Category Archives: Insurance & Medicare Coverage

Dr. Spry, when it comes to healthcare why is CKD never talked about on TV News Networks like CNN, MSNBC, and FOX NEWS? And why haven’t Congress and the FDA been talking about how they’re going to cure CKD for millions of Americans with CKD on TV?

Kidney disease is a silent disease and it is difficult to get many headlines when the concepts of kidney disease require a bit of explanation.  We occasionally get some press related to kidney transplantation and especially related to altruistic kidney … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Insurance & Medicare Coverage, Kidney Failure, Kidney-Related Health Questions

I am looking at trying to find help for my 34 year old daughter who live in Grand Rapids, Michigan. She has suffered with major kidney stone issues for about 10 years. As I understand it she has stones forming in only 1 of her kidneys which I understand is very unique. The doctors do not seem to know what is causing the stones to be able to stop their growth. She has had multiple lithotripsies and both of the other 2 more invasive procedures. None of these have resulted in clearing her kidneys of the stones completely and they continue to multiply. The last lithotripsy which was about 5 weeks ago left her with a hematoma about 12-13 cm big and much soreness. She was told it could be up to 6 months for this to heal for anything else to be done She cannot lift her 11 month old baby currently. Where do we look for help for her? Where do we look for a doctor who is familiar with situations like hers, who can help her, and who is on her local Michigan insurance. Any information you could provide would be most appreciated.

The problem that you describe is a urological problem and should be evaluated by a urologist.  I am a nephrologist and I have not experience with lithotripsy and treatment of existing kidney stones.  Neither I nor the National Kidney Foundation … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Insurance & Medicare Coverage, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments, Urological Issues

I would like to know what I can do if my father has chronic kidney disease and he is in need of a transplant but since he is illegal, there is no way for him to receive a transplant. What would you recommend on doing?

I can only suggest that your father visit with a social worker that is assigned to your father.  I am not sure what you mean by your father being illegal, but if he in the country illegally, then it is … Continue reading

Posted in Ask the Doctor, Insurance & Medicare Coverage, Transplantation

Hello, both of my sons were born with multi-cystic dysplastic kidney disease. They are now 11 & 15. No complications, my 15 yr old in the past has had borderline high blood pressure, no longer protein in urine, blood in urine no longer, rare mucus in urine last 2 tests. Last ultrasound for both was 2.5 yrs ago. My 15 yr old at that time functioning kidney measured 10.8 cm and non functioning kidney still had 2 cystic spaces in total measuring 3cm. My now 11 yr old at that time functioning kidney measured 12.2 cm length, and had dilation of left renal pelvis (his good kidney) which was said probably due to extra renal pelvis. Questions: 1. I know the functioning kidney may grow larger due to being solitary, however, when is that solitary kidney too large on average? 2. At what age do the kidneys reach full maturity in size? 3. Should there be routine ultrasounds until the kidney reaches full maturity? I have a private company health insurance, and the medical director says that without symptoms repeat renal ultrasounds would not change management. Everything that I have researched and been told, is that routine ultrasounds until maturity. Any information that you can give me will be greatly appreciated! Thank you so much for taking the time to read what I have written!

I am an adult nephrologist and do not see children.  I am not familiar with the recommendation to perform repeated ultrasound examinations of a dysplastic kidney to document growth or change.  Enlargement of the kidney is not a problem that … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Insurance & Medicare Coverage, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues, Treatments

Can generic Immune drugs be used after a kidney transplant to save costs? Such as Cellcept-Prograf-and others?

Yes, generic drugs can be used but the doses will have to be carefully adjusted by measuring blood levels of the drugs.  Your transplant team should be notified if you switch from brand name drugs to generic so that they … Continue reading

Posted in Ask the Doctor, Insurance & Medicare Coverage, Kidney-Related Health Questions, Medication and Kidney Function, Transplantation, Treatments

My husband has CKD and has his red blood count checked every 2-4 weeks. He receives a shot to boost red blood cell production approximately every 2 1/2 – 3 months. We want to travel the country in our RV but he fears it will be impossible to set this up in other states than our home state. Can this be done in a dialysis center easier than through private nephrology or oncology clinics?

