Category Archives: Dialysis

My 27 year old son is in kidney crisis with a creatinine tonight of a 10.4 and rising. He is on a kidney diet and is still urinating. He has been otherwise healthy until last week and is currently puzzling the medical community. When would you start dialysis?

I am unable to comment on treatment without performing a complete history and physical examination. The decision to start dialysis must be made by the physicians who are evaluating your son. There are specific indications for starting dialysis but the … Continue reading

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

Hello doctor. My mother has stage 5 chronic glumerulonephritis.She was advised to have a dialysis. Due to high creatinine level , she was inserted with IJ catheter in her neck for her dialysis treatment. Her dialysis treatment was only twice a week and it started last June 2018 . But still she suffered a lot of pain in her back and stomach. She has also dry cough that unable her to sleep especially at night times. She has also difficulty in breathing and unable to urinate. During dialysis, she has high fever and even chill. After dialysis her body temperature goes back to normal. Is this normal in her case? Or is she not receiving a good care? What shall we do? Thank you doctor.

I cannot make a specific diagnosis based on the information that you present. Your mother’s response to dialysis does not seem to be going very well.  These are not the kind of responses we expect with dialysis. I suggest that … Continue reading

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

My lab results include a total stdKT/V. This includes the following components: spKdt/V, eKdt/V, Krt/V, spKt/V, stdKdT/V, stdKrT/V. Please define these components for me. Thank you.

The abbreviations that you mention are various ways of describing the efficiency of your dialysis treatments. These results describe the expected degree of clearance of urea from your body during a single dialysis session. The equations are very sophisticated math … Continue reading

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

Hi! I have ckd end stage and having hemodialysis treatment for 17 years. Have you known about the herbal juice called INTRA from Canada? Can this Intra are good to us patient with ckd and can my kidney be heal on this juice?

I am not familiar with any juice or product that will return kidney function to someone who is on dialysis. I have never heard of INTRA and would suspect that this is a scam meant to part you with your … Continue reading

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

The doctor says it’s OK to get my Hectorol Injections at the beginning of treatments. Isn’t it dialysed? Doesn’t that reduce the effectiveness?

Hectoral (Doxercalciferol) is a very large molecule and is a fat soluble molecule, hence, it is not removed to any great extent by dialysis. It is true that the dose is typically given at the end of dialysis as per … Continue reading

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

I am stage 4 CKD. I have uremia, although I have been followed since stage 2-3. My GFR is about 20, creatinine 2.5, and Bun 51. My doctor wants to start peritoneal dialysis to try and preserve what function I have left. It is progressing much faster than they expected. I am not diabetic. I have hyperaldosteronism, which they had a hard time discovering and so had malignant hypertension for about 15 years. I’ve already had a heart attack too. My question: is this really helpful for helping what is left of the function and if it is, why do they wait till they are so bad? I have never smoked, I have never been a drinker, and no caffeine for 30 years. Thanks.

The decision to start peritoneal dialysis or any form of dialysis is based on any benefit you might derive from the dialysis and not based on any specific level of kidney function. It is true that peritoneal dialysis may help … Continue reading

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

Hi, I was diagnosed with kidney failure in Nov and have been receiving hemodialysis 3 times a week 4 hours each time. I saw my provider the day after treatment and asked him to check my urine as I am still urinating and it feels like all that is a concern in the Center was fluid. The test results showed I had a creatinine level of 198 and an albumin level of 858. My Doctor told me to ask why I am dumping protein in my urine. I am also a type 2 diabetic and have been in control until the last couple of weeks where my fasting surges are up around 178, they have been 110 and Below before. I ask questions but no one seems to answer me. I need to have at least an idea if I can fix it. I don’t retain fluid but that is all anyone is worried about.

Patients on dialysis commonly continue to make urine. Hence, making urine is normal for a dialysis patient. Patients with kidney disease and especially diabetic kidney disease commonly spill protein in their urine. I am unable to make any other diagnosis … Continue reading

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

Hi doc, I am diabetic patient. My creatinine is 9 and I am also anemic. What would you recommend to reduce creatinine level?

A serum creatinine of 9 milligrams per deciliter (mg/dl) suggests very advanced chronic kidney disease (CKD). There are no medicines that lower the serum creatinine. I recommend that you consult with a nephrologist in your country. These laboratory results suggest … Continue reading

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

Who gives permission for dialysis to be slowly stopped?

In most cases, the patient must consent to stopping dialysis. If the patient is not competent, then the legal guardian or next-of-kin must consent to stopping dialysis.

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

My Mom has been on home hemodialysis for 11 years. It has been a beautiful experience because when we started her life expectancy was very short and 11 years later we have had all this time with her. In the last 17 months, my Mom has been hospitalized 3 times and ending with several weeks in rehab which means dialysis moves from home dialysis to dialysis clinics. This means transport to center from rehab. This means you are now under a different doctor’s care that does not know you or your history. Many things that we are trained to do stops and you start receiving dialysis that is less then what is expected at home. Technicians are rough. They jab at your fistula as if it is boot leather and not a delicate life line. Clean techniques are less. You feel like each time you send your loved one to dialysis you are playing Russian Roulette with their life. You try to ask questions to understand your treatment for the day and they act like it is a national secret. You ask them to consult with your home dialysis nephrologist to align center care with home care. This does not happen. When my Mom went to the hospital her dry weight was 75.3. I had to advocate for her because her feet looked horrible. Her blood pressure is low, she has crackling in lungs, and she weighed 88.5. Now this doesn’t seem a lot but in pounds this 29.04 of weight gain. In March, when she got this bad, they put her in ICU in order to get her fluid off. So my questions are why do they not assess there patient by weight gain like we do at home? Why does a family member have to assess legs and see that they are huge? She has a difficult time breathing on exertion. Why is care in a center less then what she receives at home? Her albumin levels are low. I asked why they weren’t giving this to her and I was told they don’t do this because it’s so expensive. So why is Mom not in the hospital if clinics can’t give her the care she needs?

You are asking all of the proper questions and I don’t know why dialysis care cannot be more consistent in large centers. I suggest that you ask to have a multidisciplinary conference with the staff at the dialysis center. There … Continue reading

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