Category Archives: Nephrologist

My question is out of desperation. My husband has suffered kidney issues since he was 12. And at the age of 35 and after many kidney surgeries and procedures had his left kidney removed. It was not draining correctly causing severe pain and after several attempts to repair it, the doctors decided removing it was the best option. Now he is having similar problems with his other kidney. After research of my own, I went to the local urologist here and told him I thought my husband had a floating kidney. He said he had never heard of that but thought it made sense. He did all the tests and said, yes, that his kidney was moving and that was what was causing the pain and why it was not draining. He said he would look into the surgery and put in a stent for the time being. When we went to the followup, we were treated much different. We were told that floating kidney was not real and they would not do the surgery and all they would do is put in stents. I guess my question is, how can a Doctor say something he can see with a test is not real and where do I go from here for treatment. There is a surgery out there that can fix this but instead my husband is forced to suffer and live a life in pain.

I have never heard of a floating kidney.  I understand that this term used to be used years ago to describe pain moving around in the back, but the kidney only moves up and down when you breathe.  Everyone’s kidneys … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Urological Issues

Hi Dr. Spry — 39/yo amateur bodybuilder here. I learned a couple years ago that I have kidney dysplasia, one side completely polycystic kidney and the other mildly hypertrophied. I am used to my creatinine running high (over 1.3) and GFR just shy of 60. However some recent labs have disturbed me! Serum Creatinine 2.0 — note that I weigh ~100kg/225lbs largely muscle, this has crept up over time correlated with my weight gain (1.3, 1.5, 1.7, 1.8…) 24 hr urine contained 2.3g protein! — note that I didn’t know not to train, and trained legs (intensely) the day of sample collection eGFR 35-40 — could this be related to creatinine? BUN 44 — Note that I have been on very high protein diet, upwards of 4g/kg (400-450g total) I have been on Losartan for hypertension for about a year and a half. My BP is usually well controlled. Due to some other chronic illness (HIV, well controlled CD4 healthy normal range) I track my lab values in a spreadsheet. I can see a correlation between my weight/muscle gains from 200-220lbs and the increased serum creatinine and reduced eGFR. When I learned that I had the kidney dysplasia I had a proper radioactive measurement, and all I have in my notes is that GFR was fine and healthy for one kidney. Questions: 1. Is it possible/believable that this is all caused by my atypical muscle mass and intense training? (High creatinine, thus low GFR, exercise induced proteinuria) 2. With the kidney dysplasia, do I technically have CKD with basically 50% of a normal person’s kidney function? I am freaked out thinking that I’ve suddenly in the last 9-12 months had some sudden kidney injury!

By definition, you have chronic kidney disease (CKD) because the dysplastic polycystic kidney has been present for at least three months.  Hence, you do have reduced kidney function.  The body building that you are doing will increase the serum creatinine … Continue reading

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

Good health to you doctor! It’s been 2 months since I go through hemodialysis procedures on the Artis machines. Upon admission to the hospital, urea 26, creatinine 1300. There were no external factors of chronic renal failure. After the procedure of hemodialysis, the legs and feet began to swell for the 5th time. Can you please tell me how to make a hemodialysis program correctly? To me 52 years, the dry weight of 89 kg, body height of 188 cm.

I am unable to recommend dialysis treatment without performing a complete history and physical examination.  I suggest that you discuss your concerns with your nephrologist.  If you still have swelling in your legs and feet, then perhaps more fluid must … Continue reading

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

I’m 20 and had my kidney transplant back in 2008. I deal with chronic pain/anxiety and depression. I heard about hemp cbd oil Charlotte’s Web and was wondering what the effects could possibly be if any? I read that it has no affect on the liver kidney or stomach but want to be 100% sure. I’ve had surgery for my chronic pain, tried physical therapy and nothing has worked. I heard so many great things about hemp cbd oil and really want to try it.

I have no personal experience with CBD hemp oil.  CBD oil can also be made from marijuana.  I have no information on what this would do to your transplant medication.  The biggest risk is that this medication could change the … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Nephrologist, Transplantation, Treatments

I have recently been told I have an issue with my kidney but they have done tests and cannot seem to know why the kidneys are decreasing in function. They do, however, see a small blockage on the right side causing some issues, but no answer as to why the left side is also decreasing. I have not been diagnosed with kidney disease and there are no additional veins blocking the ureter junction that may cause the current blockage. They ruled that out to as well as kidney stones so if its not congenital, not kidney disease, no other areas seem to have any other damage, including the spleen and pancreas. So my question is, what else could cause such a freak random thing to occur?

I am unable to make a specific diagnosis based on the information that you present.  The blockage on the right kidney is obviously an area to be examined.  I am a nephrologist and have no expertise in blockage of the … Continue reading

Posted in Ask the Doctor, Nephrologist, Symptoms and Side Effects, Urological Issues

When my kidney transplant failed recently after 22 yrs, I lost a lot of muscle mass within a few days. I am on now on dialysis. If I try to gain my muscle mass back by eating high protein diet and exercising, how can I tell if the weight gain is due to fluid or due to muscle mass gain?

