Category Archives: Hypertension/High Blood Pressure

Hi, the patient has pain on her back, got done many tests and finally went for biopsy test, below is the test report. The doctor said nothing to worry just control blood pressure and stress and use less salt in food. But I consulted few other doctors, they said it is benign condition and can lead to kidney disease after 10 or 20 years but it is rare. It is a chronic kidney condition and has no treatment. Maybe after 20yrs, if unlucky can lead to end stage kidney disease. Another doctor says might the kidney have only 10yrs of life. Histopathology Report Clinical Data: Patient has microscopic hematuria, Negative family history. Specimen: A Light microscopy in formaldehyde. B. immunofluorescence in Michel’s medium. Diagnosis: IgA nephropathy with mesangial proliferation. Oxford classification score (M1E0SIT0). Interstitial fibrosis and tubular atrophy constitutes 20% No activity and mild chronicity Description: H&E, PAS, and trichrome stains. The biopsy consists of renal cortex containing 10 glomeruli. Seven glomeruli show segmental mesangial hypercelluarity (M1), without endocapillary proliferative lesion ( no celluar cresentsand no fibrinoid necrosis) (E0). Segmental sclerosis and adhesions to Bowmans capsule is seen in one glomerulus. (S1), no globally sclerotic glomeruli is seen. Thrichrome stains demonstrate segmental small mesangial red deposits. Blood vessels show mild degree of arteriolosclerosis. Interstitial fibrosis and tubular atrophy involves 20%of the cortex (T0) Immunofluorescence Microscopy (IF): Insufficien, renal medulla only. If stain performed on paraffin embedded tissue and show a cortex with 7 glomeruli. IgG: Glomeruli, negative. Tubules, 1+protein resorption droplets. IgA: Glomeruli 3+ granular mesangial staining. Tubules, negative, IgM: Glomeruli negative, Tubules, negative. C3: Glomeruli negative. Tubule: negative. C1q: Glomeruli, negative Patient Details : Female 26. Please give a Good Opinion on this report. I’m so confused and lot worried.

IgA nephropathy is a relatively common type of glomerulonephritis and has a variable course.  Some patients have only blood in the urine.  Others have protein and blood in the urine.  I am unable to give a prognosis without performing a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Treatments

I am a female, age 58, no diabetes, or high blood pressure, recently tested GFR 48, down from GFR 68 twenty days ago. I have fluid retention and a lot of back pain with fever 100 – 102. No UTI (but suprapubic pain). Urinalysis: No protein, Leukocyte (70), hemoglobin small, all other normal. Doctors point at creatinine level (1.17) and believe due to dehydration and other symptoms not related to kidney. No referral to urologist, no diagnosis of kidney disease, no treatment offered for symptoms. Any recommendations to treat symptoms — now can’t work/function. Thanks. (p.s. I know need to push for more tests).

I am unable to make a specific diagnosis based on the information that you present.  I agree that you need further testing.  I suggest that you consult with your primary care physician for further testing or referral.  An ultrasound examination … Continue reading

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

Hello! I am a 34 year old female. At my last physical my doctor informed me she wants to monitor my kidney functions more & wants me on a diet because my GFR labs were in 2015 or 14 (can’t remember which year she stated) were at 110. My next 6 month checkup my GFR was in the 80’s, my next 6 month checkup the 70’s and now my check up on 3/31/17 my GFR was 63. I do not have high blood pressure but at 5’2″ & 175 lbs I am overweight. I don’t have diabetes although it is in my family history. She plans on seeing me in 6 months as usual and I am dieting & exercising in the meantime, but should my doctor and/or myself be way more concerned with this & see someone about it? My ankles are swollen with pitting edema from the calf down year round without let up. This edema has been since I was 20 and only 124lbs. Any insight you can give me would be greatly appreciated! It seems that my kidneys are functioning at the rate of an elderly person & I am a single,divorced mother of my 3 beautiful children so I really want to stay on top of this.

You physician is doing the proper monitoring.  I would also suggest that you have urine testing for blood, protein and blood.  This should be part of your monitoring in addition to measurement of your estimated glomerular filtration rate (eGFR).  You … Continue reading

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

My husband has creatinine 2.3, 1 kidney, also high pressure under control 140/80. He is taking 7 pills a day to lower hypertension. He will have an aorta operation replacement with a 15cm long, at the end of the month. He also has hidden blood on urine in today laboratory test. What kind of fruits and vegetables he has to eat to reduce the creatinine to normal levels. He recently had catheterization and angiogram both of them because of the aorta problem on 4 April. Please help me to make a diet to lower creatinine. Urgent!

