Category Archives: Nephrologist

Hello! I am a white woman 39 years old. I plan to move to the US. I have type 1 diabetes and kidney transplantation from my mother. Now the level of creatinine is 1-1.2. In Russia, I take the Advagraf (Tacrolimus) 6 mg and Myfortik (Mycophenolic acid) 720 mg, as well as insulin aspart (Novorapid) and insulin detemir (Leveemir). I also have hypertension, I take Valsartanum, Amlodipinum, Bisoprololum, Physiotens. I have a green card. How can I get medicine in the US and how can I get a doctor’s consultation, take an analysis for the concentration of tacrolimus, other blood and urine tests? Where can I get acquainted with the rules for obtaining or buying such drugs? Which doctor should I consult for? What kind of insurance plans do people in the US use with my diseases? Will I be able to fly with my drugs for 6 months? Thank you.

If you are relocating to the United States, it will be important for you to find a kidney transplant center near where you will be living. The National Kidney Foundation has a web page devoted to finding a kidney transplant … Continue reading

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

Good afternoon Doctor, I am 37 years old and I live in Colombia I have an unspecified chronic kidney damage, I feel very bad since the nephrologist says that if I have a biopsy I can bleed because my kidneys are small, creatinine It is 2.40 I do not have diabetes or suffer from high blood pressure my bones if they hurt me a lot and there are days that I feel very tired I would like to know a treatment and what can I do Doctor please. Thanks from my heart.

If you have none of the usual risk factors for kidney disease, such as high blood pressure, diabetes, family history, or obesity, then a kidney biopsy may be the only way to tell you what your disease may be. In … Continue reading

Posted in Ask the Doctor, Diabetes, Hypertension/High Blood Pressure, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist

I’m at Stage 4 kidney function. Now my feet and ankles are very swollen and have proteinuria and leg pain. Am I near getting dialysis? Please tell me. I‘m very worried. Thank you.

The decision to start dialysis is a joint decision between you and your nephrologist. If you are having sufficient symptoms that you would choose to undergo the risk and inconvenience of dialysis therapy, then you may be near needing dialysis … Continue reading

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

I’ve some indications from bloodwork and urinalysis that something may not be right with my kidneys. I go for a retroperitoneal ultrasound and here are the exact words of the radiologist: Right kidney measures 11.4 x 5.9 x 5.6 cm. Left kidney measures 10 x 5.4 x 5.8 cm. Both kidneys are mildly atrophic with cortical thinning. No hydronephrosis or obstructing stone. A hypoechoic structure in the cortex of the right kidney midpole measures 1.5 x 1.4 x 1.7 cm, mildly complex. Bladder is distended and unremarkable. Impression: Mild medical renal disease. Complex cyst versus hypoechoic mass in the right kidney renal cortex. This indicated, follow-up contrast-enhanced CT or MRI is recommended for further evaluation. Then I go for an abdominal MRI wwo contrast and the doctor who ordered it writes back (exact words): Good news: your most recent MRI of the abdomen/pelvis did not show any disease of your kidneys. Your liver is fatty. Does that mean the ultrasound found something that wasn’t really there was nothing there or that the MRI just showed that what is there is nothing to worry about? Thank You.

An ultrasound examination is generally better at detecting cysts than a Magnetic Resonance Imaging (MRI) scan. A urologist is an expert in the evaluation and treatment of complex cysts of the kidney. I am a nephrologist and cannot comment about … Continue reading

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

What causes dialysis medaport & chemo medaport to get infected? What are treatment protocols to treat infections to medaports? Do you have any suggestions to prevent another infection from occurring to my mom’s medaport?

Any indwelling device is more prone to infection. Dialysis catheters and medication catheters are foreign bodies that are not natural to the body and as such, they are common avenues for bacteria to invade the body. The treatment of infections … Continue reading

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

Good morning, I am 59 1/2 years old and was told at my annual physical yesterday I am at stage 2 CKD. I have hypertension controlled, Metoprolol 25mg, no other risk factors. My GFR was 79, urine was clear. Family history father + for diabetes Type 1 and hypertension. Mother has CKD and hypertension. Grandmother lost a kidney, history unknown. Should I be concerned? See a nephrologist? Thank you.

I typically recommend that you consult with a nephrologist when your estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared. Most primary care physicians (PCP’s) are capable of managing early stage chronic kidney … Continue reading

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

I have chronic kidney disease due to upj obstruction. My right kidney is functioning 27% and the left is 73%. I also have Type 2 diabetes. I’m not over weight nor do I have high blood pressure. I had a stent put in for hydronephrosis. I have a urologist but should I see a nephrologist?

I suggest that you consult with your primary care physician (PCP) to see if referral to a nephrologist is necessary. In most cases, your PCP should be able to manage early kidney disease. If complications arise, then referral to a … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

I have been having pain in my back and right side off and on for a few years. I was diagnosed with CKD. I recently had an ultrasound that shows significant cystic changes in my right kidney. My renal size is 14.4 cm in length and there is a dominant lower pole renal cyst demonstrated in the inferior right kidney measuring greater than 5 cm. There is a small exophytic component to this cyst. I had a previous cat scan w/out contrast that documented non-obstructing calculi a couple months earlier. On this Ultrasound there is significant ectasia at the renal pelvis, there is a superior pole cyst measuring 4.7 cm. The collecting system appears to be less than 10 mm in caliber. There is suggestion of very mild pelvocaliectasis. The left kidney similarly demonstrates mild pelvocaliectasis. This kidney has no significant solid of cystic abnormality in the left renal parenchyma. The left kidney measures 13.4 cm. The bladder looks normal. A) What does all this exactly mean? B) Do I need surgery? C) I have a niece with PKD that we don’t know if it came from my side of the family or not, can it be PKD? D) What type of intervention is normally done if any?

From your description, I do not believe this represents polycystic kidney disease (PCKD). The number of cysts seen in PCKD is often too numerous to count and it appears you have a countable number of cysts on your right kidney … Continue reading

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

My father creatinine level is 2.3 but urea is 112 and increasing day by day. What can we do? How do we get urea level lower?

I am unable to make a specific diagnosis based on the information that you provide. I suggest that you and your father consult with a nephrologist in your area. From your description, your father may have acute kidney injury but … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Kidney-Related Health Questions, Nephrologist

My daughter is 22 yrs old and has had either a +1 or +2 protein and +1 to +3 blood in all of her urine tests since 2015. Had a cystoscopy done that showed nothing. Now she has a positive ANA titer of 1:1620, sed rate of 24, and c reactive protein of 1.22. White blood count of 11.2 Strong urge to urinate all the time but no infection. Not real obvious swelling but she complains of sore joints and she gets puffy under her eyes. Her total protein/creatinine ratio is 341.1 but her eGFR says >60. Rheumatologist ran 13 tubes of blood and she’s tested neg for all major autoimmune diseases. But there is obviously some type of inflammation issue going on somewhere in her body. Could all of her positive protein and blood urine tests be causing the positive ANA test? And should we be concerned that there is a kidney issue going on?

I am unable to provide a specific diagnosis based on the information that you present. In some cases a kidney biopsy is necessary to make a specific diagnosis of inflammation of the kidney. This could be some form of glomerulonephritis … Continue reading

Posted in Ask the Doctor, Glomerulonephritis, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist