Category Archives: Kidney Failure

I started home hemodialysis about 10 months ago and I’m concerned about shortness of breath that I’m having recently. I am trying to figure out a number for the amount of fluid I can safely remove in a run of dialysis. I found a formula that says under 10mL/kg/hour is safest but I tend to break medical formulas. I am 7 feet tall and my dry weight is approximately 173kg; I am about 25% overweight (my ideal weight as far as anyone can tell me would be about 135kg). Using this formula I calculate I can remove almost 7L of fluid in a 4 hour run and still be in the safest range for CV complications. I am currently removing a maximum of 4L in a 4 hour run but recently this doesn’t seem adequate as I have had to have several “catch-up” dialysis sessions to keep my fluid weight down. Does this formula work for me? If needed can I safely remove more than 4L during a run? I should add that I have high blood pressure that never goes low after HD.

Very large individuals, such as yourself, have a very hard time maintaining fluid balance with dialysis only three times per week.  While the formula that you mention is one that I also use, it may not be appropriate for large … Continue reading

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

My wife is 51 years old. Her creatinine level was always below 0.97. On 18 April, her creatinine level rose at 1.41 and gfr was at 51. On 25 May her creatinine level was 137.6 umol/L and gfr went down to 37. In the 1st investigation period she was having fever and in the 2nd investigation period she had coughing. Now her creatinine level is 1.55 even though she is on 30gm protein level diet plan. What is the cause of quick drop of her gfr?

I am unable to make a specific diagnosis based on the information that you present.  This appears to be something that is causing acute kidney injury.  I recommend consultation with your physician and further testing as to why she is … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects

Good health to you doctor! It’s been 2 months since I go through hemodialysis procedures on the Artis machines. Upon admission to the hospital, urea 26, creatinine 1300. There were no external factors of chronic renal failure. After the procedure of hemodialysis, the legs and feet began to swell for the 5th time. Can you please tell me how to make a hemodialysis program correctly? To me 52 years, the dry weight of 89 kg, body height of 188 cm.

I am unable to recommend dialysis treatment without performing a complete history and physical examination.  I suggest that you discuss your concerns with your nephrologist.  If you still have swelling in your legs and feet, then perhaps more fluid must … Continue reading

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

I have kidney disease and I had my right kidney removed from failure 5 years ago. My creatinine level is 1.45. Is that bad? The ER said I am not too good. I keep gaining weight. I don’t feel good. Just like I was feeling when I lost my other kidney. What is making my stomach feel like a baby kicking me inside and how can I tell if I’m in failure again?

You must consult with your physician.  I am unable to make a specific diagnosis based on the information that you present.  You will need to have further testing done including blood and urine testing for kidney disease and possibly a … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

How rare is “Humoral Rejection” and what if any are the advances in medicine for it? “Wegeners Granulomatosis” is what my friend had. He has no kidneys and has had 3 failed transplants. He is now being told he is no longer a candidate for transplant. He is under 30. Can you give me all the information you have on this? I want to research as much as I can and see if he has any other options.

Humoral rejection is a form of rejection that is caused by the B-cell side of the immune system.  Cellular rejection is the other form of rejection that more commonly occurs in kidney transplants.  Humoral rejection is very difficult to treat … Continue reading

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

I’m a 49 yr old male. My height 5′ 6″, weight 97kg . I’m a diabetic. Blood pressure and kidney patient. My creatinine is increasing day by day and has reached to 4.3. Suggest me how to reduce my creatinine.

As your kidney disease progresses, the only way to lower the serum creatinine is with dialysis or transplantation.  I suggest that you discuss your options with your nephrologist.  You should be planning what to do in case your kidneys continue … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Failure, Kidney-Related Health Questions, Transplantation, Treatments

I have a catheter. I have had it for 15 months (it was placed after I had a triple heart bypass). My problem is that my veins in my arm are to small for a fistula. My Doctor put one in my arm. It didn’t work and there were so much pain in my arm and I lost circulation in the arm. The Doctor went back in and closed it off and started circulation again. The veins in my right leg were used for the bypass. My question is can the catheter be moved from side to side in my chest. The one that being used is one that can stay for 2 yrs. I have an appointment with another vascular Doctor in July.

The best vascular access for long term hemodialysis is a fistula.  A fistula is associated with the best life expectancy compared to any other option that might be available. If you are eligible for a kidney transplant, that would be … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Medication and Kidney Function, Treatments

Dr. Spry, which physical side effects would a CKD patient have to start showing that would justify either dialysis or a kidney transplant?

Most of the time, chronic kidney disease (CKD) has no symptoms until a great deal of kidney function has been lost.  The most common symptoms of advanced CKD are fluid retention and swelling in the feet and legs, nausea, especially … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Transplantation, Treatments

My father is 60 years old. He has CKD problem last 2 years. We are continuously in touch of our family doctor, but his creatinine level getting increased slowly. Now his creatinine level is 5. So requesting you to kindly suggest us?

I am unable to provide a specific diagnosis based on the information that you provide.  Your father should be seeing a nephrologist for examination and recommendations about treatment of advanced kidney disease.  The nephrologist will evaluate your father, determine the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments

My 88 year old mother has been recently diagnosed with stage III Kidney disease. Her potassium levels were found to be high. She’s already on warfarin to prevent clotting due to a genetic blood factor. The poor thing doesn’t know what to eat and is rapidly losing weight. Her urologist gave her a booklet which lists foods she can’t eat. Those foods coupled with the Vit K list of foods not to eat are leaving her with very little food choices. She’s not able to see a dietician for weeks. I’m afraid she’ll lose so much weight that her kidneys will fail. Can you help with a couple day menu of foods she can eat?

I am a strong advocate for the DASH diet.  The DASH diet will be the best thing for her chronic kidney disease (CKD).  Since she is taking warfarin as a blood thinner, it is important to eat consistently and avoid … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments