Category Archives: Dialysis

What is the baseline GFR to start dialysis? When other renal panel results are close to or normal with the exception of BUN 66ml/dl; Creatine 4.44mg/dl and co2 @21 mmol/L, last GFR was 12ml/min/1.73m2.

Dialysis is not started on the basis of the glomerular filtration rate (eGFR) test. This test tells us that you have low kidney function, but the decision to start dialysis is made between you and your nephrologist. You and your … Continue reading

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

I’ve been on dialysis 6 years now and diahrrea has always been a problem from the beginning. I do not have a gallbladder. Ocassionally, I have normal bowel movements. I went to taking a probiotics and an immodium daily and this really helped for several years but now I’m back to battling this problem again taking as many as 2 immodium daily to get it to stop. I see a gasteroentrologist but nothing from her! My blood levels are all normal ranges. Any help? Or suggestions?

I am not able to make any specific diagnosis based on the information that you present. Diarrhea can be a major complicating problem for patients on dialysis. It can interrupt the treatment and can also result in embarrassment for patient … Continue reading

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

How is the frequency of hemodialysis treatments determined? How is the length of these treatment determined?

There are a number of factors that are considered when prescribing dialysis treatments. Early in the story of dialysis it was noted that patients dialyzed once per week and twice per week did not do well. It was not until … Continue reading

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

My husband was diagnosed with kidney disease years ago and has had regular blood tests and Dr visits. Last week his lab work came back with a GFR of 18 (his previous GFR was 23) and he feels sick and weak and his eyes have yellow spots. We called his nephrologist and he is out of the office the next 2 weeks without another Dr covering his patients. Will he make it two weeks without starting dialysis?

I am unable to make a specific diagnosis based on the information that you present. It is difficult to make the decision about dialysis and it should not be based on the estimated glomerular filtration rate (eGFR). An eGFR of … Continue reading

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

My Dad is 74. He is a type 1 diabetic and has COPD, CHF and is in Stage 4 kidney failure. His BUN is 43 and creatinine is 3.2. So far troponin has been negative. He has SOB, swelling and very weak. B/P has been pretty normal for him at 158/69 and sugar was 168. He was in ICU 2 weeks ago with sugar over 700 and B/P 190/89. At what point will they say dialysis? Could or would he even be considered for kidney transplant? His heart is only working at 25-30%. Thank You.

It is difficult to offer medical treatment advice or offer a prognosis, but based on the information that you present, it is unlikely that your father would be accepted as a kidney transplant recipient given his complex medical problems at … Continue reading

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

Hello, I’m a Software Engineering undergrad. For my final year, I’m interested in building an application to predict kidney disease through data mining. Please help me out with sharing relevant sources dataset in the recent years of patients who had CKD (Chronic kidney disease). Thank you. Regards.

The information that you request can be found in the United States Renal Data System (USRDS) which can be found at:  https://www.usrds.org/adr.aspx This web site includes data up through 2017 and data about causes of chronic kidney disease (CKD) as … Continue reading

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

My uncle is a 73-year old man with multiple myeloma and, as a result, opioid-induced bowel dysfunction. He had surgery recent (resectioning of small intestine). Along w/being on a ventilator, he’s now in renal failure. Actually, his kidneys were probably already failing before surgery. Zero kidney function. Doing dialysis daily. Our concern is that he is SEVERELY swollen. Hands, feet, arms, knees. He looks like he’s going to pop! Several liters of fluid are being removed from his system daily, but it doesn’t seem to be helping. Questions: How much swelling can one body take? And are there additional ways of removing fluid more effectively? The rural hospital he is in does not offer CRRT and we don’t even know if such would make that much of a difference and until now, he was too critical to be a candidate for transfer. His nephrologist and cardiologist don’t seem to exactly agree on the best approach. We are at a loss about all this and wondering whether he’s getting the most thorough care that he should be. Please help!

I am not sure how I would help. In cases of acute kidney injury, dialysis is commonly done daily for fluid removal and removal of toxic products. For patients in the intensive care unit (ICU), continuous renal replacement therapy (CRRT) … Continue reading

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

Dear Dr. Spry, My cousin brother has been diagnosed with MSK in China. After the doctor did surgery of kidney stone removal, they said his kidney is not able to work again. His creatinine has risen up to 2000+, and now he is under Hemodialysis treatment. I want to know if there is any advance treatment can help this situation. The kidney failure started last week. In China, the doctor says the process is irreversible and he has to live his life with Hemodialysis or perform kidney transplant. It is so sad and my cousin brother is only 29 years old. Thank you for all your help.

Medullary Sponge Kidney (MSK) can cause kidney failure but it is unusual. I am not able to make a specific diagnosis with the information that you provide. I am unsure if this is permanent kidney failure or acute kidney injury. … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Medullary Sponge Kidney, Transplantation

How can phosphorus be controlled when on dialysis and should one stop eating any food containing phosphorus?

This should be discussed with the dietitian assigned to you on dialysis. The dietitian is best able to review your current diet and suggest changes that will result in a more normal blood phosphate level in a dialysis patient. The … Continue reading

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

My husband has only one kidney, working at 20%. To avoid dialysis, I work to keep all food low sodium and low potassium. The sodium is easy; I changed to Central Asian Cumin, Coriander, Cardamom, etc. Potassium is more difficult but there are about six vegetables and I work mainly with those. That’s the background. Here is the question. The two lowest potassium veggies are summer squash, green and yellow. BUT also on the “avoid” list are nuts and seeds. Think SEEDS. Both those squashes are about 50% seeds down their centers. Small seeds, soft seeds, but seeds none the less. So I quickly scoop out the seeds and discard them. What do you think? The disabled kidney cannot handle seeds. I want above all to save the kidney. Am I doing the right thing, or working too hard at it? Your comment, please. Thanks.

I do not have enough specific knowledge about the various foods that you describe. I suggest that you consult with a dietitian. A dietitian, who is familiar with chronic kidney disease (CKD), should be able to guide you in your … Continue reading

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