Category Archives: Medication and Kidney Disease

I keep getting these red marks on my arms that look like a bunch of broken capillaries whenever I barely bump my arms on things. They go away after a few days but it will happen again with another bump. Is this a product of bad kidneys, age (almost 60) or low iron (I’m anemic) or combo of all?

There are many causes of increased skin bruisability. Aging alone is responsible for loss of skin integrity. Kidney disease can be associated with loss of protein leading to thinning of the skin. Any use of blood thinners can lead to … Continue reading

Posted in Anemia, Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Symptoms and Side Effects | Comments Off on I keep getting these red marks on my arms that look like a bunch of broken capillaries whenever I barely bump my arms on things. They go away after a few days but it will happen again with another bump. Is this a product of bad kidneys, age (almost 60) or low iron (I’m anemic) or combo of all?

Dear Dr. Spry, for IGA nephropathy fish oil is recommended. Given so many brands and levels of pollutants, can you suggest one that is better and that you recommend to your patients? Also will the plant based (algae) Omega 3 have equally good impact? Can my son have that instead? He is stage 2 (kidney function 79 percent) but has mild proteinuria. He is also taking Losartan for proteinuria though he has normal BP. Many thanks.  

The use of fish oil for treatment of IgA nephropathy is predominantly based on the results of a single study at the Mayo Clinic: https://pubmed.ncbi.nlm.nih.gov/10446945/ The drug that was used was omega-3-acid ethyl esters similar to the prescription drug known … Continue reading

Posted in Ask the Doctor, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function | Comments Off on Dear Dr. Spry, for IGA nephropathy fish oil is recommended. Given so many brands and levels of pollutants, can you suggest one that is better and that you recommend to your patients? Also will the plant based (algae) Omega 3 have equally good impact? Can my son have that instead? He is stage 2 (kidney function 79 percent) but has mild proteinuria. He is also taking Losartan for proteinuria though he has normal BP. Many thanks.  

I have been taking 50 mg of Atenolol once a day for many years. Today I had my first telephone conversation from the nurse/kidney specialist from my insurance company and she recommended that I take Metoprolol instead because it was less risky for my CKD. (I also take Hydralazine 75 mg 2x a day and Losartan 50 mg 2x daily.)

Atenolol is a very long acting Beta Blocker medication that becomes more long acting when kidney disease is present. It does not injure kidneys but the dose may have to be adjusted as your kidney function declines. Metoprolol is a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Nephrologist | Comments Off on I have been taking 50 mg of Atenolol once a day for many years. Today I had my first telephone conversation from the nurse/kidney specialist from my insurance company and she recommended that I take Metoprolol instead because it was less risky for my CKD. (I also take Hydralazine 75 mg 2x a day and Losartan 50 mg 2x daily.)

I am 33 years old. Should I be worried based on these numbers??? Note, I made sure to be well hydrated for the most recent test. Also, should I discontinue use of Valacyclovir and Allopurinol which was started in July 2021? Here are all the numbers: Serum Creatinine: 1.43 in 2019, 1.40 in July 2021, 1.43 in September 2021. BUN: 17 in 2019, 15 this month. BUN/Creatine ratio: 12 in 2019, 10.4 this month. All urinalysis came back in normal ranges. No protein in urine.

I am unable to make a specific diagnosis based on the information that you present. These numbers could be normal depending on your body size and muscle mass. I am unable to recommend medication without performing a complete history and physical … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function | Comments Off on I am 33 years old. Should I be worried based on these numbers??? Note, I made sure to be well hydrated for the most recent test. Also, should I discontinue use of Valacyclovir and Allopurinol which was started in July 2021? Here are all the numbers: Serum Creatinine: 1.43 in 2019, 1.40 in July 2021, 1.43 in September 2021. BUN: 17 in 2019, 15 this month. BUN/Creatine ratio: 12 in 2019, 10.4 this month. All urinalysis came back in normal ranges. No protein in urine.

Hello, I recently had blood work done that showed my GFR is 57 and would like additional information on kidney disease. I showed positive for Albumin in my urine and have taken extremely high doses of NSAIDS for over 30 years. I am a white female, age 53 years old and am not happy with my internal medicine doctor just calling it a sluggish kidney. I have flank pain, malaise, shortness of breath walking from room to room, cold a lot, extreme itching all over primarily on my back, insomnia, nausea, heart palpitations, extreme muscle weakness and fatigue/pain in them. I need a Nephrology doctor, don’t I? Thank you so much. 

I am unable to make a specific diagnosis based on the information that you present. The use of Non-Steroidal Anti-Inflammatory Drugs (NSAID’s) in high doses for many years can cause chronic kidney disease (CKD). If that is the case, stopping the … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Nephrologist | Comments Off on Hello, I recently had blood work done that showed my GFR is 57 and would like additional information on kidney disease. I showed positive for Albumin in my urine and have taken extremely high doses of NSAIDS for over 30 years. I am a white female, age 53 years old and am not happy with my internal medicine doctor just calling it a sluggish kidney. I have flank pain, malaise, shortness of breath walking from room to room, cold a lot, extreme itching all over primarily on my back, insomnia, nausea, heart palpitations, extreme muscle weakness and fatigue/pain in them. I need a Nephrology doctor, don’t I? Thank you so much. 

