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!

My mother is 84 years old. She had dialysis for almost 4 years and had her last treatment on 12/22/17. She decided that she no longer wanted to have treatment. Her decision totally. The dialysis treatment was brutal and literally killing her. My question – she entered into home hospice the first of January 2018. As of today, she has not had dialysis for 80 days. She is also still producing urine – while not like she was before. She has always urinated more than anyone I ever known that was on dialysis. While I know she was probably not filtering the toxins out, she was still urinating a lot. She is confused – which is normal, very little intake of any kind. I know my mother is a strong woman. We are just so puzzled by the length of time since her last treatment. By no means do we want her to die, but from what we were told/reading, we thought she would go quick – like usual ESRD patients who stop dialysis. Thank you.

The length of time that one can go without dialysis is variable and dependent on the underlying state of health of the individual. For individuals who have been on dialysis for more than 6 months, such as your mother, the … Continue reading

Posted in Ask the Doctor, Dialysis, End of Life Issues, Kidney-Related Health Questions

Hi Doctor, I had a creatinine serum test done two years ago and the result was 0.6 and I just had one done last month and the result was 0.9. All other tests were good. Please, I would like to know what caused the increase, even though am still within the normal range? I am a 41 yr black female. Thank you.

The most likely explanation is a difference in the laboratory testing from day to day.  I am unable provide a specific diagnosis without knowing your complete history and performing a physical examination. The measurement of the serum creatinine by the … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Serum Creatinine

I have lab results of creatinine at 2.21. The level was 1.6 five months ago. I have had my bladder and prostate removed. What stage am I at?

I suggest that you go to our web site and use the estimating equation for the glomerular filtration rate (eGFR). This will then allow you to estimate your Stage of chronic kidney disease (CKD).

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

My 88 year old grandfather has stage 3b CKD but is otherwise in good health besides suffering from high blood pressure. He is presently taking Diovan/HTC 80/12.5 mg, Monopril 5 mgs and finally Amlodipine 5mgs. His personal physician wants to increase his BP meds because he found it too high on his last checkup. Given the fact my grandfather takes Diuretics, ARB’s, ACE’s and CCB’s each with its own mechanism of action. What category would be the best choice to increase in order to safeguard his kidney? I have heard that Ramipril (=Monopril?) is the best choice. Also his kidney specialist has prescribed Sodium Bicarbonate 500 mgs x 3. Could the salt content in these pills be contributing to the increase in BP? Thank you for all your great work!

Diovan (Valsartan) is an angiotensin receptor blocker (ARB).  Monopril (Fosinopril) is an angiotensin converting enzyme inhibitor (ACE-I).  I do not recommend the use of both an ARB agent and an ACE-I agent for blood pressure control in patients with chronic … Continue reading

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

My mother was diagnosed with CKD stage 3B. It is now stage 4. Last test showed her kidneys are only functioning at 23% their normal capacity. I have type O negative blood. If I turn out to be a perfect match, can I donate my kidney anonymously to my mother by contacting her doctor? My sister is power of attorney and claims the doctor said she’s too old to get on a donors list and because her disease is related to high blood pressure, she is automatically disqualified to be on the list. I find this hard to believe. She’s 68 years old. I’ve asked my mum if she’d take one of my kidneys and she says no because I might need it later. If it will save her life, I would do anything. So I’d like to know if a person can anonymously donate a kidney to a family member without the family member having to know where it came from. Thank you. The time before last, her kidney functions where at 28%. Now they’re 23%, so she’s losing them fast and I’d like an answer as soon as possible. Thank you.

I order for you to donate a kidney, your mother must first be evaluated to make sure she is eligible for listing on the transplant list.  In order to be evaluated, her estimated glomerular filtration rate (eGFR) must be less … Continue reading

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

My father is above 60 years old. Recently he was facing some problem with urine. So he had a test and it says: urine microalbumin- 360mg/L, urine creatinine-1.03 gm/L, Micro Albumin Creatinine ratio 350mg/gm. What does it mean? Is it a kind of kidney damage?

Albumin in the urine (albuminuria) means that some damage has occurred to the kidney as a result of diabetes, high blood pressure or hardening of the arteries (atherosclerosis). Normal albuminuria is less than 30 milligrams per gram of creatinine. Hence, … Continue reading

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

I have Diabetes that is not well controlled at the moment. (Diabetes Doc and I are working on additional treatment options). Sugars before were controlled. I had some blood work done recently which one of the tests showed a BUN/CREATNINE ratio of 27. Should this be investigated further or should I be concerned? I have lots of fluid in my right leg that is being investigated further. Thanks.

The Blood Urea Nitrogen (BUN) to creatinine ratio is a calculated number that is sometimes used to suggest that dehydration may be present.  There are many causes of an abnormal ratio but this usually does not need further investigation when … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

I changed BP meds from Benicar to Valsartan HCTZ and just about the same time my GFR dropped to 40 and creatinine went up to 168. Do you think there is any connection here? If so can this be corrected or is the damage to the kidneys irreversible? Thanks.

The hydrochlorthiazide (HCTZ) is a diuretic and can lead to a slight decline in the estimated glomerular filtration rate (eGFR) and a slight increase in the serum creatinine. Benicar (Olmesartan) and Valsartan (Diovan) are very similar drugs and act in … Continue reading

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

I recently had my yearly physical and received a shock in my blood work. About myself–I’m a 61 year old female, 5’6″, 170 lbs. No previous history (or so I thought) of renal disease. My serum creatinine was 105 umol/L and potassium was 5.6mmol/L. My eGFR is 50. My blood pressure at my physical was 130/86. I’m a former RN and I’ve been upset by all this. I phoned the doctors office and was told that my eGFR has “always been low’ and “that’s just your normal.” Is an eGFR of 50 ever normal? I pressed them, but the Doctor didn’t order any more blood work and no urinalysis. The Doctor had said that my blood pressure is a bit high but that I need to lose weight. Last year my serum Creatinine was 101umol/L, but at least my potassium was normal then. So now I don’t know what to do. I’ve put myself on a low protein, low K diet, and increased my exercise. but I don’t know if I should worry or not.

An estimated glomerular filtration rate (eGFR) of 50 milliliters per minute per 1.73 meters squared is in the range of Stage 3 chronic kidney disease (CKD) if it is repeated and shown to be consistent over more than 3 months. … Continue reading

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

A couple of years ago I had elevated creatinine and BUN. I was taking a lot of NSAIDs (800mg ibuprofen in the morning and naproxen in the evening). Those values would have been elevated for only a couple of months at most. I stopped immediately and the values returned to normal and have not been elevated again since that time. Question one is could that have caused permanent kidney damage or is there even a way to know? Question two is can I take, say, 400 mg of ibuprofen occasionally or for a few days at a time and be safe in doing so?

The long term use of non-steroidal anti-inflammatory drugs (NSAID’s) has been associated with chronic kidney disease (CKD).  If your kidney function tests, such as the estimated glomerular filtration rate (eGFR) and your urine tests have returned to normal, then you … Continue reading

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