Category Archives: Medication and Kidney Function

My adult daughter had a kidney transplant in 2007. She has aura migraines and neurologist is wanting her to get Botox injections every 3 months for these migraines that are stroke like. ARE THEY SAFE FOR HER? Our Doctor said he does have much info on it.

I am not aware of any contraindication to the use of “Botox” injections in patients with a kidney transplant or in patients who are using immunosuppressant medication. Your daughter may want to check with her transplant center to see if … Continue reading

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

Dr. Spry, For 80 year old female (my mother) underling cardio surgery with stage 4 CKD, eGFR: 22, Creatinine: 1.99-2.20 mg/dL, Bun: 55 mg/dL, and potential sulfa allergy, it appears there are very limited pain management/medication options available even with ERAS protocol. We have been given Tylenol Extra Strength as only option from cardiology team due to other Rx having contraindications with sulfa allergy and renal/kidney condition. Are you aware of any pain medicines or nerve blockers that we should explore/ask about? Mother also takes carvedilol and candestartan so typically need to avoid NSAIDS. Interested in your opinion about any options from better to worse for us to investigate. We know that pain management is critical to cardio surgery recovery. Thank you.

Narcotic pain medications are commonly used for surgical pain relief in patients with chronic kidney disease (CKD). Narcotics such as hydrocodone, oxycodone, fentanyl and hydromorphone are commonly used in patients with advanced CKD. I suggest that you review these with … Continue reading

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

73 years old diagnosed with stage 5 kidney failure with no symptom at all today. I had to go to urgent care for frequent urination, temp and tremor. The urine test shows UTI. My question to you Doctor, was it safe to give me a shot of Rocephin and 10 tablets of Cefdinir 300 mg one a day? I felt real good only few minutes after the shot. Thank you.

The dose of Rocephin does not change with advanced chronic kidney disease (CKD). The dose of Cefdinir changes from two per day to one per day with CKD. Antibiotics will take at least 4-5 days to be effective but you … Continue reading

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

My husband is 78 years old. His kidney functions were entirely normal until the cardiologist put him on 12.5 mg Hctz/day. When he rechecked in two weeks, his creatinine was 1.52, BUN 24, and GFR 43. Since it was obviously caused by this med and he stopped them in two weeks. Does he have a good chance of his kidney functions returning to normal? Any advise would be greatly appreciated.

I am unable to provide a prognosis without performing a complete history and physical examination. If the decrease in kidney function was directly related to the hydrochlorthiazide (HCTZ), then this should quickly recover, usually within a week. If this was … Continue reading

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

I have been on PPI’s for about ten years. I have been on omeprazole for about the last five years. I am a 66 year old white male, with a slightly elevated glucose level (110). I am 5’9″ and weigh 150. I was placed on PPI’s secondary to gastric ulcers and early Barrett’s; I was also diagnosed with polycythemia 8 years ago which is presently controlled with phlebotomies and daily aspirin (another reason PPI’s were suggested). Recently my creatinine has risen to 1.5 and GFR fluctuated between 57 and 44, and I just began seeing a nephrologist. Should I stop taking the PPI?

There is clearly an association between chronic kidney disease (CKD) and the long term use of proton pump inhibitors (PPI’s) such as Omeprazole and others. An association does not necessarily mean a causation, however. I suggest that you review this … Continue reading

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

Hello, doctor. I’m a mother with a 2 month old baby. I was diagnosed of IgA nephropathy since 2010. Will it still be okay to breastfeed my baby though I’m drinking prednisone and furosemide? I know it will affect my milk, and if so, will I ever breastfeed her again? Or once I stop my medications can my baby still drink my milk?

Prednisone should not pose any risk to your infant as long as you are not on high doses of prednisone. Furosemide is more of a problem. I suggest that you visit with your pediatrician about this and determine what is … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Medication and Kidney Function, Nephrologist, Pediatric Issues

I am a healthy, normal weight, non-diabetic, 31 year old Caucasian female. I have had bloodwork done 3 different times over the course of 2 years and my creatinine is consistently over 1.2 mg/dL and my eGFR is consistently under 60 mL/min/1.73m2. I was recently told the reason could be that I am on the oral contraceptive Ocella, which contains the hormone Drospirenone which has antimineralocorticoid activity and can act as a diuretic. However, the person who told me this, is not a physician. Is it possible for consistent abnormal lab work to be caused by Drospirenone or is that unlikely?

I am not aware of any diuretic activity for drospirenone. Drospirenone is a progestin-like compound and can have some anti-mineralocorticoid activity, but this would cause fluid retention and not diuresis. I am not able to provide any other diagnosis based … 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

My brother-in-law has had a transplanted kidney for 32 years. But it is now failing and must go on dialysis as he waits for another transplant. Since he still has some kidney function left, should he continue to takes his rejection meds so that he can enjoy some kidney function for as long as it lasts? We realize this is a question ultimately for his physician but what is the industry standard practice, so to speak. As an aside, he has been a motivational speaker for NKF conferences.

In most cases, the transplant physicians recommend continuing some anti-rejection medication while awaiting a second transplant. The dose and the types of anti-rejection medication that are continued is often a local recommendation at the discretion of the transplant physician. I … Continue reading

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

Could her renal failure be the underlying cause of the sudden memory loss?? Approximately 6 weeks ago, my 85-year-old Mother lost her (mostly) short-term memory. It was sudden and severe. Tests did not show a UTI but they treated her with low level antibiotics “just in case” – CT Scans and MRI’s are clear, lungs are clear. She has hypertension, high blood pressure, neuropathy, and has been on oxygen 24/7 since February. Until this time, she never had a single issue with memory. In 2004, she had a blood clot go to her kidney causing renal failure and has less than half (maybe ¼) of one kidney. She had one dialysis treatment in 2004 and has not had to have any more. Could her kidney failure be the underlying cause of the memory loss?? There are so many doctor’s involved that no one seems to be able to get on board with a solid answer or consensus. My understanding is that if it were due to a UTI, the memory would return (at least a little) as the antibiotics began to clear up the infection but this has not happened. Can you help me? Perhaps point me in the direction of the right specialist (her PCP, her nephrologist, her heart doctor?????) Besides the memory loss, she has not had any other physical symptoms that have developed in the last 3 months. A lung infection this summer has completely cleared after a (half) round of prednisone (which she forgot to keep taking but had enough to wipe it out, apparently). Mentally, until 6 weeks ago, she played Bridge 3-4 times a week, was president of the residential Independent Living Council (10 years), was in a book club, read at least one book per week for fun, played Mahjong, was very active in her facility, very structured and almost rigid in her routines. Now, she cannot remember where she is (in a rehab facility) and cannot remember why she is in there or what happened 30 minutes ago, or, 10 minutes ago sometimes. Thank you for any help you can offer.

I have not seen this sudden of memory loss be related to kidney disease. From your description, this seems like a very sudden and unexpected event. This might be described as acute delirium. Your mother has a number of very … Continue reading

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

My GFR has dropped from 28 to 17 in a matter of 6 months but my diet has changed for the better, potassium went from 6.1 to 5.1 using Veltassa, staying well hydrated but nobody can explain the quick drop in GFR. My question is my primary care doctor has me on Actos and Glyburide for Type 2 diabetes and my last A1C was 6.8%. I am hearing and reading that I should not be taking Actos but my primary care doctor and 3 different nephrologists say its OK. Please help.

Actos (pioglitazone) in a diabetic drug that can cause fluid retention in patients with chronic kidney disease (CKD), but if you are tolerating the medication well and your diabetes is well controlled based on your HgbA1c, I don’t see a … Continue reading

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