This is a complex question and involves many variables.  In general, your nephrologist or nephrology nurse must evaluate your blood pressure, your weight gain between dialysis sessions, the amount of swelling that you have, and examine your heart and lungs. … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects

Hi. I am female, 45 old from India. I have done RIRS in my left for 1cm and 5mm kidney stones on 9 may 2017. After they put stent on my left side. I have taken CT scan before stent removal. The CT scan report shows 4.2mm, 2mm, and 3mm stones on my left kidney. The stent removes on 5/6/2017. Now my question is my kidney function is normal? But now no blood in my urine. and urine color is normal. and amount also. Another question is Why is it painful?

I am unable to make a specific diagnosis based on the information that you provide.  The question that you ask is a urological question.  I am a nephrologist and I do not perform surgery.  I suggest that you discuss your … Continue reading

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

Hi, My husband is a sporadic diabetic. He had bypass surgery in 2005. Over the course of this past year, he started seeing a nephrologist for his kidneys. The doctor put him on sodium bicarbonate and at first numbers improved. We transitioned from the sodium bicarbonate tablets to baking soda 1/4 tsp per gallon of water on two weeks off two weeks. His numbers improved upon the first test after adjustments according to his doctor then the next test he showed too much sodium and we were told to cut back on his salt. We immediately cut down on adding the baking soda because we are already on a strict salt diet and this week were told he needed the sodium bicarbonate added back into his diet “he wasn’t getting enough”. His doctor is adding three tablets to his daily medications and when I asked about getting too much sodium and his heart health her response was that most kidney patients die from heart attacks. She is also suggesting he begin initiating the process to prepare for dialysis by taking a training course and getting vein mapping so they can schedule an appointment for surgery. I am going to request copies of all his blood work results Monday. She indicated his latest test was at 22 points gfr and that it had decreased 7 points from the prior test. before that it had increased and looked good but the only concern she had during the last appointment was his sodium levels. I have four questions. * It seems everyone is affiliated for several cities away and we would like a second opinion about getting dialysis. How do we go about getting this completed and can you help us after we get a hard copy of the test results? * What is your take on sodium bicarbonate? Is this the only thing that can help the kidney numbers improved outside of diets and dialysis (low potassium diet, low carb diet, etc.) His potassium levels are within normal range and his carbs are doing better than they ever running around 120 to 150. He used to have numbers into high 300 and low 400 for carbs.) Kidney disease is chronic and a direct result of his diabetes according to a number of medical health professionals. * Are there other options for stages three and four kidney disease? The only difference in medications lie in his vitamin D, calcitriol, and sodium bicarbonate. Yes he has low vitamin D levels too. He has moved between the two stages over the past year. When he was first diagnosed he was in stage 4 and we were told the numbers would not improve but after removing a large amount of protein he dropped to stage three but is now back to stage 4 since we reduced sodium levels via baking soda. * Is there a medication for the kidneys rather than going directly to dialysis that would work to slow the decline and possibly improve filtration? Example he had been put on a high protein diet when he had to have an amputation due to diabetes. We were never told to reduce the protein levels down until we moved and he ended up in the hospital here. As I mentioned earlier his numbers improved greatly after cutting out the high level of proteins that were meant to help him heal. I simply would like to know if there are other options, if so how well do they work? My husband has no swelling in the legs either. * Are there any contraindications for dialysis? I see on the web that primary concerns revolve around mental health issues and cancer issues which we are not affected with at this time.

You ask a number of questions that I am unable to answer without performing a complete history and physical examination.  Your husband has chronic kidney disease (CKD) and his diabetes, heart disease, high blood pressure and peripheral vascular disease make … 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

I am in Stage 3 ckd. This has been the case for past 16 years. The medicines that I’m taking are Losartan 50mg and Omega-3 fish oil. Till 2 years ago, I was taking Losartan 25 mg and due to protein leak in urine this was increase to 50 mg. My query is regarding sperm count. Does this increase in Losartan cause a massive decrease in sperm count. i was having just over 20million as the count 2-3 years ago, recent check indicates the count is under 13 million and the ones having rapid progression is zero. This was not the case 2-3 years ago. I’ve been to UK for 2 years and has returned back to India. I used to have fish daily and now I’m having less of that. Other than these I don’t see any difference between now and that time. I was diagnosed with vericocele as well recently. Could you please let me know if the increase of losartan or change in climate or the diet could cause significant decrease in the count and cause vercocele?

The diagnosis of abnormal sperm count and varicocele are usually within the expertise of a urologist.  I am a nephrologist and have no way to comment about your current problems.  I have used Losartan for many years have not heard … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Function, Nephrologist, Symptoms and Side Effects, Treatments, Urological Issues

My MRI results are paraspial soft tissues demonstrate partial hemorrhage left renal cyst measuring at least 7 cm. What does this mean and could it be something bad?

I am unable to make a specific diagnosis without knowing your complete history, performing a complete examination and reviewing the magnetic resonance imaging (MRI) results.  I suggest that you review the results with your physician or perhaps consult with a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Cysts, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Treatments, Urological Issues