Category Archives: GFR

Is an 87 year old man with CKD and GFR of around 30 allowed to to engage in a religious fast. More precisely,what would be the danger in not drinking and/or eating for a 24 hour period?Would an individual in such a medical condition be allowed to abstain from food for 24hrs if he drank liquids?

Chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of 30 milliliters per minute per 1.73 meters squared should be able to go without food and water for limited amounts of time.  This partially depends on other medical … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Symptoms and Side Effects

I am a 79 year old white male with Type 2 diabetes. My left kidney was removed 28 years ago due to a tumor. Fasting levels are in the 96-110 range. eGFR is 49 (up from 43 two months ago.) Serum creatinine 1.53; Potassium 5.4; BUN 29. Recent 24hr UA: UA Protein (calc) 80. Total Protein is 4.3. I feel my PCP is not taking enough action or giving me enough information about my lab results. His notes indicate that everything is normal with my lab results. My BP runs 120/78. My meds include 10mg of dextrostat and Lisinopril HCTZ 20/12.5 Does the dextrostat or (the supplement L-thinine 200mg) have a negative affect on my kidney function?

Dextrostat (dextroamphetamine) is a very potent stimulant and can cause elevation in your blood pressure.  I am not aware of the drug L-thinine.  This is not a compound with which I am familiar.  Since you only have a single kidney, … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Kidney-Related Health Questions, Laboratory Testing

I have been working with a nutritionist and one of the latest supplements recommended is Cal-Amo which is Ammonium Chloride; Betaine hydro hloride; Calcium Chloride; Calcium Lactate; Magnesium citrate; Calcium stearate. I am a stage 3 Kidney disease person, aged 78 female. Is this a safe product for me at this time ?

I have no experience with a supplement called Cal-Amo.  I am not aware of any research that has been done on this supplement in patients with chronic kidney disease (CKD).  Of the compounds that you mention in Cal-Amo, I would … Continue reading

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

Hello Dr. Spry, My CKD has progressed to ACR = 23,42 mg/mmol, eGFR-EPI = 40 (mL/p/1.73m2), p-urate = 559 umol/L (230 – 480), p-standard bicarbonate 21 mmol/L (22-27). Should I be concerned about a high risk of further progression and therefore 1) Should I ask for referral to a nephrologist? 2) Should I ask for the high urate to be treated? 3) Should I ask for bicarbonate therapy to be started?

I am not able to recommend medical therapy unless I am able to perform a complete history and physical examination.  I generally recommend referral to a nephrologist when the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

Hello Doctor, My husband had a liver transplant 5 years ago. He is not in Stage 5 CDK, due to the anti-rejection drugs. He is relatively healthy, has high BP, leg swelling, extremely tired and urinates frequently. He is seeing a Kidney Doctor at UCSD and recent blood work showed his GFR is 15-20. My question is what is it that I look for? My husband had a really difficult time with transplant and had to have at least 6 surgeries and he is just downright done with Doctors. My fear is that he will NOT do dialysis or kidney transplant (even if he is a candidate. I would like to give him information so he can think about options. Do you have any information or any kind of books, suggestions?

Your husband should consider all aspects of his care.  The amount of effort that has been put forward to give him a new liver and a new life is extraordinary.  Kidney disease is an unfortunate complication of that process.  I … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Transplantation, Treatments

Hey, I am currently seeing a Nephrologist in my home town and I am due for a follow up appointment on August 24th. I have been tested 4 times in the past year due to high levels of Creatinine. I am a 42 Year Old Male, 6’1, 185lbs and Caucasian. My Creatinine has been tested as 1.22, 1.25, 1.11, 1.34, 1.19. I take a 5mg Lisinopril and 10mg Celexa and exercise 3 days per week. On the two tests were I scored a 1.11 and 1.19, I reduced my protein intake from 125 grams down to around, 50-75. My GFR is running in the 50’s and 60’s depending on how the Creatinine is ranging. My doctor says that I am in Stage 3 CKD. I wonder though, I have had 3 Urinalyses over the time frame but my tests always show Negative for Albuminuria and Proteinura. I have now completly overhauled my diet to manage Sodium, Protein, Phosphorus, and Potassium. Should I seek a second opinion? AM I really in stage 3 and does it matter that my urinalyses keep coming back negative? What would your advice be?

The creatinine results that you describe are within the range of variation for the laboratory testing.  The creatinine tests can vary between 0.1 and 0.15 up and down and this is just the normal variation in the accuracy of the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Serum Creatinine, Symptoms and Side Effects, Treatments

I had my left kidney taken because of cancer. I am trying to understand how to keep my only kidney healthy. I have a couple of questions: 1. Is 45% usuage of kidney good? If I understand articles 100% is two kidneys, so 45 % should be 95 % usage of one kidney, correct? 2. My gfr is at 44.8 – is this a good number? By your chart, I am in stage 3b, but is that with two kidneys? I will have more questions down the line but these are my two for know. Thank you for your help “One Kidney Care”.

Your math is correct, but you still have chronic kidney disease (CKD) because of the removal of one of your kidneys.  Hence, your estimated glomerular filtration rate (eGFR) is normal for your single kidney, but you still are at risk … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

For the last 7 months my GFR level has decreased from 71 to 54. I am a 55 year old white female with diabetes. Should I be concerned?

Yes.  A decline of kidney function by nearly 20 milliliters per minute per 1.73 meters squared in less that a year would be a source for concern.  I suggest that you also have urine testing for blood, protein and infection … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diabetes, GFR, Kidney-Related Health Questions, Laboratory Testing, Treatments

A 82 year old frisky male has had reasonably well controlled DM and Hypertension for decades was diagnosed with CKD a year ago. He also has increasing microalbuminuria and stable retinopathy (of unknown causation). If all other possible causes of CKD can be excluded, can it be determined whether his CKD was caused by DM or hypertension?

High blood pressure (hypertension) and diabetes are the two most common causes of chronic kidney disease (CKD).  It is most likely that both hypertension and diabetes are the cause of his kidney disease.  The presence of the retinopathy and microalbuminuria … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

Hello to all, I suffer from Stage 3 CKD, with about 40-50 kidney function. I was wondering if taking Glucosamine sulfate is safe, since it contains high amounts of potassium?

Glucosamine sulfate should not cause any problems for your kidneys.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments