Category Archives: Ask the Doctor

Do you have any questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask away. Dr. Leslie Spry is happy to provide answers to all your kidney-related questions. Check back soon for answers!

Will abandoning my NSAID help my kidney function? Background: I am a 59-year-old woman, thin, low to normal BP, no drinking, no smoking ever. Diagnosed with autoimmune ankylosing spondylitis in 1989–full blown. History of back problems in teens. Have been on relatively high dose NSAIDs since 1989, which is credited for my decent range of motion despite entheses in various places. My creatinine has been gradually going up and my GFR is now 54, Creatinine 93. Is this to be expected of someone my age? Is it too late to make a difference, to stop the NSAID?

The long term use of high dose non-steroidal anti-inflammatory drugs (NSAID’s) is associated with progressive chronic kidney disease (CKD). This is especially true when combined with acetaminophen (Tylenol) or phenacetin (analgesic powders). If you are seeing a decline in your … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Medication and Kidney Disease

I am 41 yrs old and had a nephrectomy last year to remove a kidney that had failed me. My current gfr is 58, my creatine is 1.05 and my blood calcium is 10.3. Having a higher blood calcium concerns me. Are there things I can do to lower this number? Also, is my gfr typical for having one kidney? Thank you in advance.

I am unable to explain the mildly elevated calcium level based on the information that you present. An estimated glomerular filtration rate (eGFR) of 58 is normal for a single kidney. I suggest that you consult with your physician for … Continue reading

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

I am a 65 year old female with one kidney. The second kidney was removed due to a car accident when I was 16. Prior to 2016, my GFR has been stable and in stage 4. From January 2016 through July 2017, the GFR on my remaining kidney dropped 6 points from 63 to 56. In July, after getting this information, I went on a low sodium, low potassium, low protein diet. In October 2017 my blood work was re-checked and my cholesterol jumped from 206 to 284 my BUN was 25, Creatinine was 1.1 and my GFR had dropped another 6 points to 50 which is stage 3. I am stunned at my readings and at a loss as to why my GFR has dropped 13 points in less than a year when they have been stable. My doctor is an internist and I wonder if these kind of changes would warrant a visit to a specialist or a renal dietitian. Thank you.

I am unable to suggest a reason why your kidney function would decline. I do not recommend a low potassium diet or a low protein diet. I recommend the DASH diet. The DASH diet is a high potassium and low … Continue reading

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

I am a diabetic, since 2000, and I have problems sleeping at night. I also urinate 3-5 times at night. I take Metformin/Glibencamide 3x daily, as prescribed by my doctor. Grateful for your response at your convenience. Regards.

Passing urine during the night can be a sign of kidney disease or your diabetes not being well controlled. I suggest that you discuss your concerns with your primary care physician (PCP) and ask for further testing. This is a … Continue reading

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

I am suffering from essential hypertension for more than 20 yrs (BP not more than 140/95 mmhg at first) and taking drugs for lowering BP like Dytide, Natrilix etc. I am taking Losartan potassium + Hydrochlorothiazide for last 15 years and BP is now more or less 130/85 mmhg, taking thyroxine sodium 75 mcg for last 6 months. I am suffering from Gilbert’s syndrome from very beginning. My Creatinine is over 1 mg/dl for last 10 years. At last it is 1.25 mg/dl (now I am 46 yrs old) Indian, wt.69 kgs.FBS 89 PPBS 133 HbA1C is 6.1, Ca+ 10 mg/dL PO4 4 mg/dL, no protein, sugar, ketone bodies found in urine R/E. Potassium 4 mg/dL, Total cholesterol 195mg, LDL 110 mg, HDL 54 mg, SGPT 74 mg, SGOT 45 mg, Uric Acid 6.64 . GFR calculator shows eGFR is 62-74% which is type II CKD. But my Doctors of Kolkata, India say that no medicine is available for this stage, and continue all medicines as previous. Is it really CKD? May it rise further? What is latest medicine to roll back creatinine level to below 1mg/dL or to rise eGFR to above 90%? Please advise.

I agree with your physicians in India. There are no medications which cause a decrease in the serum creatinine or an increase in the estimated glomerular filtration rate (eGFR) that is sustained and beneficial to the kidney in the long … Continue reading

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

Is it necessary to weigh yourself daily in the early stages of CKD?

