Category Archives: Kidney Biopsy

Is kidney biopsy needed if the creatinine levels didn’t go above 1.5x? Normal urine test, normal ultrasound, no symptoms?

A kidney biopsy is indicated when there is kidney disease present that cannot be explained by the usual diagnostic criteria. A kidney biopsy provides a specific diagnosis of kidney disease so the specific treatment can be recommended. I suggest that … Continue reading

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

A kidney biopsy says that I have hyperfiltration injury. What is that? I am on more Losartan to lower blood flow in kidneys. My weight is great, I exercise regularly, drinking 64+oz of water a day and limiting my potassium.

Hyperfiltration injury is generally described as enlarged kidney filters (called glomeruli). It also can show scarring of the filters that we call “glomerulosclerosis”. It can be seen in patients who have a low birth weight, are born prematurely, have diabetes, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, Hypertension/High Blood Pressure, Kidney Biopsy, Kidney-Related Health Questions, Nephrectomy / One kidney

Hi Dr. I’m really concerned about my mom. From March through mid-July her creatinine went from 1.06 to 1.78. She is 82 (GFR now 26 and now in stage 4). The acceleration is alarming to me, but her nephrologist doesn’t seem concerned. I am concerned at this rate if it continues, I’m thinking stage 5 in three months or so. Nephrologist doesn’t think the risks of a biopsy are worth it. My big concern is that it may be something that can be changed now before more permanent kidney damage is done (if it isn’t due to that now), but as I said, Nephro not very open to digging . . . and I understand to a degree, especially with some things she went through last year, but what is the alternative, renal failure and dialysis? Do you think this rate of decline is fairly normal or more alarming? What are your opinions on the risks of biopsy? And I realize all you can say are your opinions so I won’t hold you to it if, in our case, you are wrong. Just trying to get an idea if this is normal protocol? Do nothing and wait to see how bad it gets? Is there any other less invasive tests that I can ask for?

I am unable to provide a specific diagnosis based on the information that you present. The best course would be for you to have a conversation with the nephrologist about the specific diagnosis related to your mother’s kidney disease and … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

Hi Dr.- I am a 36 year old female. I had a history of hypertension for the last 10 years. A UTI post I delivered baby (last 7 years). In Feb this year I got an infection again where budding yeasts present morphologically consistent with Monilial organism were found. My gynecologist suggested I undergo some blood tests done. As per the reports, my creatinine was 1.41 mg/dl and uric acid was 6.3mg/dl. Even my Liver profile tests showed high levels of ALP 170u/l, GAMMA GLUTAMYL TRANSFERASE (GGT) 109u/l, ASPARTATE AMINOTRANSFERASE (SGOT ) u/l. I was then diagnosed with CKD. My creatinine levels sometimes have dropped to 1.19 and even uric acid levels were normal. However, now creatinine level has reached to 1.43 and uric acid to 6.9. I got even a DMSA scan done 3 months back and as per the reports both kidneys are normal in size and position with irregular cortical margins and mildly impaired cortical function and small areas of cortical scarring seen in lower pole region. No one has told me till yet why I have CKD and how serious my current stage is. I have just been told to consult with a renal dietitian to keep my kidney functioning better. Can you please suggest how many years I have without the need of dialysis/transplant and if my levels can stop here only? My BP is under control and on a average its 130/90. I haven’t had a UTI in 2 months. Also, during the last 10 years, I was on a lot of NSAID medications due to headache problem but have stopped having them since Feb this year. Your guidance here will be appreciated a lot as I am too young to have a disease like CKD.

I am unable to make a specific diagnosis based on the information that you present. In some cases a kidney biopsy is necessary in order to be sure of a specific diagnosis as far as your kidney disease. I am … Continue reading

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

Dear Dr. Spry, Namaste and Good Morning! I am from Nepal and doing treatment of FSGS since 5 years. Please find some basic details: Age: 34 yrs Weight: 66Kg BP: 110/70 Creatinine: range from 0.7 to 1.1 Sugar: No Albumin in Urine: No (As taking Wysolon) Did temporary dialysis as creatinine reached to 7.6 during first time treatment. Medicine: Wysolon (continuous taking since 2.5 yrs), Tachograph (started since 3 months) Problems: Proteinuria. When Wysolon goes to 10mg, it relapses and again Wysolon started with 60mg or 40mg. My main problem is relapse and the side effects of Wysolon. Moon Face, Hair Fall, Fungal Infections, Memory Loss, Weakness, Low Vision, high hemoglobin are some side effects I am facing now a days. Please, suggest solutions to stop proteinuria or minimizing side effects of Wysolon?

You are describing steroid dependent nephrotic syndrome or steroid dependent proteinuria related to focal and segmental glomerulosclerosis (FSGS). This can be a difficult disease to treat. I am unable to recommend medical treatment without performing a complete history and physical … Continue reading

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

On my annual physical yesterday, my general practitioner told me my GFR is 58 and that indicates stage 3 CKD. She didn’t recommend a nephrology consult. Just follow up in one year. Is that appropriate care?

