Category Archives: Nephrologist

Does dialysis warrant daily narcotic use? I am concerned for a dialysis patient that takes a minimum of 6 10mg hydrocodone and 400MG neurontin daily. ESRD, no other current medical issues.

Daily use of potent narcotics in patients who are on dialysis is not usually warranted.  I am unable to make any other specific diagnosis based on the information that you present.  I suggest that the dialysis patient make sure that … Continue reading

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

After removal of stone from my left kidney naturally, I observed frequent drops of pus. I consulted with kidney specialists at SIUT Karachi Pakistan. They, after a series of tests declared that my left kidney has got infection, according to report, Daie Cell observed 0.3%, Tissues 0.2%, Creatinine 2.9, Pus18%, Platelets in blood reduced to 2200, Ultrasound revealed that left kidney collapsed by 0.3 cm. I am feeling pain and pus+ blood mixed drops are continuously discharging. The tests also revealed the presence of infection in cum-discharge. Doctors suggests two options to me. One to immediately remove this infected kidney, the body will be maintained on one kidney which is healthy. Second to undergo Laser Cystoscopic Surgery, in which infected part of your kidney will be cut-cleaned and cured for infection, the option being not available in Pakistan. I was advised to go UAE for this operation. My question to this worthy forum is to suggest me if the treatment of infected kidney is better option or the simply removal of kidney is good one. I am in doubt if this infection may re-occur even after having Laser Surgery..? An early reply is appreciated, please.

The question that you ask is a urological question.  I am a nephrologist and have no expertise in surgery or surgical treatment of kidney disease.  I suggest that you consult with your urologist, who is a kidney surgeon. If you … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments, Urological Issues

What happens to CKD patients who can’t have dialysis or a kidney transplant because of a high risk of bleeding during surgery? What do they do?

I do not understand the bleeding problem.  In most cases, bleeding can be controlled with treatment.  In some cases, major surgery, such as transplant surgery may not be possible, but dialysis should still be possible.  I suggest you ask for … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist, Transplantation

My daddy is 74 yrs. old and almost almost 300 pounds. He has diabetes Type 2, COPD, congestive heart failure and has recently had pneumonia which caused a ton of fluid on his lungs. The Lasix used to help with the fluid is causing kidney failure. Is dialysis reasonable for a quality life?

The decision to start dialysis must be made by your father and a nephrologist based on the his ability to tolerate the treatment and the goals for treatment.  Your father should discuss his desires and wishes with his nephrologist and … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Nephrologist, Treatments

Hello Dr. I am writing to you for my father who is 86 years old. He is diabetic and has a pacemaker implant. Last year, his hemoglobin fell to 8 which was due to bleeding ulcers in the stomach caused due to the blood thinning medicine. However that was brought under control. Over the last 3 months his creatinine has gone up from 2.1 to 4.3, The doctor has suggested that we should now think of a dialysis. I would be greatly thankful if you could advise if a dialysis is required at these creatinine levels with his condition? Thank you and best regards.

I am unable to recommend medical treatment without performing a complete history and physical examination.  Your father has very low kidney function and you should consult with his nephrologist as to the best course of action.  Dialysis in someone who … Continue reading

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

I have type 2 diabetes. My last blood test shows my GFR is 41. My Doctor recommended that I drink 64 ozs of water daily but I see on different kidney websites that liquids should be limited. Should I follow her advice. She is a general practitioner and not a kidney or endocrine specialist.

I would recommend that you continue to drink water and avoid dehydration.  Water should only be limited if you are on dialysis or have significant problems with heart failure.  I do not recommend limiting your water intake with Stage 3 … Continue reading

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

I am in Stage 4 CKD – most recent GFR was 20. I am interested in peritoneal dialysis when it gets to that stage. I understand the peritoneal surgical implant needs to heal for 3-4 weeks before use. Is there a medical necessity criterion for the surgery in anticipation of dialysis? I would like to get the surgery done so that I will be ready when/if the GFR drops to 15. My GFR has dropped from the high 30’s to 20 since January.

This is a discussion you should have with your nephrologist.  Catheters can be placed well before starting dialysis and can be left in place until needed.  In some cases, the catheter can even be buried below the skin and then … Continue reading

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

Can someone who has had hepatits B and diabetes be a kidney donor?

Each transplant center has the capacity to decide who will and will not be allowed to be a kidney donor.  The diabetes that you mention would likely be denied by most transplant programs.  Hepatitis B might not be an exclusion … Continue reading

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Living Donation, Nephrologist

My daughter has been on dialysis for nearly 17 years with several different complications. She is 35. We never thought she could get pregnant. That seems the possibility now. I can’t find any data on that for her time in ESRD. I’m in shock. What are her chances of survival? The baby’s?

The chances of successful pregnancy for a patient on chronic hemodialysis treatments is very poor.  Successful pregnancy has been reported but dialysis treatments must be increased.  Dialysis treatment times may have to be increased to more the 30 hours per … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist, Pregnancy / Kids, Symptoms and Side Effects, Treatments

I have done ultrasound of abdomen. Report says. -My both kidneys are normal in shape, size, position and echo pattern. Corticomedullary demarcation is maintained. No mass lesion seen. Mild separation of right pelvicalyceal system noted.

I do not identify any kidney disease based on your ultrasound report.  I suggest that you consult with your physician to determine if there is any cause for concern.  

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects