Category Archives: Kidney Biopsy

Hello Doctor, The problem I am mentioning here is for my father. He is 62 years old and has both high blood pressure and diabetics. For the past couple of years, he is noticing foamy and bubbly urine and reached out to many hospitals in Hyderabad, India and went through many tests. All the tests showed he had protein loss, however all the doctors asked him to ignore it. For last 1 year, we are seeing increase of protein in his urine and he went to 24 hours urine examination test and results are shockingly high. Can you please help me with how to move forward with this? Test results : Urinary Protein show as 3780 Creatinine shows as 1148 Urine volume 2800 Protien / Creatinine ratio 3.29 Thank you!

The problem you are describing is one of protein in the urine (proteinuria) that is known as nephrotic syndrome. In most cases, the only way to make a specific diagnosis is to perform a kidney biopsy. There are many causes … Continue reading

Posted in Ask the Doctor, Kidney Biopsy, Kidney-Related Health Questions, Nephrotic Syndrome, Proteinuria

Hi Doc, Hope you are good. My wife is suffering from CKD 5. Diagnosed last year during pregnancy. Hypertension family background. Had an operation 5 years ago for nose bone. BP stays normal around 130/90 mostly or below and most high 150/100 some time only in a month. Creatinine at the time of diagnosed: 2.1 After Pregnancy (Creatinine ): 3.1 (eGFR 19) then she had DCR Surgery and after: 3.3 now eGFR is 14.4 Urea : 31 Uric Acid : 6.5 Protein, Calcium, Phosphorus, and Potassium values are normal. Please suggest why creatinine is increasing and eGFR is decreasing since she has been dieting and controlling her BP. Can it be reversed? Please help and advise. We are also seeing a specialist in Pakistan.

I am unable to make a specific diagnosis based on the information that you present. Your wife has progressive kidney disease and in some cases, this requires a kidney biopsy in order to make a specific diagnosis. Urine testing for … Continue reading

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

Hello Doctor, My father who is 73 years old is suffering from Nephrotic syndrome since July 2017. He has swollen ankles, pitting edema till the knees, mild pleural effusion 5cc. In the latest Urine report : RBC- 0-1 and granular casts are reported. The output is around 50-60% with half Lasix tablet and without lasix is 40-50%. GFR is 53% creatinine is 1.3 earlier (in July 2017) GFR was 64% and creatinine was 1.13, and only proteinuria was the problem. We had to start ACE inhibitor, due to which creatinine and GFR mildly increased. Now only diuretic is going on. He also has myelofibrosis. WBC – 13.70, while platelets are normal. I would like to know whether Myelofibrosis can be the underlying cause of Nephrotic syndrome. The kappa and Lamba light chain in urine both are High. Kappa – 83.60- Ref range.

I am unable to make a specific diagnosis based on the information that you present. Nephrotic syndrome can have many causes and the best way to make a specific diagnosis is to perform a kidney biopsy. Myelofibrosis is a disease … Continue reading

Posted in Ask the Doctor, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist, Nephrotic Syndrome

Doctor, we have a 10 year old who has had multiple strep infections, was thought to have had glomerulonephritis at that time. Then as a precaution had tonsils out, now at age 21 with no other infections present has the same kidney symptoms without infection. Can this be due to exposure to chemicals at his work?

I am not able to make a specific diagnosis based on the information that you present. It is true that streptococcal infections can be associated with inflammation within the kidneys (glomerulonephritis). In some cases, this may require a kidney biopsy … Continue reading

Posted in Ask the Doctor, Glomerulonephritis, Kidney Biopsy, Kidney-Related Health Questions

Good day doctor, a diabetic patient for 17 yrs, hypertensive for 6 months, suffering diabetic nephropathy. The hypertension has refused to come down, saw a nephrologist but hasn’t been able to bring my htn down. Am suffering serious edema, back pain, leg pain and swollen legs because of fluid, was placed on diuretics (frusemide) but it is not bringing down the edema. I have creatinine of 1.20 and protein in urine of +. I did a test for microalbuminuria and it is 814mg/dl. My sugar level is normal. For sometime now I am suffering serious proteinuria, albuminuria, hypertension, edema on different part of my body, back pains and leg pains presently. Please kindly help me with drugs to reduce the protein in my body and a good diuretic i can use to reduce/stop the edema, also drugs to bring down the htn because it has been 165/107 and no drugs i have used seems to work. My nephrologist managing all this is not helping me because no improvement. I don’t want total failure of my kidney. Please give me other medical advice. Thank you.

