Category Archives: Medication and Kidney Disease

I am a kidney transplant patient and had my kidney for 35 years. I now have to have a CAT scan for bowel screening and have been given laxatives but my bowel is very loose. After having diarrhea, and I am worried about taking laxative they have given me. I don’t want it to stop my immune suppressants to stop working or to loose all my fluids.

I agree with you that you should be cautious about bowel preparations. I suggest that you drink clear fluids such as water and sports drinks to make sure you do not get dehydrated. I also suggest that you discuss your … Continue reading

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

Hi Dr., Why are antimicrobials (like anti-fungal, antibiotic, and antiviral medications) on the list of “5 Drugs You May Need to Avoid or Adjust if You Have Kidney Disease”? It didn’t really go into detail as to why they were on the list. I understand that with CKD, medication tends to build up but with antimicrobials, what are the effects of their buildup? Second, on the same list, it said that upset stomach/antacid medications can disrupt the body’s electrolyte balance if one has CKD. In what way? Please talk about the pathophysiology of this. Thank you.

There are many different antibiotics and each has a mechanism for clearance from the body and each has unique toxicities when dosages are too high. As mentioned in the article, the kidneys are very important in clearing and metabolizing drugs. … Continue reading

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

Is it safe to drink lemon water in the mornings? I have read about the benefits and I like the idea of it but I am eight months post-transplant. I was thinking eight oz of water to a tablespoon of lemon. Will that pose any issues to my transplanted kidney? Thank you.

I have often recommended lemon juice for patients with kidney stone disease and do not think this would affect your kidney transplant. I do not think it would pose a problem for any of your transplant medications, but I do … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Medication and Kidney Disease, Transplantation

I was started on weekly Aranesp injections about a month ago. I read an article that said taking Aranesp can double your risk of having a stroke and can increase the risk of cancer. What are other treatment options for anemia in dialysis patients?

Aranesp (darbepoietin) is a drug known as an erythropoiesis stimulating agent (ESA). It is used to treat anemia in dialysis patients. There are other ESA’s available but all of them have some risks of stroke, heart disease and may make … Continue reading

Posted in Anemia, Ask the Doctor, Dialysis, Kidney-Related Health Questions, Medication and Kidney Disease, Nephrologist

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 dad has stage 3 kidney disease.  He is having trouble sleeping.  Can he take an over the counter sleep aid?  If so, which one?   I am trying to get an appointment with his kidney Dr. but he is wanting me to get him something before I can go see his Doctor.    

I am unable to recommend medical treatment without performing a complete history and physical examination.  Some of the over-the-counter (OTC) sleep aids can interfere with other medication he is taking.  The OTC sleep aids may also have unusual and untoward … Continue reading

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

I have lithium related CKD with a GFR of 19 currently under the care of a good nephrologist and am considering treatment from a registered Tibetan Dr. I take 5 meds for bipolar and have been in remission for 20 years and am wondering if there is any evidence that Tibetan Medicine would interact with these medications or cause any harm to my kidneys.

I have no information about “Tibetan Medicine”. I suggest that you follow the advice of your nephrologist. I am unaware of any scientific studies that suggest that medicine in Tibet is effective in the treatment of any chronic kidney disease … Continue reading

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

I have stage 4 CKD, eGFR 30; creatinine 2.3, borderline to becoming diabetic, overweight, and in extreme pain. I have myleofibrosis, and am transfusion dependent, resulting in very high ferritin levels of 2700+ plus for many years. Now I have hemochromatosis in my hands, cervical spine, etc, which is causing numbness and increased pain. Every time we try chelation therapy to rid the ferritin, my kidneys get worse and never quite recover to previous level when I stop chelation. If I try to go on chelation and allow kidneys to fail, would dialysis help get rid of high ferritin levels?

Dialysis does not clear or remove any ferritin, as this is a storage form of iron and is not free in the blood. Dialysis can help to remove some of the chelation drugs along with free iron.  The chelation drugs … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function

I was on Ramipril for 1 1/2 yrs for high blood pressure which is now normal. At the time of diagnosis, my GFR was 81 and now it is 62. My doctor thinks this decrease was caused by Ramipril.  How long should recovery take?

Ramipril is an ACE-inhibitor and lowers pressures inside the kidney.  I am not sure how Ramipril would be associated your kidney disease.  A normal estimated glomerular filtration rate (eGFR) is greater than 60 milliliters per minute per 1.73 meters squared. … Continue reading

Posted in Ask the Doctor, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function

I have GFR around 48-50 and take 500 mg magnesium each day. I read that people with this GFR should not take magnesium supplements. Is there any research about this?

Patients with advanced kidney disease (usually an estimated glomerular filtration rate or eGFR of less than 15 milliliters per minute per 1.73 meters squared) should avoid taking supplements containing magnesium.  In case the magnesium levels are low (and these levels … Continue reading

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