My father who is 72 has been in the ICU for Covid related complications since August 2. He has been sedated most of the time but is now more lucid. During the time in ICU, he became a dialysis patient as well. Prior to becoming ill, he was a very strong and physically healthy person who walk/jogged 50 miles per week and lifted weights. He was on seroquel and Welbutrin for his mental health challenges (bi-polar and anxiety). His doctors do not want to put him back on the Wellbutrin, they say for kidney reasons. Now that he is more lucid, he is crying all the time. He cannot speak because he has a trach now. He will be transferred to an LTAC setting next week. I want to know your recommendations for his mental health meds now that he is on dialysis. The ICU doctors don’t seem to worry too much about it because it isn’t “emergent” but he has a long way to go in rehab and being mentally prepared, or at least not crying continually, will be important. For now, they are giving him Valium to keep him calm.

I am not a mental health professional and I am not able to recommend medical therapy without first seeing the individual for a complete history and physical examination. I have taken care of many patients coming out of the Intensive Care … Continue reading

Posted in Ask the Doctor, COVID-19, Dialysis, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function | Comments Off on My father who is 72 has been in the ICU for Covid related complications since August 2. He has been sedated most of the time but is now more lucid. During the time in ICU, he became a dialysis patient as well. Prior to becoming ill, he was a very strong and physically healthy person who walk/jogged 50 miles per week and lifted weights. He was on seroquel and Welbutrin for his mental health challenges (bi-polar and anxiety). His doctors do not want to put him back on the Wellbutrin, they say for kidney reasons. Now that he is more lucid, he is crying all the time. He cannot speak because he has a trach now. He will be transferred to an LTAC setting next week. I want to know your recommendations for his mental health meds now that he is on dialysis. The ICU doctors don’t seem to worry too much about it because it isn’t “emergent” but he has a long way to go in rehab and being mentally prepared, or at least not crying continually, will be important. For now, they are giving him Valium to keep him calm.

What medications can have a detrimental effect on GFR levels?

The list would be very long. The most common offenders are Non-Steroidal Anti-Inflammatory Drugs (NSAID’s) such as Motrin, Ibuprofen, Advil, Aleve, and Naproxen. These drugs should be avoided in patients with chronic kidney disease (CKD). Your primary care physician is … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Nephrologist | Comments Off on What medications can have a detrimental effect on GFR levels?

I am 72 yrs of age. Over the past 2 years, my eGFR ranged from 57 – 65, no protein in urine, normal ACR and BUN. Is it true that we lose 50% of our kidneys by age 60? For my age, male Chinese, medium frame, not muscular, what should be the expected eGFR range? My renal doctor has diagnosed me as stage 3A. She keeps BP to 120/80. There is no medicine. I don’t see any benefits in consulting the doctor. By the way, I read some new medicines like canagliflozin, dapagliflozin and empagliflozin, may be helpful to slow progression. Also, I was recommended to take supplements eg DTS (made from ginseng) and lingzhi mushroom, to support renal functions. Do you have any comments?

The natural loss of kidney function that occurs with age is a loss of about 1% per year (on average) beginning at around age 40. Hence, I would expect your kidney function to be somewhere in the range of 65 … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function | Comments Off on I am 72 yrs of age. Over the past 2 years, my eGFR ranged from 57 – 65, no protein in urine, normal ACR and BUN. Is it true that we lose 50% of our kidneys by age 60? For my age, male Chinese, medium frame, not muscular, what should be the expected eGFR range? My renal doctor has diagnosed me as stage 3A. She keeps BP to 120/80. There is no medicine. I don’t see any benefits in consulting the doctor. By the way, I read some new medicines like canagliflozin, dapagliflozin and empagliflozin, may be helpful to slow progression. Also, I was recommended to take supplements eg DTS (made from ginseng) and lingzhi mushroom, to support renal functions. Do you have any comments?

My dad was diagnosed with polymyalgia rheumatica 2 years ago. He was placed on prednisone, showed improvement, his dosage was lowered, then he began experiencing additional symptoms (i.e. swelling in ankles and feet; fatigue; loss of appetite). Recently, he had a kidney biopsy which showed nephrotic syndrome proteinuria and inflammation of the kidney. His doctor just prescribed him Tacrolimus. Dad is concerned about the side effects of Tacrolimus and is wondering if increasing his prednisone (back up) might help as an alternative, or if there is another immunosuppressant that is not as strong that might be a less risky option?

I am unable to recommend specific therapy without being able to perform a complete history and physical examination. The treatment of kidney disease should be based on a specific diagnosis from the kidney biopsy. That specific diagnosis makes it possible … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Nephrologist | Comments Off on My dad was diagnosed with polymyalgia rheumatica 2 years ago. He was placed on prednisone, showed improvement, his dosage was lowered, then he began experiencing additional symptoms (i.e. swelling in ankles and feet; fatigue; loss of appetite). Recently, he had a kidney biopsy which showed nephrotic syndrome proteinuria and inflammation of the kidney. His doctor just prescribed him Tacrolimus. Dad is concerned about the side effects of Tacrolimus and is wondering if increasing his prednisone (back up) might help as an alternative, or if there is another immunosuppressant that is not as strong that might be a less risky option?

I read that herbal supplements should be avoided. What about herbal teas with turmeric, ginger, or ginseng?

I’m not sure in what context you are referring. In patients who have had a kidney transplant, I am very concerned about taking any new herbals or addition of new dietary habits that can change the way that the immunosuppressive … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Medication and Kidney Disease, Medication and Kidney Function, Transplantation | Comments Off on I read that herbal supplements should be avoided. What about herbal teas with turmeric, ginger, or ginseng?