There are no diets that lower the serum creatinine and improve kidney function.  There are diets that can slow the deterioration in kidney function.  I am a strong advocate for the DASH diet.  You can review the DASH diet at: … Continue reading

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

I want to understand my health risk if I donate a kidney to a close friend. My father had type 1 diabetes diagnosed at age 18. He was insulin dependent his entire life. My father died at 62 years old due to congestive heart failure. My mother has type 2 diabetes and high blood pressure, both were diagnosed in her 50’s, she’s 67 years old. My mother has had two mild strokes, but suffers no physical impairments. My mother’s father had extremely high blood pressure and late life diabetes. He suffered many strokes, resulting in paralysis, loss speech and finally an inability to swallow. I’ve read that kidney donation could result in high blood pressure or diabetes. Based on my family history, am I at a greater risk of suffering post operation hypertension or diabetes.? I am in very good health aside from my anemia, which I am told is a result of beta thalassemia. I am 5’4″ and 135 pounds. My blood pressure is typical 105/68.

I am unable to provide a prognosis based on the information that you present.  It certainly seems that you are at risk for chronic kidney disease (CKD) based on your family history and you should be screened for CKD annually. … Continue reading

Posted in Ask the Doctor, Diabetes, Donation, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Living Donation

My husband has hypertension not always controlled well with medication. He currently takes 200mg metoprolol and 40mg lisinopril daily. Control is extremely variable. Should be see a nephrologist to rule out renal hypertension?

His primary care physician (PCP) should be able to diagnose and treat his hypertension.  Nephrologist commonly see very resistant hypertension and consultation may be needed, but his PCP should be able to determine if consultation is necessary.  

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

Dear sir, I am 24yr old studying medicine and type 2 diabetic for 3 years. Recently my urine microalbumin is 42mg/l at spot sample and my HgbA1c is 7.9 percent and my systolic bp is high 159/70. What is the risk of developing clinical proteinuria and what is prognosis of my this renal condition? I am taking only medications for diabetes.

I am unable to make a diagnosis or a prognosis without performing a complete history and physical examination.  As a diabetic, you should have very careful control of your blood pressure to less than 130/80 and you should have an … Continue reading

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

I am from India but now I am working in Saudi Arabia. Before 2 months I have a leg pain and I consult a physician here. So doctor told me to check the creatinine. That time my creatinine level is 1.2, then my blood pressure was 155 that time. But leg pain problem and my disk some problems. I took X-ray also. Doctor told creatinine increase the reason in blood pressure. So I start blood pressure medicine 5 mg tablet. After one month, I checked again creatinine. It is not changed same value 1.2. Sir, I want to reduce my creatinine level. I make everyday 20 minute walking and small exercise. and drink lot of water. Last one year, my stomach acidity is very high and also little pain around the chest, mainly armpit. Sir, please give me your advice to reduce creatinine. My age 33, weight now 92 kg. If I make exercise any problems? How many liter water drink each day? Please give me your advice?

I am unable to make a specific diagnosis based on the information that you provide.  There are no treatments that specifically lower the serum creatinine.  I suggest that you continue to follow your physician’s advice.    You should drink water … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing

I have ADPKD (stage 1) and am considering rhinoplasty. Is general anaesthesia safe for me? I am a 52 year old female in good shape and no blood pressure issues.

I am not able to give medical advice without performing a complete history and physical examination.  In general, anesthesia is not a problem for patients with Autosomal Dominant Polycystic Kidney Disease (APCKD).  I would always suggest that you have a … Continue reading

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

I was diagnosed with IGA Nephropathy about seven years ago and did several rounds of chemotherapy and my IGA nephropathy has been in remission up until two years ago. My blood pressure spiked after I went through a house fire and loosing my mom a few months later . My GFR and creatinine have been fine up until I got a bad tooth infection. My GFR is now 57. It was over 60. I generally only get blood pressure spiked around my menstrual cycle. I’m on 5 mg of Lisinopril once daily to protect my kidneys and keep blood pressure in check. I was wondering if blood pressure and kidneys would be affected by starting a workout regimen. Lifting weights (light weights) and treadmill. Also my regular doctor said I could start on a meal replacement called isagenix and there are one to two days a week that you cleanse with a cleanse drink. Is this OK in your opinion?

Exercise and light weight lifting are excellent ways to maintain your overall health and your kidney health. I have no experience with the supplement that you mention and would not have an opinion about use of this substance. For more … Continue reading

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