Category Archives: Kidney Failure

Hello, my mother is 86 years old with advanced dementia and is in renal failure. We are signed up for home hospice and are providing comfort care only. She has never had dialysis. She has all typical symptoms, itching, weakness, confusion, in addition to hiccups. She has recently started vomiting and is experiencing tremors. In her comfort care medication pack, her hospice doctor has prescribed: Prochlorperazine (10mg) every 6 hours as needed for nausea and vomiting; Lorazepam (0.5mg) every 6 hours as needed for anxiety/sundowning; Diphenoxylate-Atrop 2.5-0.025 as needed for diarrhea. Some research has suggested that hospice medications are general and frequently geared more towards cancer diagnoses than renal failure. Since her kidneys are not functioning, will these medications build up in her system and do more harm than good? The Diphenosylate has helped the diarrhea tremendously. I have only given her Lorazepam once. I haven’t started the Prochlorperazine, but if her vomiting increases, I would like to alleviate as much discomfort as I can. Your thoughts on end-of-life comfort care medications for patients in renal failure would be very appreciated. I want to make her as comfortable as possible. Thank you.

The three medications that you mention, Diphenoxylate/atropine, prochlorperazine, and lorazepam are all metabolized by the liver and do not require changes in dosing for kidney failure. I do not think there should be any change in dosing for your mother … Continue reading

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

My father, age 86 years and has a failure in one of his kidneys. Now he has a 3.00-3.2 creatinine and 68-90 Urea nitrogen and his pressure sometimes is not stable. I ask for your help to know how to protect him and what is the best food program to treat his case. What must he avoid in terms of medications and foods? Best regards.

I am unable to make a specific diagnosis based on the information that you present. Recommendations for diet and medications would require that I perform a complete history and physical examination. Many elderly will have a hard time following a … Continue reading

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

I have ESRD and have not started dialysis and I just found out I have a mass on my right kidney. If found cancerous, the fix is to remove part or all of the kidney. My question is, will I still be able to avoid dialysis for a few more years? I’ve been ESRD for more than 8 years ago, when they wanted to put me on but I had a wait and see approach, being very careful about intake and I’ve been maintaining. Could I maintain the current level of filtration with one kidney? Thank you.

I am unable to offer a prognosis based on the information that you present. I would need to perform a complete history and physical examination in order to offer a prognosis. If you lose one kidney and maintain the other, … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Nephrectomy / One kidney

My boyfriend was recently diagnosed with stage 5 kidney disease as well as heart failure (had a heart attack). Due to his blood pressure, it is delaying dialysis. I have concerns as to how the delay will effect him and when is the wait too long. He has had congestion for some time, even before the diagnosis and remains stuffy and breathing seems to be labored. His blood pressure still has not come down as they would like. He has had a lot of weight loss and I am noticing his skin being slightly darker. He is also getting mixed instructions on what he should and shouldn’t eat. Not sure if it is because they are dealing with three issues, the heart, blood pressure and the kidney failure.

I am not able to make a specific diagnosis based on the information that you present. I am not able to provide medical treatment suggestions without performing a complete history and physical examination. Your boyfriend sounds very ill and he … Continue reading

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

What is the possibility of help for my Mom? She has PKD and her kidneys have catalyzed, which means they are not filtering anymore. She is only 53 years old and currently is in the hospital. She is right now using fluids to hopefully flush out and bring her creatinine level lower from a 13 and lower her blood pressure which has been almost 200. My grandmother, her Mom, died after 10 years of being on dialysis and my Mom’s sister has just started at age 52, 4 years ago. And kidney transplant, I believe, is the answer vs years of dialysis treatments.

I am unable to offer treatment suggestions without performing a complete history and physical examination. I suggest that you continue to consult with the physicians and the nephrologist, who are currently caring for your mother. I would agree with you … Continue reading

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Nephrologist, Polycystic Kidney Disease, Transplantation

Dr. Spry, I was curious as to how long conditions such as diabetes and/or high blood pressure take to develop damage to the kidneys, or to be classified as either in Stage 1 or 2 of CKD. Also, how common is it for a person underage the age of 30 to be diagnosed with CKD from these conditions. A 24 year old male with a history of amphetamine abuse is concerned that they cause blood pressure spikes if he is at risk for CKD in the near future. Just had a GFR test and had a .81 serum creatinine level but no urine test. If you could give us your best insight into this matter that would be greatly appreciated, thank you so much in advance for your input.

Amphetamine abuse (and other forms of drug abuse) can cause chronic kidney disease (CKD) without involving high blood pressure. The high blood pressure can certainly cause CKD and is the most common cause of CKD in the US today. In … Continue reading

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

Can I use any antibiotic or penicillin with kidney failure? I have 10% kidney function on both sides and have little spots on my body and face and then it turns into sores?

The most commonly used penicillins do not require dosage adjustment with kidney failure. The doses of some antibiotics must be adjusted in patients with kidney failure. Your physician should be aware of your kidney failure and adjust the dose of … Continue reading

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

How long does it take for a kidney problem to start? Because July 2017, I checked my thyroid level. At the same time, lab report added urea -24 level also. Then, Nov 2018, I checked my full body test. Now my creatinine is 7.9. Consulting with doctor. They say it is failure and my kidney shrunk. But I have no symptoms.

It is very possible to have kidney failure and not have any symptoms until someone starts to lose appetite and lose weight. In some cases, it is impossible to know what started the kidney disease and exactly when it started. … Continue reading

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

Hi! My mother is undergoing dialysis since last year, however instead of getting better after the dialysis, she’s more often got exhausted. Her current ultrasound has a remark of nephrolithiasis right – small stone measuring 4.19mm and mild hydronephrosis grade 2 left. These are medical terms which I want to understand more. Can you please simplify and explain her condition in English or common languages that we could easily understand? Further, is dialysis only remedy for her or other means of medication will do? Your reply would be highly appreciated. Thank you.

The ultrasound report that you mention suggests that there is a kidney stone in your mother’s right kidney that measures 4.19 millimeters in diameter. There is also changes in the left kidney that suggest a mild obstruction. This does not … Continue reading

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

My father of 75 is on his 23rd year of receiving his kidney transplant. His eGFR fluctuates from 12 -28, creatinine above 4. He has started dialysis 6 months ago. His nephrologist wants to stop the two immunosuppressants, completely. What could happen to the transplanted kidney if/when rejected by the body? Does it have to be surgically removed?

This is a difficult question to answer. There are many factors that have to be considered, such as the exact immunosuppressants that are to be stopped, your father’s underlying illness, the risks with continued immunosuppression in a dialysis patient, the … Continue reading

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