Category Archives: Kidney Failure

Dr. Spry, My father suffered a kidney failure, apparently resulting from a UTI this past March. Though he is a long-term diabetic (over 27 years), his medical records state his condition as AKI rather than CKD. He is now dialysis-dependent, but his doctor seems to believe his kidneys could recover sufficient functionality for him to go off dialysis, though it’s been nearly 8 months since the diagnosis. What indicators would a doctor use to identify AKI vs CKD in a less obvious scenario where the UTI or the Diabetes could be the root cause, unlike an actual physical injury or nephropathy in the absence of a pathogen beyond diabetes, where I presume it would be easier to classify as AKI or CKD, respectively. How would the doctor determine if there is a possibility for some kidney function to return? From what I can tell of his creatinine, potassium, urea, albumin levels, there doesn’t appear to be a consistent improvement in any metric that would allow a quantitative assessment of kidney recovery. Is there a qualitative method to assess the viability of a kidney? Short of a biopsy is there another quantitative method outside the typical blood work to judge how much kidney function is just dormant vs. how much has been lost permanently? Apologies for the multiple questions! My father is being treated at the top hospital in his city, one well-known for international medical tourism (though he’s a local). His doctor appears to be a very competent and straightforward professional. Unfortunately, doctors in India are extremely reluctant to share technical patient information and I’m relegated to scouring the internet to help my dad navigate his condition. Thank you for any information you can share on the subject!

Acute kidney injury (AKI) means that the tubules of the kidney have been injured but the filters of the kidney (glomeruli) remain intact. If there is tubular injury, then the kidney is capable of repairing this injury and then the … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis

Hello, Dr. Spry, Thank you for taking my question. I am a 44 year old white male with major gi problems and a serious paternal-family history of kidney failure and death. My GFR has dropped from 131 on December 30th 2016 to 106 and as of October 10th 2017; this is a drop of 25 ‘points’ in under one year. I am very worried but have tried not to be so, because I am still above 60. Nevertheless, this drop is precipitous and, I think, serious. When taken into consideration with high liver enzymes after 10 ERCPs for biliary blockages, gastroparesis, Crohn’s disease, diverticular disease, low blood pressure, edema, blepharitis, breathlessness, and my family history, I think a serious problem is taking place. If you have any ideas, I’m open to them. Thank you, and Happy Autumn.

Unfortunately, the accuracy of our kidney function estimating equations is not that good above 60 milliliters per minute per 1.73 meters squared. The new CKD-EPI formula is a bit better in the higher ranges above 60 but still has a … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney Failure, Kidney-Related Health Questions

Hi Doctor! My mother lives in Florida and I am moving out that way to help take care of her. She is in kidney failure and needs a kidney. I am going to be tested to see if I qualify and also match her so I can give her one of my kidneys. I have a question about medications. I take a few medications and wanted to know if you knew if that would affect the doctors from accepting me as a donor. Zomithozide, Prilosec, Xanax, Paxil, Trazadone, Bactrim, Zyrtec, multivitamin, and D3 & B12. Thank you! If I have to wean off of any of these meds I will do so to help my mom.

I am not able to recommend medication changes without performing a complete history and physical examination. Only your physician and primary care provider (PCP) should recommend changes in your medications. I suggest that you review them with your PCP. I … Continue reading

Posted in Ask the Doctor, Donation, Kidney Failure, Kidney-Related Health Questions

Dr. Spry, I was diagnosed with multiple myeloma two years ago based upon a bone marrow test of greater than 35% plasma cells. They call it smoldering MM. I have my blood tested every 3 months and my concern is with recent numbers. My calcium has been low at 7.5, B12 is 1462. My intact PTH is 238 with norm range at 10-65. My EGFR was 70 two months ago and is now 59 from blood test two weeks ago. I read various info on this and it suggest that I have kidney failure. I’m taking vit D, calcium and Alendronate medication. I had a MRI of my parathyroids which was negative. So it appears this could be secondary hyperparathyroidism, which usually kidney failure is the cause. I see my endocrinologist next Wed and I welcome your comments. I forgot to mention that my urine creatinine level is normal and albumin in the urine is normal.

