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!

I have only one kidney. My left kidney was removed because of a cancerous tumor. To maintain my urological health, how much water or other fluids should I drink daily? Thank you for your helpfulness. I look forward to receiving your recommendation.

It is not possible to recommend a specific amount of water that will handle all individuals, in different climates and differing degrees of physical activity. Each person is unique and despite the fact that you have had one kidney removed, … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

I was born with unilateral renal agenesis. I am a 73 year old female, obese and a T2 diabetic. I have people pushing the “keto” diet at me all the time. I am fighting to maintain an A1C of 7.0 or below. I have RA, no access to a pool for water exercise and am unable to walk for more than half a block. I am desperate to lose the weight and get all of this under control. But I have a creatinine level of 1.27. I was warned against these high-protein/fat diets because they can cause ketosis which is not good for my situation. There are articles all over the internet claiming that it is good for kidney function. I don’t see how. I am keeping my digestible carbs low, eating lean poultry and fish and low-carb vegetables, 1000 to 1200 calories and doing “sit and be fit” exercises. I feel like I am doing what I should. How can I access the information I need to make the keto freaks back off?

There are many “ketogenic” diets but the critical concern has to do with protein and sodium intake. If the ketogenic diet emphasizes substitution of protein for carbohydrate calories, then this will usually result in excess protein intake. If the diet … Continue reading

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

I recently looked at my lab results from an ER visit and my GFR was 57.99. I am a 54 year old female with high blood pressure recent heart attack. Should I be concerned is that stage 3A kidney failure?

In order to qualify as chronic kidney disease (CKD), it is necessary that the estimated glomerular filtration rate (eGFR) to be less than 60 milliliters per minute per 1.73 meters squared and be present for at least 3 months. A … Continue reading

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

I am 52 years old. Caucasian female. Morbidly obese. Former smoker, suffers from chronic lymphedena times 10 years. I have chronic edema of lower extremities. I have recently lost 75 pounds and stopped smoking. A1C runs 5. My GFR has been falling steadily during my every 90 day bloodwork. Today it was 58..last 3 months 65 and prior 75. I have chronic pain (severe) and have used Ibuprofen and Indocin either or not both. I am getting scared.

The Ibuprofen and Indocin (indomethacin) that you mention, both decrease kidney function. I recommend that you review your concerns with your primary care physician (PCP). You may need to stop using these non-steroidal anti-inflammatory drugs (NSAID’s) in order to preserve … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

Recent blood test reported gfr of 58 when normal range starts at 59 (Labcorp). I am 71, almost 72. All other items on Metabolic Blood Panel are within normal limits. Should I be concerned?

In some cases, the estimating equations that we use to calculate the estimated glomerular filtration rate (eGFR) will underestimate the true GFR in elderly females. This is one criticism of the equations. Hence, I recommend that you also have urine … Continue reading

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

Hello Doctor, I recently had a renal artery duplex scan because of a gradual elevation of my BUN 30 to 33, serum creatinine 1.38 to1.44, GFR 52 to 49, bun/cr ratio 22, and urinalysis normal. I am 70 yrs old with strong hx of atherosclerosis (cardiac stents & bil endarterectomy) and on lisinopril and metoprolol, aspirin and statins. MD looking for renal artery stenosis from my history. Stenosis not found. However right kidney incidental findings of a cyst (1.64×1.4×1.4 cm) and a homogenous mass in central area of renal cortex 3.4×3.3×3.1cm with vascularization. Renovascular resistance of right kidney increased. I am completely asymptomatic. Could the homogenous mass with vascularization represent malignancy or preferably benign ie angiomyolipoma? Will MRI be next step or biopsy? Are these lesions causing my elevation of my renal functions (increase renovascular resistance?). If results unfavorable, cyst removal or nephrectomy? Thank you

The problem that you describe is a urological problem. I am a nephrologist and I have no surgical expertise. A urologist is a surgeon and would have expertise in the differential diagnosis of a kidney mass. I suggest that you … Continue reading

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

I had a kidney infection and was given IM and oral antibiotics. Infection was resolved but I continue to have kidney pain. It has been 4 months since infection. Is there something else going on?

I am unable to make a specific diagnosis based on the information that you provide. Pain is an unusual presentation for kidney disease, but it could suggest a residual infection of the kidney or stone disease. I suggest that you … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions

Dear Doctor, I was born in dallas Texas with Beckwith-Wiedemann syndrome. Now I am 39 years old. Last 10 years it was all right. Just in my kidney, I have stones and they told it is a Sponge Kidney. Can you advice me to follow with a specialist regarding my case?

I have no experience with the Beckwith-Wiedeman syndrome. I do not know of any association with Sponge Kidney. It is mostly associated with tumors of the kidney and occasional Wilm’s tumors of the kidney. I would recommend that you see … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Medullary Sponge Kidney, Nephrologist

In 2011, I wound up in the hospital with ESRD. I am diabetic. My kidneys came back to stage 3 ckd. Now I retain water as I loose that water my kidney function goes down. My gfr was 43 than went down to 38 now it is at 32. If I loose more water it will be lower. I was wondering what foods I should avoid & which ones I can eat at this time?

You should follow a low salt diabetic diet. I recommend that you limit your sodium intake to less than 2300 milligrams per day. I am a strong proponent of the DASH diet. You can review the DASH diet at: reading

Posted in Ask the Doctor, Diabetes, Diet/Nutrition, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions

My father is age 92 and his blood urea is 80mg/dl and creatinine is 4.6mg/dl. His legs have swelled and urine is normal. Now what should I do?

You will need to seek consultation with a nephrologist to see if there is any way to reverse your father’s kidney disease. At age 92, he would have a very bad prognosis for dialysis treatments. Your father should be consulted … Continue reading

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