Category Archives: Nephrologist

I am 62 year old Type 1 diabetic with Stage 4 CKD. My eGFR is currently 23. I am an amputee and have a hex of CHF, sepsis, ARDS, acute renal injury x’s 3. I was on an ACE inhibitor but was taken off of it by my new nephrologist. From what I have read, an ACEi is standard treatment. Your thoughts?

Drugs such as Angiotensin Converting Enzyme Inhibitors (ACE-I) and Angiotensin Receptor Blockers (ARB) agents are used to try and preserve kidney function in diabetics with protein in the urine. In your case, your nephrologist may have evaluated the risks or … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, Kidney-Related Health Questions, Nephrologist, Treatments

I have felt miserable with my dx of CKD Stage 4. I have had every test under the sun. I even see a therapist. My labs are stable considering having had this dx since Oct 2017. It came out of no where. Is there any kind of treatment to help. My biopsies stated that CKD came from Chronic Interstitial Nephritis. Biopsies done one year ago Jan 2018. I have become anemic, high blood pressure and high cholesterol since my dx. Does this chronic illness/disease continue to get worse? I have not seen or heard of any treatments unless my GFR is at 15. Mine is 20 now. I just feel as though I have searching for over a year for something. I cannot take this fatigue, lower back pain, dizziness, feeling faint, nauseau, unable to concentrate and mild confusion to go away. I get there is no cure but there must be something.

At some point, your nephrologist must determine that the symptoms you are relating are potentially treated by dialysis and transplant. You should be eligible to be evaluated for listing on the transplant list once your estimated glomerular filtration rate (eGFR) … Continue reading

Posted in Anemia, Ask the Doctor, Dialysis, GFR, Kidney-Related Health Questions, Nephrologist, Transplantation, Treatments

When performing a radical nephrectomy for stage IV UTUC with lymph node involvement, why would a surgeon ‘Z stich the gonadal vein? Would this typically lead to an inability to ejaculate? Would blocking ejaculation be the motive of this step, to prevent cancer cell migration to the female sex partner?

I am a nephrologist and have no surgical expertise. I have no experience with radical nephrectomy or the surgical stitches that you describe. Your question would have to be addressed to a urologist. I do not believe that cancer can … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrectomy / One kidney, Nephrologist

I am contacting you on behalf of my daughter. She is 23 and has had chronic kidney infections since 6 Mos old. We have done vcug’s which initially showed reflux, but when the last one was done at 9 showed little to no reflux. She even tried prophalytic antibiotic treatment. That worked for a while. Finally at 17 she begged to stop looking for an answer. I relented but now she’s 23 and just let me know the problems are starting again. In November she was put on an antibiotic and it initially worked but as soon as she stopped taking them she had symptoms again. She was in the ER 2 weeks ago and was given an antibiotic infusion. She was then put on po antibiotics and finished those 7 days ago. Today she sent me this: “So about a week off of antibiotics and suddenly have some of the worst flank pain I’ve had. The adventure continues. I started hurting at like 2. When I’m laying down it’s minor pain, but when standing up it’s completely overwhelming.” Do you have any ideas? Anyone you can suggest she see? Any ideas would be greatly appreciated. Thank you for your time and consideration.

In most situations where bladder or kidney infections fail to clear, there is an anatomical problem with the urinary tracts. This comes under the expertise of a urologist. I am a nephrologist and I have no surgical expertise related to … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis, Urological Issues

My 3 year old daughter was diagnosed with extrarenal pelvis. She was seen in the ER in October for a severe UTI, since then she got UTI three more times! She had an ultrasound last week & that was how they discovered it. Her pediatrician said this isn’t a problem & won’t cause her to have more UTI’s? Should I take her to see a specialist? And will this affect her later on in life?

I am an adult nephrologist and do not see children. In this case, I suggest that your daughter see a pediatric urologist. It is true that an extra-renal pelvis does not typically cause any problems, however, if she is young … Continue reading

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

I have medullary sponge kidneys. Two big surgeries, cystoscopes, lithotripsies. I have pain when the stones are in the kidneys, none in ureter or urethras. Thanks.

Medullary Sponge Kidney can be associated with a deficiency of citrate production by the kidney. You should be evaluated by a nephrologist and have 24 hour urine testing to see if there are possible treatments for your kidney stone disease. … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions, Medullary Sponge Kidney, Nephrologist

On 11-27-18 I had an MRI done to check the soft tissue damage in my lower back. Partially visualized on scout imaging is a T2 hyperintense lesion in upper pole of the left kidney measuring 2cm. Also partially visualized on scouting imaging is a T2 hyperintense lesion in the lower pole of the left kidney measuring 2.3cm. How critical are these? Will they continue to grow and how fast. Will they harm the kidney? If they need to be removed, is it risky operation? I have yet to talk to a surgeon about, I am looking for information before I do.

I am a nephrologist and have no surgical expertise. I have no expertise in the surgical evaluation of tumors of the kidney. I suggest you consult with a urologist. A urologist is a surgeon who deals with tumors of the … Continue reading

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

Hello Doctor. My brother was diagnosed with UTI and kidney stone. The urologist said this cause was as result of narrow part of ureter connecting kidney with bladder. First operation was performed to insert stent and my brother has some relief. Now the urologist said that the permanent solution is to cut off the narrow part of ureter and join the join the good part together. I want to know if this is the best solution?

I am a nephrologist and do not have any surgical expertise. A urologist is a surgeon and deals with questions of the urinary tract and surgery. I suggest that you seek any advice about this type of surgery from a … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis

I have mild hydronephrosis with proximal hydroureter in left kidney and size is 12.7×4.9 cm.While I feel pain in lower abdomen as well in both kidneys. I took medicines but problem is still present. What should I do to determine the disease and treatment?

The problem that you describe is a urological problem. I am a nephrologist and have no surgical expertise. I suggest that you consult with a urologist, who is a surgeon and deals with blockages of the kidney. For general information … Continue reading

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

My brother was diagnosed with stage 5 renal failure with about 3-5% function left. My brother received a kidney transplant 25 years ago from our other brother and only has 1 kidney. The hospital is saying that he cannot receive dialysis until he gets insurance but does not qualify for Medicare until he is sicker or he gets an outpatient consultation- which the hospital canceled because he doesn’t have insurance. My brothers creatinine levels keep rising but the hospital says his potassium levels is what needs to be watched. My sister and I both want to get tested to donate but they said they can’t test us until he is assessed by the transplant team which also won’t help until he has insurance. I do not want my brother to get so sick he can’t handle a transplant but I feel he is being held back from treatment. Is there any other steps we can take? I feel like we are just watching and waiting for him to get too severe.

Your brother should consult with a nephrologist. If your brother has only 3-5% kidney function remaining, he should be eligible for social security disability insurance (SSI) and this would also make him eligible for Medicaid and possibly Medicare. It is … Continue reading

Posted in Ask the Doctor, Insurance & Medicare Coverage, Kidney-Related Health Questions, Living Donation, Nephrologist, Transplantation