Category Archives: Nephrologist

Hello. My now, 5 year old son, when I was pregnant, he had fluid on his kidneys and was born with hydronephrosis. He had his checkups every 6 months up until we moved to another country in 2016. He was doing OK. No problems up until 2 months ago, he had been complaining of back pain, so I took him to get a sonogram to check fluid and he had little, not as much as he had before, and he had blood and urine tests done. The tests came back that he had a kidney infection. He was put on antibiotics. After he finished his medicine, the pain continued so I took him to a kidney specialist and all he did was tell me to go get him a US renal sonogram and get his urine and blood work. So I took him to get the sonogram. Doctor said he had no fluid on either kidney. The right kidney was 86x33x37mm and 10.6mm, his left was 82x33x39mm and 13mm. Doctor said no fluid on his kidneys, which was a relief but she said his spleen was swollen. She told me a child his age should be 105mm but my son was 116mm and she told me to wait for his blood and urine test results to come back to see if it’s from an infection or if not, then it’s normal. I am still waiting on his results but my question is what should I do next? Who should I take him to next? Should I worry with us being in another country? The health care is not anywhere close to the United States and that has me worried. Do I take the results and sonogram information back to the kidney specialist or should I see someone else? Any and all help and information would be very much appreciated. If you need more information or any questions, please contact me.

I am an adult nephrologist and I have no expertise with children. I would offer two recommendations. In most cases, I would have your son evaluated first by a pediatrician, rather than going directly to a kidney specialist. A pediatrician … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Blood/Urine Testing For Kidney Disease, Hydronephrosis and Hydroureter, Kidney-Related Health Questions, Nephrologist, Pediatric Issues, Urological Issues

My mother is in stage 4 kidney failure and is in fluid overload. Her nephrologist just upped her Lasix to 320mg per day. She has had fluid on her for 6 weeks now and was in the hospital for 1 week. She has been at the local nursing facility for 4 weeks now and the fluid is not going down. Tomorrow will be 72 hours since doctor raised her Lasix dosage yet she seems to not be able to urinate frequently enough to get fluid off of her arms, hands, feet, and legs. Is there any way to help get fluid off of her? Her gfr is 19 to 20. Any suggestions would be greatly appreciated.

Resistance to the effects of diuretics is a common feature of advanced chronic kidney disease (CKD). In some cases, dialysis is the only alternative. In some cases, the diuretics can be delivered directly into the vein so as to increase … Continue reading

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

I’m a 25 year old female and had a left pyeloplasty 3 years ago to resolve a recurring hydronephrosis issue (left kidney only). Since the surgery my pain has not lessened, but at my six month post-op appointment, my surgeon said that function looked fine, so we haven’t pushed any further. Pre-surgery I experienced left sided flank pain, as well as pain that would spread up and down the entirety of my left side of my body. I still experience this now, plus lightheadedness, light sensitivity, extreme fatigue, and confusion (that resulted in me being stroke-coded last year). It was pointed out to me by someone working on my back (also about a year ago) that the back left side of my rib cage is raised higher than the right side, at the same trouble spot that’s always been painful. I’m curious if any of this sounds like it’s even related to the initial issue for which I had the surgery. It’s been difficult to connect the symptoms but I’m starting to doubt that the root cause is kidney-related at all. Thank you!

I am a nephrologist and have no surgical expertise. The problem that you are describing is pain after surgery. This could be a urological problem. A urologist is a surgeon who deals with both the kidneys and the urinary tract. … Continue reading

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

In March 2019 I went to see a naturopathic doctor because I was having panic attacks and my blood pressure would go up and I went to the ER several times. She did different stool/urine/blood tests and turns out I had H Pylori, parasites and worms, in addition to some kind of anemia and vitamin/mineral deficiency. She put me on different supplements to kill the h pylori and parasites/worms and different vitamins minerals I was lacking. I’m starting to feel better and my blood pressure is normal. In mid May 2019 I started noticing some bubbles in my urine. We did more blood/urine tests and it showed urine was cloudy, leukocyte esterase 2+, WBC 40-60, squamous epithelial cells 20-27 and Urea Nitrogen (BUN) 8. There was NO protein, NO nitrite found in urine. She said I had a UTI but I didn’t have any symptoms at that time. Now in June 2019 I did the urine strip test at home and it shows low levels of leukocyte, but everything else seems OK. I’m still seeing bubbles in the urine and I’m getting concerned. Does it sound to you like there could be something wrong with my kidneys or can all the supplements that I’m taking somehow causing bubbles in the urine? Should I see a nephrologist? Thank you for all your help.