Multiple myeloma (MM) can be a cause of chronic kidney disease (CKD).  I am unable to make a specific diagnosis of CKD based on the information that you present. I cannot be sure if you have primary or secondary hyperparathyroidism … Continue reading

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

Hello doc. Have a good day ahead. I just want to ask how can I cure my kidney failure? I got urine blood last August and late at night when I woke up to urinate until now I feel that pain on my right side. I have UTI before and spotted blood. I feel weak, can’t move and painful when I urinate. Please, need some advice what herbal medicine I will take? What to do? Food, diet? What to eat and what not to eat?

I am unable to make a specific diagnosis based on the information that you present. I recommend that you see your physician for a complete history and physical examination. I believe that you need further testing in order to establish … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Herbal Supplements in Kidney Disease/Failure, Kidney Failure, Kidney-Related Health Questions, Treatments, Urinary Tract Infection/Pyelonephritis

Good morning Doc. I’m from the Philippines. My mom has renal kidney failure. She is on hemodialysis since April of last year. She is now 54 y/o. She was suffering a heavy cough and it is worse when it’s evening. She has difficultly breathing and has back pain. As a daughter, I’m very worried about her especially when I always see her like that. As per her doctor, she has water in her lungs and she needs to undergo dialysis 3x’s a week. I just want to ask what is this kind of disease and if this can worsen her situation? What are the things or causes of it? and how do you treat it?

I am unable to make a specific diagnosis based on the information that you present.  She appears to have end stage kidney disease and is on dialysis.  There are many causes of kidney failure including high blood pressure and diabetes. … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Nephrologist, Risk factors

Are jaundice and kidney failure often associated? My sweetie just got out of the hospital after 30 days. His sole kidney is not working properly and he has started dialysis. I expected him to be puffy or swollen, but was completely shocked to see him yellow. I haven’t had much success googling this. Thanks for your feedback.

Jaundice is not usually associated with kidney disease, but if the original disease was liver disease and the kidney disease followed, this could be the case. Patients on dialysis are often anemic and this can have a sallow or yellow … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions

My question is regarding my boyfriend, who is a type 1 diabetic and has kidney disease. In May of this year, his GFR was 80 and now today his GFR is at 18. His kidney doctor is speaking of dialysis and saying he needs to find a treatment center before his appointment in a month. He is supposed to limit potassium and phosphorus in his diet, and drink a quart and a half of fluid per day. My question is, he seems to be doing worse everyday and his face is a little swollen more and more each day. Are there any remedies that can help his kidneys function a little better such as natural remedies that he may take or drink? What do I do to help him make it until next month?

If dialysis is indicated, there are no herbal or dietary supplements that will help someone with advanced kidney disease. If he is having increasing symptoms, I suggest that your boyfriend contact his nephrologist for advice.

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, GFR, Herbal Supplements in Kidney Disease/Failure, Kidney Failure, Kidney-Related Health Questions, Nephrologist

Hi, My mother needs a hemodialysis access for her failing kidneys. She has been as low as 12% but the latest is 17%. She had pre-op testing to form a fistula, and scheduled surgery. At surgery, she was put under, and an ultrasound determined that her veins/arteries would not support a fistula. Now she is being advised to have a graft and has it scheduled a week from today. So my question is: If an ultrasound can determine the viability of a fistula, is it not worth having another exploratory ultrasound done to be sure there is no location that a fistula would be fabricated? And while there under the ultrasound, if it is verified that her veins are too weak, at least they could view and make a plan for the graft ? The surgeon’s decision to not do the fistula was one persons view at one point in time. Should we not seek further verification? Thanks you.

I am a nephrologist and not a surgeon. In this instance, a repeat ultrasound and Doppler examination is unlikely to show new findings. The size of the veins and arteries do not change in a short time. A graft in … Continue reading

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

I recently came down with an upper respiratory infection, one of its side effects being a chronic coughing, for which Benazonatate, 100 mg, 3 x daily for 10 days, has been prescribed. I’ve read of some 4000 instances of kidney failure among Benazonatate users. How safe is Benzonatate for me. Age 77, GFR 46?

Any drug may have uncommon and rare side effects, including acute kidney injury.  Benzonatate is not a common cause of kidney injury.

Posted in Ask the Doctor, GFR, Kidney Failure, Kidney-Related Health Questions