Category Archives: Kidney Biopsy

In 1996, I was found to have hematuria. In 2000, I started experiencing ulcers on my legs diagnosed as the result of leukocytoclastic vasculitis. I should I just go with this? In 2005, I had proteinuria. A few years later I allowed a biopsy of my kidney. Results showed a damaged kidney. Some unidentified autoimmune cause. Only treatment my nephrologist could give me is blood pressure control. Now, I am told peritoneal dialysis is next.

I am not able to establish a specific diagnosis based on the information that you present.  It is possible to have leukocytoclastic vasculitis of the kidney.  It is commonly called Henoch Shonlein vasculitis or purpura (HSP).  It can be an … Continue reading

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

Hi Doc, I was just diagnosed with CKD stage 2, no protein in urine. Is it safe to try and get pregnant while in stage 2? What are the risks? Thx!

Stage 2 chronic kidney disease (CKD) implies that your estimated glomerular filtration rate (eGFR) is between 60 and 89 milliliters per minute per 1.73 meters squared and has been so for at least three months and that you have some … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Urinary Tract Infection/Pyelonephritis

I have stage one CKD. I found this out by seeing I have very foamy urine. I tested positive on the ANA blood test as well. I have been diagnosed with Lupus. What are the usual treatments for patients with what I have. Also, how long until immunosupressants like Prograf take to kick in and stop foamy urine?

I am unable to make a specific diagnosis based on the information that you present.  In most cases of systemic lupus nephritis, a kidney biopsy is necessary in order to make a specific diagnosis.  A specific diagnosis is necessary in … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Lupus, Urinary Tract Infection/Pyelonephritis

In May of 2019, I went in for my yearly physical and received a phone call from the Dr’s office (PCP). I was told my GFR was 56. I was sent for an ultrasound of my kidneys, came back fine. I did a 24-hour urine study, I’m sure you know what I am talking about – it was done at home, I kept the urine container in the refrigerator and took the container to the Dr’s office. That test was good also. In September 2019 another blood test was done and the GFR was 52. In December 2019 the GFR is 48. Every time I go to the office I give a urine sample and there is no protein or albumin in my urine. I do not have High Blood Pressure or Diabetes. There is not any genetic predisposition for kidney problems. I am a 59-year-old caucasian female. In December I asked my Dr if I had Kidney disease. He said my GFR is level G3a that my kidneys function is mild to moderately decreased. He did not say I had Kidney Disease, did not talk about dietary changes or sending me to a specialist. I do not know what has caused this but now I am reading about dietary changes I can make. No NSAIDS or Asprin only Tylenol since May. Do I have kidney disease? What should I be doing to help myself? Thank you

In many cases of early kidney disease, especially in females, a definitive diagnosis of chronic kidney disease (CKD) is difficult to establish. If all of your testing is otherwise normal, then you are doing everything that you can to avoid … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, Exercise, GFR, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Urinary Tract Infection/Pyelonephritis

I have CKD Stage 2. Do you have any advice or recommendations for me that would help me ask my nephrologist for a kidney biopsy or examination(s) of my actual kidneys? I don’t know if 1 or both of my kidneys are affected/not working fully. Kidney cancer (as well as other cancers) run in my family.

It is important to know your specific diagnosis as far as your kidney disease is concerned.  You should also know your estimated glomerular filtration rate (eGFR) and know if there is any blood or protein in your urine.   Treatment … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney Biopsy, Kidney Cancer, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Urinary Tract Infection/Pyelonephritis

I have Stage 3 CKD…and diagnosed with c1q. I have been vomiting and diarrhea really bad…three days straight…it has stopped. But my question is am I going to go through this often??? I’m at work today but my energy level is zero…tiring very fast and just feeling weird. I have no insurance. I did go to Parkland, but the ER was so full I couldn’t wait. Please help..scared.

C1q nephropathy is a very rare kidney disease that is established by performing a kidney biopsy and finding the disease in someone who does not have any other characteristics of lupus or complement deficiency syndrome. It most commonly causes protein … Continue reading

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

My brother has nephrotic syndrome and has developed nephritis. As far as I can see his medications are not working anymore. Any recommendations? Would love to hear from you.

In most cases, a kidney biopsy will be necessary in order to establish a specific diagnosis as to the cause of your brother’s nephritis. Once you have a specific diagnosis, then treatment can be recommended.  

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

In 2016, proteinuria and neutropenia was found during routine lab work in my African American teen. Orthostatic was ruled out with multiple urine and 24 hrs test. Hem/onc work negative and ANCA and complements negative. Biopsy 3 years later states acute tubular injury. What are we missing?

