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 eGFR has always been between 51 and 53. This month test results shows eGFR of 45. Serum creatinine has always been around 135, this months results are showing 155. Please can you let me know if I need to be worried or if this is an known level of variation. I am already following a healthy diet. Any other suggestions that you can provide to improve my health?

The estimated glomerular filtration rate (eGFR) between 45 and 60 milliliters per minute per 1.73 meters squared is Stage 3a chronic kidney disease (CKD).  These numbers are potentially normal variation and the only way to tell may be to wait … Continue reading

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

A week ago I went to the ER with what I thought was a kidney stone attack. I’m 80 yrs old and in general good health. Some years ago I had an attack and had one or two stones removed from a kidney. In the ER they did a scan to show to their Urologist. The scan showed I had a very large cyst on my right kidney and that cyst, depending upon scan view “slice” showed it surrounding a stone. The left kidney was free of any shown cysts and normal. The scan showed the cyst to be round and symmetrical, not tumor like. At the moment I’m awaiting a decision from the Urologist re how to proceed. The Urologist told me initially upon looking at the scan, “it looks like a very difficult case”. The Urologist has since taken ultrasound views of the affected kidney area supposedly to show and review with a Radiologist. From what I’m thinking, the treatment plan might be for the Radiologist to aspirate the cyst then the Urologist to “roof” the cyst and then go in and remove the stone. After the initial stone, intense pain, I took a couple of pain killers and the severe pain subsided and it’s been “low grade” ever since. Sitting or bending certain ways can bring on the pain, but otherwise it’s continually like a mild tooth ache. It seems to be taking time for my Urologist to come up with a treatment plan and date for a procedure. Is the treatment for my condition one that requires any experience/training beyond what a typical Urologist and Radiologist would be doing on a regular basis. Are there any Medicare _+ Medigap insurance issues covering such a procedure.

I am a nephrologist and have no surgical expertise.  A urologist is a surgeon and has expertise in the surgical treatment of kidney stones and complex cysts of the kidney.  I suggest that you continue to consult with your urologist. … Continue reading

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

At my most recent check up, my microalbumin levels were very elevated. My level was 33. My creatinine was normal, and my ratio was normal. However, I am concerned about the high level of albumin. I do not have diabetes or high blood pressure, but I am overweight. Do I have kidney disease?

I am unable to provide a specific diagnosis of chronic kidney disease (CKD).  If the urinary ratio of albumin to creatinine in the urine is normal, then an elevated albumin concentration in the urine is of no significance.  I suggest … Continue reading

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

My father age is 67 years, wt is 49 kg . Now creatinine level fluctuates between 2 to 3.9 mg and GFR is 22.7 ml/min. I want to know that how increase in GFR. What is stage of CKD & treatment?

There are no treatments to increase the glomerular filtration rate (GFR).  Decreasing GFR is the result of chronic kidney disease (CKD) that destroys the small filters of the kidney known as glomeruli.  Once those small filter are destroyed, they cannot … Continue reading

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

What kind of pain medication can kidney patients take that is safe and won’t damage your kidneys any further?

Acetaminophen (brand name Tylenol) is safe for patients with chronic kidney disease (CKD) as long as doses are under 3000 milligrams per day.  Higher doses can cause liver injury.  Aspirin can be taken for short periods of time and not … Continue reading

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

Canadian health care guidelines allows a CKD patient not to have dialysis even if the eGFR is 6. They say CKD patients can live a normal life even at that low number without dialysis or kidney transplant. Does America health care go by this guideline?

I begin dialysis when I think that dialysis will benefit my patient.  This is not based on any number, but rather , will dialysis improve the symptoms of my patient to the point that the patient is willing to undergo … Continue reading

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

I am a 39 years old. Kindly interpret my result: sugar and protein negative Rbc 2-5 (1+) Pus cells 0- 1 occasional. All were blank except for amorphous urates and squamous cells which are occassional and bacteria few. Thank you.

The information that you supply suggests that this is a urinalysis result.  There are a small number of red blood cells in the urine, but I am unable to make a specific diagnosis based on this information.  I suggest that … Continue reading

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

As a Nephrologist how high could you tolerate the serum creatinine number being before you would seriously consider dialysis or kidney transplant for a CKD patient?

As a nephrologist, I use the serum creatinine as an estimate of kidney function, but the decision to start dialysis requires that I listen to my patient and have them tell me what symptoms they are having and whether dialysis … Continue reading

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

I am writing on behalf of a friend from Turkmenistan. My friend is studying in China and does not know much English, which complicates things. But from what I can gather, his father is having a problem with kidney stones. His father has only one kidney, and last year he had an operation to remove his kidney stones. However, according to my friend, the operation was not that successful because many kidney stones still remain. His father does not want an operation, but wants to know if there is medicine or any other treatment he can have to get rid of the kidney stones. According to my friend, the type of kidney stones his father has are called “korall.” He sent me some photos, and it looks like this many has had a LOT of kidney stones removed already. Do you have any advice for my friend and his father, or do you have any suggestions as to what my next step should be in finding an answer for him?

I am not familiar with “korall” stones.  The problem that you pose is a urological problem.  Consultation with a urologist, who is a surgeon, would be most appropriate. For more information on kidney stones click here:    

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

Dr Spry, are there different ways of measuring egfr? Following the national foundation’s link my son’s egfr is 46 (with wt and height and 41 without wt and height). But according to his doctor it is 37. His creatinine is 2.1, age 30 and height 70 inches and wt 165.

The estimated glomerular filtration rate (eGFR) can be calculated in at least four different ways in adults and three different ways in children.  This does not include the calculation of the estimated creatinine clearance with a Cockcroft Gault equation.  I … Continue reading

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