Category Archives: Dialysis

I have acute kidney injury and I am on dialysis. What blood test can show my kidneys can work without dialysis?

The nephrologist who is prescribing your dialysis should be monitoring your serum creatinine, hemoglobin, potassium, bicarbonate level and your daily urine output. Decisions about stopping dialysis often involve reviewing all of this information and sometimes performing a 24 hour urine … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Diet/Nutrition, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

Are there proven medical studies that benefit patients taking high doses, 80mg 2x day, of furosemide, while on dialysis, if they are not having issues with retaining fluids, or high levels of potassium?

Lasix (Furosemide) has been used in dialysis patients to increase urine output. By increasing urine output, this results in fluid losses that do not have to be removed during dialysis sessions. As long as you have urine output on dialysis, … Continue reading

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

My guy is on dialysis. His spKt/V is .9. I just want to know how low can this number get before he needs to be admitted to the hospital? URR 56, eKt/V .80, stdKt/V 1.71, BFR 422. Rx Duration 3 hours 45 minutes. Please, do not say talk to his DCI clinic. I truly believe he is a test subject to them and his care is not the best. A lot of blood loss from vials and miscalculating the needs so blood leakage there. Been two months of hearing oh they took another vial or oh my needles were leaking etc. Also receiving three MIRCERA in a month 50 mcg. So please give me an answer, when should we get emergency help?

The desirable single pool dialysis clearance (spKt/V) per dialysis session is 1.2 or greater. Hence, his dialysis clearance is inadequate and he either needs more time on dialysis or needs to have his dialysis prescription adjusted. I suggest that you … Continue reading

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

Hi, Dr. I am a CKD IV patient and I am Asian. My daily maintenance meds are for diabetes, high cholesterol, hypertension, Kionex to lower potassium. This year my GFR ranges between 16-19. Blood pressure average 135/70, glucose around 70-100. My creatinine hit the highest last July 4.24 and my GFR at 13. My A1c went down to 5.8%. When I repeat my labs this August, the GFR went back to 16% and my Nephro suddenly recommended me to have the dialysis access installed soon for peritoneal. I have swellings in my ankle that I noticed in 2 weeks now. Can I consult your opinion on this matter? Should I ask a second opinion to review my results? Should I have my nephro review my meds? Is there a medication to release excess fluid (to help me urinate) aside from dialysis? Thank you.

The decision to start dialysis has to be common decision between you and your nephrologist. This is commonly made on the basis of your progression, your symptoms and other medical conditions you may have. The placement of a peritoneal dialysis … Continue reading

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

My uncle diagnosed of acute CKD. He’s a known diabetic and hypertensive with background RVD. 3 months ago his creatinine was 3.8 mg/dl and urea was 114 mg/dl, PCV 28% and he rejected dialysis, so I started him on Lasix IV 80mg, normal saline 1 litre, iron sucrose 100mg and epo 4000 IU twice weekly for 3 months, and the urea and creatinine dropping with the treatment on weekly basis and PCV also increasing weekly till urea and creatinine became 45mg /dl and 1.6 mg/dl, respectively, and PCV 38% and I stopped the treatment for two weeks and creatinine shot up to 2mg/dl with urea 55mg/dl and PCV 35%. Please, what do we have to do?

I am not able to recommend medical treatment without performing a complete history and physical examination. Your uncle should be seen by a nephrologist. It is first necessary to determine if his kidney disease is related to his diabetes and … Continue reading

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

Hello Doctor. Due to chemo from childhood that affected his kidneys, my 27 year old stepson has recently started dialysis and is doing it at home. Lately he started vomiting at night (which is when he does his dialysis) and is losing weight. He has been very careful with his diet and taking precautions. He does not know why he’s vomiting and is feeling very discouraged (we all are). Would appreciate any enlightenment on why this is happening and how to stop it. This is all new to us and I just want to help him with this difficult time. Thanks.

Vomiting and nausea are frequent symptoms of kidney failure, however, these symptoms should get better with appropriate dialysis. I would check with the nephrologist caring for your step son and see if the dialysis that is prescribed is adequate for … Continue reading

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

My creatinine is 274, up from 176. eGFR from 38 to 23 in the past 6 months. I saw an Internal Medicine specialist 6 months ago but may not be able to see them for another month or two. Should I be pushing for an appointment faster? My GP seems unconcerned but I remember the specialist telling me its not so much the number but any change in the numbers that may be of concern. To me I see that as an alarming rate and that I will be in kidney failure in a few months or less. Thanks.

I typically recommend seeing a nephrologist when your estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared, which is also consistent with Stage 4 chronic kidney disease (CKD). At that point, planning for … Continue reading

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

Hi Dr. Spry, My GFR has been fluctuating between 14 and 9 kidney disease due to med. The only symptom that I have right now with GFR 9 is fatigue; still walking 1/4 of mile 4 times a day. I know I am near dialysis anytime now but blood pressure is 120 over 60 with no med; glucose 110, potassium 3.7, sodium 142, eating well. I am maintaining weight of 173, not taking any medicine to control these numbers, but I am on a very strict diet. Dr’s can’t believe that I still do not have the symptoms of kidneys that only work 9%. I do not want to start dialysis till I am no longer able to maintain normal life. My question is for you, Dr. Spry, should I start dialysis now so I do not have any complication in the future with dialysis or does it matter when I start? I need your advise on this matter. Thank you.

The decision to start dialysis must be a joint decision between you and your nephrologist. If you are not having many symptoms and do not mind the strict diet, then there is likely not much benefit to you for starting … Continue reading

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

I have stage 3 kidney disease. Is there a time frame as to when I will get to stage 5? I will not get dialysis. How long can I live when I get to stage 5 and will it be painful?

Unfortunately, there is no time frame or prognosis that can be used to estimate time to progression of chronic kidney disease (CKD). Each person is unique and each person has progression depending on the type of kidney disease, age, other … Continue reading

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

Hello, My mom is suffering from CKD stage 4 and we are looking for treatment. We found out about Renadyl probiotics as a way for enteric dialysis and ProRenal vitamins for managing kidney and body healing. We were wondering if these are safe for CKD patients? We have only read about online reviews from other patients who have benefited from using Renadyl, but would like to see recommendations from Nephrologists as well. Any guidance and other treatment options would be highly appreciated. Thank you !

I have no experience with “Renadyl”. This is not a supplement or herbal that I am familiar with. Enteric dialysis is not a medical term. Enteric dialysis is a marketing term. I am generally familiar with ProRenal D and believe … Continue reading

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