine. He maintained excellent BP’s for most of time but did drop in the 70’s but treatment was not discontinued. He also had a recent hospital stay in which over 6.5k were pulled off over 3 treatments in consecutive days and maintained excellent BP’s. The questions I have are: 1) Is the NxStage machine the right machine for him? 2) Is the staff being over cautious with the BP’s? 3) Is it just that he is coming to the end? I know there are so many other factors to consider but I just am struggling if I am getting him the best care possible. Thank you

I am unable to offer a medical opinion without performing a complete history and physical examination on your father. More frequent, home hemodialysis is a much more gentle form of dialysis than is conventional in-center dialysis. More frequent home hemodialysis, … Continue reading

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

I’m doing home Hemodialysis I’m taking Aranesp injections 40 mcg. I have had 8 doses of iron while on dialysis. I feel very tired all I want to do is lay down or sit. It is hard to wake up. I feel like sleeping all the time. I also feel like I’m thinking very slow and not understanding simple things. Is this normal? How long until this will get better? I feel like doing everyday things?

I am not able to provide a specific diagnosis based on the information that you present. There can be many causes of fatigue and tiredness in a dialysis patient, including heart disease, depression and other considerations. I suggest you review … Continue reading

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

2 years ago, my partner was diagnosed with Membranous Nephropathy – and we recently discovered he has heart disease (a stent was placed to open up a 95% blockage to one of the main arteries in the heart). While the catheterization was being done, they discovered 5 other less serious blockages – but have said that bypass surgery is required. The other blockages are not “stentable” – and given his impaired kidney functioning, we should prepare for a life of dialysis going forward after the surgery because the likelihood that he will have renal failure is high. We are seeking another opinion – but believe the recommendation will be the same. Any thoughts on how we might prevent renal failure in this situation – or is it truly something we need to mentally get ready to integrate into our life going forward? He is a non-smoker, 5’8″ and 140 lbs, not a diabetic and not a drinker – so we’re hopeful that at 48 he is still strong enough to navigate these challenges and live on. One onther question – if we were to consider a kidney transplant post bypass surgery – how long should we wait (with the assumption that he will have the standard recovery from heart surgery) We have large families and there’s many people offering up a kidney for him if that is the longer term outcomes. Thanks – appreciate your insight.

There is an increased risk of kidney failure from acute kidney injury after coronary bypass surgery. It is not a 100% absolute risk but the risk is relatively high. I am not able to give a medical opinion without performing … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, organ donation, Transplantation

Hi Dr. Spry. I just want to know if a patient can be diagnosed with stage 5 kidney disease with creatinine fluctuating 4.5 – 5.6 for the past year with NO symptoms? Once he started to feel weak and fatigued; slept a lot, felt like that every day and gradually felt worse and worse showing more symptoms of CKD that lead to dialysis or can those symptoms fluctuate; a few days slept a lot, no energy; but still ate well and the next days felt well and able to walk 1/4 of a mile? I guess my question is once you are going down with CKD symptoms, can you go down gradually but not fluctuating with the symptoms? Thank you Dr. Spry for listening.

Each patient is very different. In many cases, patients have some good days and some bad days. There is not a sudden change with progressive chronic kidney disease (CKD). Dialysis is commonly offered when there is more bad days than … Continue reading

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

If an older patient around 75 years old is on dialysis which just started, is it for the rest of their life? What if the patient can’t bear; can they stop it? Every time a technician has a hard time finding the vein and has to poke 2-3 times to get it started. They say the veins are small and hard to find. The patient also has shingles and has severe pain for shingles and no medicine is helping her.

Dialysis is an option for treatment that you must agree to. If the dialysis is of no benefit to a patient, then the patient can refuse further dialysis and withdraw consent for dialysis. In the case of this individual, consultation … Continue reading

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

Hi Dr.Spy, I have been on stage 5 for the past 2 years. I did the AV Fistula 3 Months ago. Creatinine was 4.6 – 5.4 for a year. Other blood and Urine is stable especially sodium, potassium, glucose and phosphorus. Making urine as usual; no changes. I eat well; no lousy taste. Doctors believe my kidneys are only working between 11-14 %. I will be needing dialysis soon, but nothing scheduled yet. Little activities; walking 1/4 of a mile 2-3 times a week. In the last 2 months I had a UTI E Coli twice and followed with lower lobe right lung pneumonia, which I recovered nicely. For that, I quit smoking. It has been 8 weeks. If I am home, I feel fatigue and tired and I will sleep for a long time. If I am out, I can stay up for a long time. I have been using nicotine patches and lozenges. I blame the fatigue on quitting smoking; sleeping feels good. Doctors think it’s the kidney disease. Dr. Spry, what do you think about my symptoms? Do you think, in your profession, that I can last another year with no dialysis, with no smoking (after 52 years of smoking ) and a very strict diet? Thank you for listening.

The decision to start dialysis should be based on what symptoms you are having and a discussion between you and your nephrologist. There is no set time that requires you to start dialysis therapy. You and your nephrologist should discuss … Continue reading

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