Category Archives: Dialysis

Dear Sir, I have CKD patient since Feb 2019 and depend on dialysis. Kidney Biopsy report: Diagnosis Diffuse Global Glomerulosclerosis. A recent report RBC 4.4, HB 9.7, Packed Cell Volume 30.10, MCV 68.41, MCH 22.05, RDW-CV 22.3 Urea 130.88, Creatinine 6.61 Potassium 61.11. Please advise.

The kidney biopsy report suggests that you have advanced scarring of your kidney and it is not likely to reverse. If you are on dialysis, you should explore the possibility of doing dialysis at home or kidney transplantation. I am … Continue reading

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

I am a 7 year dialysis patient. I no longer make any urine (1/4 cup per week). I am retaining fluid in my mid section and lungs (no swelling of legs or ankles). How can I move the fluid from my lungs and mid section tissues to my blood stream so it can be removed through dialysis?

Fluid removal from tissues such as your abdomen and lungs takes time. The heart is capable of translocating the fluid from the tissues into your blood space so it can be removed by the dialysis machine. This process takes time … Continue reading

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

My GFR is 33 and creatinine 1.7 urea 25. Urea not passing without tablet. How many years will I live without dialysis?

I am unable to provide a specific diagnosis or prognosis based on the information that you present. I suggest you contact a nephrologist in your country for a full history and physical examination in order to offer a specific diagnosis … Continue reading

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

I read that swimming in a well chlorinated pool for maybe 1/2 hour was OK to do while on PD dialysis. Is swimming in a family pool that is filled with salt water OK to do too?

I recommend for my patients on peritoneal dialysis (PD) and have catheters that have healed very well with no exit site issues or infection, may use a personal pool that is chlorinated or has salt water as they are the … Continue reading

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

Hello Dr. Spry, First, I’d like to thank you for taking time to reply to our question. We appreciate it. I am writing on behalf of my mother. Background: Female, 80 years old, eGFR = 22, creatinine = typically 1.99-2.20 mg/dL, Bun=55mg/dL. She has to do mitral valve surgery. We know you are a nephrologist and not a cardiologist, but want to know if you have a point of view on the below. We are trying to assess risk for further kidney damage from cardio surgery and explore options based on some reading we have done. – Is avoiding heart/lung machine (aka going “off pump”) better for the kidneys? – If one must go on the heart/lung machine, what are methods/ways (pre, during, and post-surgery) to potentially minimize kidney damage? For example, more kidney hydration during surgery? Extra saline IV pre-during-post surgery? – Are there any potential Rx or OTC or herbal solutions to minimize further kidney damage if one must do cardio surgery? – Are there other potential solutions you could suggest that we inquire about? We understand it is difficult to provide definitive advisement without seeing the patient. We are simply seeking some smart questions and potential hypothesis to consider for exploration. Thank you so much for your insight.

Kidney injury during cardiac surgery is very common, especially during heart valve surgery. In general, limiting the exposure to the “heart-lung machine” or bypass pump is important, however, the heart surgeon is well aware of this and the anesthesiologist and … Continue reading

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

My nephrologist recently recommended I limit my daily fluid intake to 40 to 60 ounces. I have been trying to limit my daily intake to 60 ounces, but I find it difficult. I have Stage 4 CKD (eGFR at 23). I am 75 years old, weigh 175 pounds, and I’m 5′ 11′ tall. I play golf 4 times per week and I work out at a Fitness Club 3 times per week. I have read some articles where 3 Liters were recommended for men with CKD, but not sure they have Stage 4 CKD. I would like your opinion on the appropriate daily fluid intake for me. Thank you for your support.

Even with Stage 4 chronic kidney disease (CKD), I do not know of a specific recommendation for fluid intake. This is a difficult question to answer because hydration or fluid intake is unique to each person, each medical problem and … Continue reading

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

I have ESRD and have not started dialysis and I just found out I have a mass on my right kidney. If found cancerous, the fix is to remove part or all of the kidney. My question is, will I still be able to avoid dialysis for a few more years? I’ve been ESRD for more than 8 years ago, when they wanted to put me on but I had a wait and see approach, being very careful about intake and I’ve been maintaining. Could I maintain the current level of filtration with one kidney? Thank you.

I am unable to offer a prognosis based on the information that you present. I would need to perform a complete history and physical examination in order to offer a prognosis. If you lose one kidney and maintain the other, … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Nephrectomy / One kidney

I am 63 and I am doing PD dialysis at home. It is going well. I have been evaluated for a kidney transplant. What is the difference between PD dialysis and transplant as far as life expectancy?

In general terms, a successful kidney transplant will roughly double your life expectancy compared to you life expectancy with dialysis.

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

I am being asked to transfer from a Fresenius PD machine to Baxter one. I have been told that the fluids used in the Baxter machine are less harmful to the peritoneum. Could you please provide your opinion on changing to the Baxter system and whether the fluids are indeed better for for peritoneum?

There are more options for different dialysis fluids with the Baxter system, but other than that I do not know of any particular difference in harm that is done by either the Fresenius or the Baxter fluids. I personally use … Continue reading

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

Hi doctor. My father is age 52 and he is suffering from urine infection and his creatinine count is now 6. He has a back pain since 10 years and due to that he consumed pain killers as well. So now he is going through dialysis for the first time today. What will be the best treatments to reduce the creatinine count?

I am unable to tell if your father’s kidney disease is acute kidney injury or chronic kidney disease (CKD). The first thing to do is to determine if the kidney disease is reversible. This will require further testing. If the … Continue reading

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