Category Archives: Nephrologist

I am having severe problems after having dialysis treatment. Is there any suggestion to help how bad I feel after treatment?

I am not able to make a specific diagnosis based on the information that you present. Fatigue is very common after dialysis. This is especially true after in-center hemodialysis where recovery times as long as 6-8 hours have been reported. … Continue reading

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

Hello! I am a 61 y.o. female and have had blood in my urine going back to 2007. An ultrasound in 2015 showed mild kidney disease. I recently had another ultrasound after another UA showed a large amount of blood in my urine. No proteinuria. I have an eGFR of 56 -Stage 3a. I’m supposed to have a CT next week. My grandfather died at age 53 from kidney failure. My father had to go on dialysis in his mid-60’s and stopped after about 4-1/2 yrs. He died at age 69. With my family history, I am curious about my prognosis pertaining to how fast I may wind up at Stage 5. I am not overweight, no diabetes or high BP. Is there any way to predict this? Thank you.

I am not able to make a specific diagnosis or prognosis based on the information that you present.  I am not sure what is causing the blood in your urine or your kidney disease.  In some cases, such as this, … Continue reading

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

My husband has just been told that the valve on the ureter tube leading to his kidney does not work properly which causes urine to back up which has led to some damage to the kidney. Is this treatable or what are options for dealing with this diagnosis?

The problem that you describe is known as “reflux nephropathy” or “vesicoureteral reflux”. This is a urological problem and should be directed to a urologist, who is a surgeon. I am a nephrologist and have no surgical expertise. I suggest … Continue reading

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

My husband had a mitral valve repair 2004. Now age 64. His valve is failing but he is also peeing red brown urine – hemolysis and we are trying to figure out why. The urine is clear red brown a few times per week . I’m worried about damage to his kidneys. He is otherwise healthy with no DM.

Hemolysis (breakage of red blood cells) is a common complication of failing heart valves. Hemolysis can also cause kidney injury. I recommend that you review your concerns with your cardiologist and heart surgeon. Your husband may need to see a … Continue reading

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

GFR 23 range for last 2 years. Watch protein intake, no dairy, exercise daily (well almost), salt intake range 1500 a day. Looking at Dr. McDougalls plant based diet. Curious as he suggests potatoes & other vegetables that are high in phospahates or potassium. Do the benefits of the plant based diet out weight the concern for potatoes etc.? My counts at this time are phosporus 4.7 mg BUN 45mg & creatinine 2.13 I’m not fond of vegetables so Dr. McDougalls diet – focused on starch as your main course – looks appealing. with bread & potatoes & think I could stay on plant based but not sure safe for CKD.

I have always encouraged a balanced diet and never focusing on a narrow list of foods. The most important part of the diet is to restrict sodium or salt intake. I suggest a limit of 2300 milligrams of sodium intake … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions, Nephrologist

Hi. I’ve been having a lot pain in both kidneys and I have stones in both. My left kidney is also significantly smaller than my right one which has hydronephrosis but the doctors won’t do anything to help unless they see it as life threatening or an emergency. What can I do? I’ve had referrals made to doctors but have yet to hear anything even after calling and I’m in so much pain. I’m at my wits end. Any advice would be extremely appreciated. I have every symptom except for the fever and blood in urine. Thank you

The problem that you describe is a urological problem having to do with recurrent kidney stones and back pain. I am a nephrologist and have no surgical expertise. A nephrologist tries to figure out why someone has recurrent kidney stones … Continue reading

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

I have kidney stones during pregnancy (only when pregnant) in which require stents repeatedly through out pregnancy until lithotripsy can be done. I have had a total of 12 stents and 4 lithotripsy all on the same side, can this have caused permanent damage and pain? My urologist says no but I have frequent pain in the same area. Just wondering if there is anything else I should be aware of or if this is a side effect from circumstance. Thank you.

I am a nephrologist and I do not have any surgical expertise. The question that you ask is appropriately addressed to a urologist  A urologist is a surgeon. I suggest that you continue to consult with your urologist.

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

I have stage 3 CKD (Creatinine 1.6 – 1.8) but keeping blood pressure down has been difficult. First of all, recent ultrasound shows Left Renal Artery blood flow is very good, left Kidney is 11 Cm size. Right renal artery plugged and dried up since April 2016. Right kidney now still operating from 2 small arteries and Vascular surgeons opinion is doing maybe 5% of load. It has reduced in size to 5.1 Cm. Question is: How much effect does atrophy hormone have in keeping blood pressure higher. And how long should it take for right kidney to atrophy down to it’s ultimate size as determined by blood supply to it. Average daily pressure is 140 / 80 with pulse about 60 -70. I am taking 100 Mg Metoprolol, 12.5 mg HCTZ, 2MG Doxazosin, and 12.5 mg Spironolactone (1/2 – 25 mg pill) Any medication changes suggested?

The small right kidney can certainly make blood pressure more difficult to control. The kidney that is getting very little blood flow produces a hormone called “renin” that causes the blood pressure to be higher and can injure your remaining … Continue reading

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

Unfortunately, I had a poor nephrologist who was not on top of things. After seeking a second opinion because of feeling so awful, I am now in full blown kidney failure, with a GFR of 13. We are to see the dialysis nurse next week to discuss options for treatment. I am leaning toward hemodialysis, with a fistula, rather than a graft. However, after researching, it appears the fistula takes up to four months to heal before dialysis can begin. Can both a graft and fistula be done at the same time, so that the graft can be used initially and the fistula used, once healed? Thanks.

A fistula should be your first choice. It would be hazardous to place both a fistula and a graft. I suggest you try for the fistula, if possible, and place a graft if the fistula is unsuccessful. Your nephrologist and … Continue reading

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

Good Afternoon Doctor: Apparently I have a small kidney stone(s) hanging out in my right side ureter tube (between my kidney and bladder) The last ultrasound also showed a small stone in my right kidney. I am in NO pain and I am not bleeding. In fact, I never felt the stone pass from my kidney to the tube. I also have hydronephrosis (sp) in the right kidney (no pain), Urinalysis shows no cancer cells. The doctor I am seeing is recommending surgery to insert a camera through my bladder to the tube to remove the stone and place a stynt there. Since I am in no pain this option does not appeal to me. I have been drinking lots of water and cranberry juice. I urinate often but not at night (presumably because I am laying down) Do you have any advice or recommendations other than surgery?

The question that you ask is a urological question. I am a nephrologist and have no surgical expertise. A urologist is a surgeon and has expertise in kidney stone disease and blockage of the kidney.  I suggest that you seek … Continue reading

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