Your description is of severe diabetic kidney disease coupled with severe hypertension (high blood pressure). I am unable to recommend treatment without performing a complete history and physical examination. It is important for you to follow a very low salt … Continue reading

Posted in Ask the Doctor, Diabetes, Hypertension/High Blood Pressure, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist

My child, 3 yr old boy, is loosing protein for last 10 days. Dipstick test 1+ proteinuria. Protein creatinine ratio is 4.25. Serum albumin 2.3 g/dl. Cholesterol 250mg/dl. No edema at present. What to do next?

Further testing is needed to determine the cause of the protein loss into the urine. I suggest that you consult with your physician and see if referral to a pediatric nephrologist is possible. In some cases, treatment may be needed … Continue reading

Posted in Ask the Doctor, Kidney Biopsy, Kidney-Related Health Questions, Pediatric Issues

We just found out today that my wife has stage 3 kidney disease. She has no s/s or history of diabetes or HTN but has had progressive symptoms of kidney disease for the past 2 years. How common is kidney disease in the absence of diabetes and/or HTN? Does that often mean better prognosis?

A majority of chronic kidney disease (CKD) in the United States today is related to high blood pressure and diabetes. There are numerous other causes of CKD. Some have a worse prognosis and others have a better prognosis. I am … Continue reading

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

I am being followed by a hematologist due to a diagnosis of MGUS ( monoclonal gammopathy of unknown significance) in 2015.  24 hr. UPEP and Urine IFE testing show the following: 3/2017 test 9/2017 test Kappa light chain 117 4040 (normal range 3.3-19.4) lambda light chain 0.73 7.44 ” ” 0.24-6.66 K/L ratio 160.27 543 ” ” 2.04-10.37 urine M spike 29.5 37.9 urine Mspike 24hr. % 29.5 110 Protein 10.1 24.2 24 hr protein 131.3 290.  The report noted presence of IgG & IgA- consider altered glomerular permability. Positive for Bence Jones Protein kappa region. All of my other blood work, Bun, creatine and GFR in normal range. Recent kidney ultrasound showed 2 simple cysts on rt. kidney. Should I be followed by a nephrologist? Do you recommend any specific additional testing? Thank you.

I am unable to make a specific diagnosis based on the information that you present. It appears that you have an excess of kappa light chains in your urine. The hematologist should be able to interpret this test for you. … Continue reading

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

I am a 60 year old Caucasian male, 180 lbs, who walks and attends gym regularly, non smoker, no alcohol but HIV+ virus non-detectable – on medication (triumeq tab for HIV+), atenolol (25mg) and Lipitor (10mg) all one per day. My eGFR has gone from 53 in May of 2015 with ups and downs to 42 in September of this year. Creatinine in the same period increased from 1.36 to 1.65. Kidney specialist has completed a battery of blood tests and urine analysis (including 24 hr.) No abnormal results arose from all of the tests and protein in urine is less than 6 mg/dl. Ultrasound shows one simple cyst but no other abnormalities. I have no physical symptoms. And no swollen lymph-nodes or swollen ankles etc., Kidney specialist says that kidney biopsy is the only option to give more information. Are there any other alternative tests that could be done? Many thanks!

A kidney biopsy would seem reasonable in your case. Most cases of kidney disease associated with HIV (+) status are associated with protein in the urine. You mention that your urinary protein is normal. It might be possible that your … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Exercise, GFR, Kidney Biopsy, Kidney-Related Health Questions, Medication and Kidney Disease

I have a 4 year old daughter that was diagnosed with HSP. She is starting to have elevated blood pressure 115/90 as well as blood and protein in her urine. They did a renal panel on her and it came back the her phosphorus level is 6.1 . I guess my question is are her kidneys going bad? Will she need to start seeing a kidney specialist? Will she have to get a kidney biopsy?

Henoch Schoenlein Purpura (HSP) is a type of blood vessel inflammation (vasculitis) that can be seen at any age, but is commonly a short-lived disease in children and resolves without much concern. It can cause severe abdominal pain, diarrhea, skin … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Pediatric Issues, Pregnancy / Kids