Protein in the urine (proteinuria) is not usually a component of acute tubular injury.  The kidney biopsy provides the diagnosis but does not necessarily explain the protein in the urine. In some cases, further observation and time will provide clarification … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Proteinuria, Urinary Tract Infection/Pyelonephritis

Dear Dr. Spry, your valuable service is much appreciated! I am an 85 years old, frisky CKD patient with virtually no perceptible symptoms so far. (I do have bilateral pedal edema that I “treat” by sleeping with my feet raised above my heart. By morning the swelling is always gone .) Three years ago my morning U-ACR was 16.0, 2 years ago it was 3.4, this year it was 7.2 mg/mmol. In 2010 there was no albumin in my urine yet, it was first detected 3 years ago. 5 years ago bilateral, mild retinopathy was detected. By last year it progressed to moderate. I asked my ophthalmologist if the cause was by T2DM or HTN. Her answer was, “probably both”. I have no peripheral neuropathy, my feet are in very good shape. My HbA1C has been between 38 and 43 mmol/mol. My mean 24 hr ambulatory BP is 121/75, but I also have pretty frequent instances of Isolated Systolic Hypertension. 3 years ago my U-osmolality was 384 mosmol/kg ( > 800 mosmol/kg). Physical examinations have revealed no problems. I do have visceral fat, OMRON number 10 (high normal is 9). Ca, Phosphate, and K are all normal, Na has been chronically low for several decades. I drink 1.5 L water a day, the water content of fruits and mostly raw vegetables consumed is between 0.7 and 1.0 L per diem. I drink 1.5 g Matcha green tea powder in 60 ml of water a day (it is somewhat diuretic). No blood or protein has been detected in my urine. Nitrit was detected once since 3 years ago. From time to time I have high SR and/or CRP markers. The trajectory of my CKD is essentially a series of descending waves of eGFR-EPI with minima (L) and maxima (H) as follows: 2003 L 57, 2005 H 72, 2007 L 53, 2008 H 66, 2011 L47, 2013 H 62, 2014 L 46, 2015 H 51, 2017 L 40, 2019 January H 62 , 2019 November L 45. Note that the last maximum and minimum are both ascending, i.e., so far I’ve managed to “rewind” the progression by about 6 years. The reason for that is that in 2017 I added, to the usual treatment of RAAS blockade and tight control of T2DM and HTN, bicarbonate therapy, since U-pH was 5 and Standard Bicarbonate was 21 mmol/L . I also began to consume a disciplined, kidney friendly diet, moreover over a year or so I managed to bring down my high uric acid, homocysteine, and PTH values. Since in my country (Sweden) I have no access yet to a nephrologist (nor to a renal dietician, by the way), I am turning to you with my questions: I still only have an unconfirmed, tentative diagnosis made last year for the first time: Diabetic CKD. What etiology do YOU think is most likely based on the above information? Do you think it is possible that I have benign nephrosclerosis? For decades in the past I got no medication for HTN. 3 years ago US showed incipient vascular “calcification” but no calcium yet, only a little bit of triglicerides, mildly thickened intima, mild atherosclerosis. This year I already have VC and moderate atherosclerosis. Can you offer any advice about what, if anything, I could do to slow down or stop the development of CVD? I understand that long term bicarbonate therapy is not without its risks. Do you have any relevant caveats to offer me? Owing to my vegetarian diet and lack of professional savvy, since 2017 I have developed Iron Deficiency Anemia: Hb 102 g/L ( vit. B12 and folate are fine, ferritin has been < 100 ug/L, transferrin saturation between 0.20 and 0.35 ). In an effort to improve my iron status, I am taking 100 mg ferrous sulphate a day with 125 mg ascorbic acid to aid absorption. Fortunately, I tolerate it well. If I continue with my vegetarian diet (mostly because of purine in meat), will I have to supplement iron for life? If you had any other advice for me, I would very much appreciate it. Thank you!

It appears to me that you are much more educated than the average patients with chronic kidney disease (CKD). You are doing all of the important things that you can do to slow the progression of the disease.  In order … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Diet/Nutrition, Kidney Biopsy, Kidney-Related Health Questions

After a double kidney transplant on a 76 year old African American woman in June 2019 in hospital. Is now in hospital Dec 3 for acute edema and heart failure, function of only 25%. They are aggressively using the intravenous water reduction drug. Has loss most of ability to walk because of swollen legs. No prior heart disease before the transplant.

I am unable to make any specific diagnosis based on the information that you present.  The physicians in the hospital would be the best to discuss the diagnosis and treatment alternatives. A biopsy of the kidney transplant may be necessary … Continue reading

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