In most cases, primary care physicians (PCP) are able to manage chronic kidney disease (CKD) in the early stages. Stage 3 CKD requires that your estimated glomerular filtration rate (eGFR) be less than 60 milliliters per minute per 1.73 meters … Continue reading

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

Hello, I have had chronic kidney stone disease since about age 23. I’m 48 yrs old now. I have had reoccurring UTIs, hydronephrosis, and/or pyelonephritis about every year or two at most, since my late teens. My family has a very high incidence of renal failure on my paternal side, while the kidney stone disease is very prevalent on my maternal side. I frequently have protein detected in my urine as long as I can remember. I sometimes have very dark bloody to brown urine, very frequently cloudy, and on/off pale foamy urine. I worry that most of this is being passed off as side effects from my kidney stones. I also have hyperparathyroidism secondary to vit D deficiency and I have a genetic Connective Tissue Disease called Ehlers-Danlos Syndrome Hypermobility Type(hEDS) with some overwhelming of Classic Type, Delta Granule Storage Pool Deficiency Platelet Dysfunction, POTS, MCAD, and multiple other Autoimmune Disorders … I’ve seen what used to be called Bright’s Disease show up on numerous family death certificates while compiling our family’s genealogy, so I am concerned that my Urologist hasn’t followed up with more specific testing to evaluate my actual kidney function aside from BMP, CMP, U/A with the frequent culture sent for analysisa. I am concerned especially with my right kidney because it drops a bit low and doesn’t drain well with the ureter arched a bit higher anatomically. I’ve had about 6 ESWL procedures, a Percutaneous Lithotomy( due to high stone volume, 30+ Ranging 1mm-9mm and some high density type stones) with a temp nephrostomy drain/bag, and most recently a Ureteroscopy with laser Lithotripsy and stent placement x 1 1/2 wk(I couldn’t have tolerated the stent any longer), all of these have been about UA showed something new for me that upset, a rare budding yeast which also showed up in a 2nd clean catch sample several days later. I am worried more so because both of my children have hEDS also, they both inherited my Platelet Dysfunction. My son, the younger at 23 yrs, has started passing kidney stones at the same age that I did. My daughter has had a few bad infections also. I can no longer take sulfonamide antibiotics or Nitro furan Antibacterials, due to an allergy to them. Since my last infection and procedure, I have been so tired, bruising, more than usual, with notable Petechia that I don’t recall occurring so much before, itching intensely,(especially at night) and notable increased swelling of my feet, ankles, and sometimes hands. I made an appt with a nephrologist, but have a fairly long wait of a few more weeks until I can get in to see them. I am just concerned and interested in your thoughts. I do have HTN, have had intermittently since my 20’s, was treated in my 30’s with a hydrachlorithiazide until no longer required after significant weight loss with gastric bypass, I have since been treating with a beta blocker in mid 40’s which also treats my POTS …keeping my HR in control. I take sublingual B12 to treat anemia also. I take a lot of medications for my various conditions.

Your medical condition sounds very complex and I am unable to make a specific diagnosis based on the information that you present. Most of the problems that you describe for your kidneys are urological problems and should be addressed by … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney Biopsy, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

Hi Doctor, I’ve been struggling with microscopic hematuria and proteinuria for 15 months (ACR anywhere from 0.3 mg/ mmol- 1g). My urine Creatinine is a bit higher at 25 mmol and urine Albumin 68mg. I’ve also been diagnosed with anemia and low hemoglobin. My doctor is suggesting a nephrologist with my family history of kidney failure, but is it necessary? My EFGR is healthy and my serum creatinine levels go from 77-88. I’m a 29year old female if it helps?

I would trust your physician and seek referral. I am unable to make a specific diagnosis based on the information that you present. Blood and protein in the urine are likely signs that you may have kidney disease. In some … Continue reading

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

My creatinine is 3.47 and my BUN is 23. I am currently hospitalized and going for kidney biopsy on Monday. Do I have CKD? The doctors are dumbfounded due to lots of liquids my kidneys have gotten worse as far as function etc.

The kidney biopsy will give you a definitive answer. Chronic kidney disease (CKD) implies that kidney function has been low and stable for three months. If you are having a kidney biopsy, this suggests that there is an element of … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions

Normal Kidney function is considered anything over 60 gfr. But what does normal imply. For example say you have a 65 gfr vs a 75 gfr. “Normal” does that mean like yea its kinda working but not great. Because shouldn’t you have 100 gfr? Like how can above 60 be normal. Shouldn’t 60 gfr be considered reduced? Or is the formula inaccurate and can misdiagnose unless its under 60 gfr. Because the gfr is low due to serum creatinine and equation but the doctors say there is no kidney disease and things are normal. Your website says anything under 90 is stage 2 kidney disease. How is that normal? It just doesn’t make much sense. Thoughts on this

The equations that we use to estimate the glomerular filtration rate (eGFR) are not very accurate or reproducible with values above 60 milliliters per minute per 1.73 meters squared. There are other ways of measuring the glomerular filtration rate but … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney-Related Health Questions, Serum Creatinine