I do not have my patients weigh themselves daily. I do think that taking your blood pressure and recording your weight once every week or two can be very informative when you visit your physician. Hence, if you want to … Continue reading

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

DEAR DR.SPRY, GREETINGS FROM GREECE. WHAT IS THE SIGNIFICANCE OF A LOW URINARY UREA READING OF 14.6 g/24h..normal values here are19.0 to 36.o..I AM 88 YEARS OLD. MY GFR CATEGORY IS G 3a (55ml/dL/172M2)…..MY ACR IS 2.5mg/gr creat. THE URINE DIPSTICK TEST WAS NEGATIVE FOR ALBUMINURIA. THE MAIN PROBLEM IS FREQUENCY OF URINATION AND NOCTURIA. THANKING YOU IN ANTICIPATION FOR YOUR KIND HELP TO A COLLEAGUE IN GREECE.

The urine urea nitrogen is a reflection of how much protein nitrogen that you are eating as part of your diet. At your older age, you may not be eating as much protein as a younger person might and hence … Continue reading

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

Hello, I recently had a painful varicocele, where at the recommendation of an online post, it said to take magnesium sulfate or epsom salts (which have magnesium sulfate), to dilate vessels, to then try to unblock the testicular varicocele. So I did, in my desperation to try to relieve the pain, but I foolishly miscalculated the amount of epsom salts to ingest, and took 15 teaspoons of it, where the next day, I felt very sick, back pain, headache, feeling very cold, muscle cramping, and even a sensation that I was going to pass out. Obviously, I took myself to an ER, and low and behold, after doing a blood test, my GFR was at 55 and my creatinine at 1.49. They put me on an IV, but then discharged me. I began watching what I was eating, as I noticed if I ate anything too heavy, around 6 hours later I began to get back pain and headache. A few days later I began to feel better, but then about a week later I began to feel sick again, with back pain and headache again. I did get some bloodwork done again a few days ago, and my GFR has gone up to 68, and my creatinine has gone down to 1.39. So, because I am still feeling pain, 3 weeks after consuming that high dose of epsom salts, I’m very concerned, so my questions are, 1. Could I have possibly permanently injured my kidneys with such a high intake of epsom salts, or can I expect to make a full recovery? 2. And if so, what is a reasonable expectation of recovery time from an acute kidney injury in my particular case. 3. Also, I’d like to know what type of injury could be possible with such a high intake of epsom salts, could I have introduced kidney stones, could I get introduced a certain type of damage to the kidney, could there be other organs involved that I’m not considering when it comes to digestion of epsom salts that could’ve been harmed by it? 4. Also, would the body have expelled all those epsom salts already, or would it have accumulated somewhere, maybe in the kidneys, or somewhere else in body where it would take a long time for the body to get rid of it? 5. And, other than bloodwork, what tests could I conduct to check the health of my kidneys? I’ve never had kidney problems in the past. 6. Any foods I should avoid while I heal? I’ve been abstaining from meats and sticking to fruits and vegetables. I will never again make a foolish mistake such as this, I learned my lesson and am alive to tell the tale. I hope I get better, and not worse. I’m sad and wanna kick myself for being such a fool.

Epsom salts and magnesium sulfate can both cause dehydration and severe diarrhea, but are generally not directly toxic to the kidneys. I am unable to make a specific diagnosis in regards to your kidney disease, based on the information that … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

My wife is 28 and was operated for PUJ 4 yrs back. She regularly had issues with UTI post operation. Recurring fever whenever gas formation took place. DTPA report suggested 60-70 % working of one kidney. She is infected UTI and culture reports suggest resistance mostly. We got married last year. Will she require to remove one kidney. Will she get pregnant? I would mail reports. I beg for your support.

The questions that you ask are urological questions. I am a nephrologist and not a surgeon. You will need to consult with a urologist in order to answer these questions.

Posted in Ask the Doctor, Kidney-Related Health Questions, Urological Issues

I was diagnosed with polycystic kidney disease two years ago. I changed a recommended kidney health diet and light excercise. Lately I have been having pain in my kidneys and adrenal glands along with low energy levels. I have not had a check up since I was diagnosed. What should I do?

Patients with polycystic kidney disease (PCKD) may often experience pain and discomfort from time to time related to cyst growth and cyst hemorrhage. You should avoid wearing tight fitting clothing. You should avoid all forms of caffeine. Light exercise and … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Exercise, Kidney-Related Health Questions, Polycystic Kidney Disease