Dialysis centers may not administer EPO (erythropoietin) or ESA’s (erythrocyte stimulating agents) to patients who are not on dialysis.  Hence, it is best that your husband get a prescription (or prescriptions) from his physician that can be filled at outpatient … Continue reading

Posted in Ask the Doctor, Insurance & Medicare Coverage, Kidney-Related Health Questions, Treatments

Dear Dr. I hope leaving this message to you helps me find a solution. I have small multiple stones in my both my kidneys. Highest is 5 mm. Due to some situations, I was not able to consult my doctor for a follow-up to see if the size of the stones decreased or increased. I have severe back pain from last week. I am afraid if this is increasing my stones or stone size. Kindly guide me with some symptoms on how to understand if this back pain is affecting my kidneys. The reason for not seeing the doctor is, I stay in Dubai and here the fees are more. I could not bare the charges. So while I am waiting for the medical card but my company says for the last 6 months that they are still processing.

I am unable to make a diagnosis without performing a complete history and physical examination.  If there are stones in your kidneys, this is best treated by a urologist.  I am a nephrologist and do not perform surgery.  You should … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Insurance & Medicare Coverage, Kidney Stones, Kidney-Related Health Questions, Medication and Kidney Disease, Symptoms and Side Effects, Treatments

Why can’t a non dialysis patient get help from a renal dietician? I have been on my own figuring out meals because in Ohio I am not allowed to get help from a renal dietician. I am working so hard to stay off of dialysis and I am so frustrated that I can not get any help at all from a renal dietician. I am so afraid that I am going to loose the battle! I just need some help.

I am not sure why you cannot see a renal dietitian.  I suggest that you visit with your physician about your concerns.  If your estimated glomerular filtration rate (eGFR) is less than 50, you may be eligible for consultation with … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Insurance & Medicare Coverage, Kidney-Related Health Questions

I was just writing inquiring why all the dialysis centers are changing dialysis patients medications in place of Epogen? They are substituting with an oral pill and in place of vitamin D and also Zemplar and they are also supplying oral Calcitriol. They think that maybe it may work better but the truth behind this is I believe the government does not want to pay for it no more. Can you please respond to this message.

All medications that are administered during the dialysis session are now included in the single monthly payment that is giving to the dialysis unit.  This is true of the United States and specifically for patients who are covered with Medicare.  Hence, there … Continue reading

Posted in Ask the Doctor, Dialysis, Insurance & Medicare Coverage, Treatments

My brother has been battling kidney disease since 2003. I believe he started dialysis in 2003 or 2004. He’s been told that he is on the list for a transplant. Then, later he’s told he is off the list. He also suffers from diabetes and heart disease. In Jan 2015, he was referred for cardiac treatment. He was told in 8/2015 that his heart problems have significantly improved and he was not at risk for any complications related to his heart. I’m concerned the medical information is not getting to the kidney specialist. He was seen recently only to be told that he was not on the list to receive a kidney and that it would likely be 6 more months before he would be considered again. I told him that it’s likely that his cardiologist may not have reported his improved status. I’ve suggested to him that he follow-up with both doctors to insure the information is getting to the right place. I can see and hear his frustration. He has worked extremely hard all of his life. But after being disabled for almost 12 years, it’s beginning to wear on him mentally. Seems like he should have an advocate to assist if with getting the care that he needs. If he is a viable candidate to receive a kidney, why is he not on the list? I believe his medication is being partially funded by the Kidney Foundation. He would be great if he could get answers to his questions and hopefully see some action towards getting him a new kidney at least to give him some since of a normal life. Anything you could do would be appreciated.

The National Kidney Foundation does not provide funding for medication orins direct patient care.  I would recommend that your brother and you both visit with the social worker who is assigned to assist with your brother’s care.  The social worker can assist … Continue reading

Posted in Dialysis, Insurance & Medicare Coverage, Transplantation