Category Archives: Insurance & Medicare Coverage

I am a 49 year old female with ADPKD…it has taken the lives of 3 generations around the ages of 72. A month ago my bloodwork showed a sharp decline in function… GFR at 17… stage 4 almost 5. I am single without insurance and am in dire need of a nephrologist and a dietician. I’m going through a local nonprofit here in Wilmington North Carolina that facilitates people with no insurance and getting appointments with a specialist but of course you can imagine the fear I have of not having a plan in place. What do you suggest that I do? Are there any clinical trials that you would be aware of or any type of immediate things that I need to prioritize first to take care of it especially if my process takes a while to get in with a nephrologist? Thank you so much, sir.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is generally a slowly progressive disease that progresses to end stage disease.  Since you have not had prior monitoring, it is difficult to tell if your kidney disease is slowly progressive or if there … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Insurance & Medicare Coverage, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Polycystic Kidney Disease, Symptoms and Side Effects, Treatments

I am a CKD patient doing PD in India with 3 exchanges per day ( one 1.5 and 2 x 2.5). I am a resident of USA, but no insurance. Will I be able to travel to the USA and get PD solutions at free or nominal for CKD patients? What documents do you need to access it? Currently I am using Baxter PD solutions.

I do not believe there is any such program available for patients who are citizens of another country, who do not have insurance, and who are traveling legally within the United States. There is no governmental program or social program … Continue reading

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

My brother was diagnosed with stage 5 renal failure with about 3-5% function left. My brother received a kidney transplant 25 years ago from our other brother and only has 1 kidney. The hospital is saying that he cannot receive dialysis until he gets insurance but does not qualify for Medicare until he is sicker or he gets an outpatient consultation- which the hospital canceled because he doesn’t have insurance. My brothers creatinine levels keep rising but the hospital says his potassium levels is what needs to be watched. My sister and I both want to get tested to donate but they said they can’t test us until he is assessed by the transplant team which also won’t help until he has insurance. I do not want my brother to get so sick he can’t handle a transplant but I feel he is being held back from treatment. Is there any other steps we can take? I feel like we are just watching and waiting for him to get too severe.

Your brother should consult with a nephrologist. If your brother has only 3-5% kidney function remaining, he should be eligible for social security disability insurance (SSI) and this would also make him eligible for Medicaid and possibly Medicare. It is … Continue reading

Posted in Ask the Doctor, Insurance & Medicare Coverage, Kidney-Related Health Questions, Living Donation, Nephrologist, Transplantation

I work for a corporation that owns LTC and SNFs. Hemodialysis pts frequently get transferred to the hospital from the dialysis center post HD. Are there any standard interventions that we could be doing for our HD pts to help avoid this? I have been trying to find info on the internet regarding some standard care guidelines for this to no avail.

This is a very challenging area of practice that has resulted in more than one quarter of dialysis patients who are hospitalized recently being readmitted to the hospital within 30 days. The readmission rate on discharge to a Long Term … Continue reading

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

If I only have one kidney due to cancer when I was 2, how do I go about getting health insurance to make sure that I am OK? I smoke cigarettes and marijuana and I really want to stop. I know how dangerous this is. I want to stay around for a long time. P.S. I‘m 22.

I cannot tell you how to get health insurance coverage. This varies from State to State and country to country.  You will have to learn what insurance coverage is available in your local area and how much it costs. I … Continue reading

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

I was diagnosed with Type III collagenofibrotic glomerulopathy in March 2015. My GFR is stage 3B, hovering around 33%. This past week I was diagnosed with multiple myeloma or MGUS [bone marrow biopsy approval pending with insurance company]. My current medications are Benazepril hcl 10mg, Allopurinol 100 mg, Verapamil ER 120mg. Will any medication for the myeloma be counterproductive to the kidney disease?

I cannot anticipate what treatment will be recommended for multiple myeloma.  There are a number of treatments that are used.  Untreated multiple myeloma can injure kidneys and make underlying kidney disease worse, hence, I recommend that you wait for a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Insurance & Medicare Coverage, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects, Treatments

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