I do not think a nephrologist would be helpful. I would suggest that you see an allopathic physician and have a general history and physical examination. I am not able to make a specific diagnosis based on the information that … Continue reading

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

About 6 months ago I started to have no control of my bladder. I’m a truck driver and when standing my urine just flooded out. I saw a urologist, he had me try a prescription but I had little success. A lot of the time my urine has a very bad “fishy” odor & is very cloudy. I drink diet cranberry juice and 8 to 10 glasses of water every day. I’m a diabetic, (A1c 6.4) & HBP. Last Dr. visit I was told I was in stage 3 kidney disease. She assured me this was normal in my age group, 64. I’m very concerned regarding the “fishy” odor and cloudiness. It does get better when I get off the truck for home time. Should I see a kidney specialist? Thank you for your time & attention!

The problem that you describe is a urological problem. I am a nephrologist and have no expertise in the treatment of bladder or lower urinary tract disease. I suggest that you continue to consult with a urologist or a gynecologist.

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

My brother has “Renal pyramids are ecogenic with multiple echodense area in them, some having posterior shadowing.” Is there treatment available or not? Please help me. What can I do?

The information that you present suggests that there are calcium deposits inside of the kidneys. I am not able to suggest a specific diagnosis based on this information. There are many possibilities as to the cause. I suggest that you … Continue reading

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

I used to live in Colorado, 7200 ft, and my kidneys got bad with a 1.5 gfr; I also had heart failure. I moved to Texas 6 months after I was in hospital. My numbers have gradually gotten better in 4 years with my gfr at 36. I was thinking of moving back to Colorado but concerns after reading that high elevation causes HARS which effects kidneys. Am I looking at info about hypoxia? Not sure if I am worrying too much or would this not effect my progress or go back in the wrong direction as a possibility. I don’t need to move but would love more input to my decision.

I am not familiar with the acronym “HARS”. This does not mean anything to me. I am not familiar with any kidney disease that would be worse at altitude and better while living in Texas. I am not able to … Continue reading

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

Dear Doctor, I was diagnosed with polycystic kidneys at the age of 18 but I’m not sure if I know what type of polycystic kidneys I have been diagnosed with. I can confirm that no one in my family has had this before. I had my son when I was 32 without any difficulty. Now I’m 37 and I would like to know: 1. What type of polycystic kidneys do I have? I have checked my medical reports they all say PKD. 2. What are the chances that my son will have normal kidneys vs polycystic kidneys? Currently my left kidney is 21.0×10.0 cm in size and right is 16.8×8.0 cm in size and my liver functions are normal. Serum creatine (enzymatic) Result is 0.73 mg/dl Flag reference value is 0.5-0.9. estimated GFR Result is >90 ml/min/1.73m^2. 3. Blood pressure goes up and down, pain at the back of my head and my feet swells. It hurts a lot on my heels, is this normal? 4. Is lemon in water good for me? 5. How can I reduce my belly fat as I’m been asked not to go to the gym? I walk 20 min a day in the morning. 6. In the long run, what do I have to look/plan for? I’m not happy doing transplantation and dialysis due to personal reasons and also this is so expensive for me too.. Appreciate your advice on this. Look forward to hearing from you. Thanking you in advance.

Polycystic kidney disease (PCKD) is an autosomal dominant adult type of kidney disease and is generally separated into two types. Type 1 is usually younger in onset (usually before age 30) and progresses to kidney failure usually in the 4th … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Kidney Failure, Kidney-Related Health Questions, Nephrologist, Polycystic Kidney Disease

Hi. I have Stage 4 kidney disease. I am on a very restricted diet. Chocolate killed me. I also have ATTD, and epilepsy. I take Trileptal 4 tab day, Calcitriol 1 pill q every day. My Doctor wants me to take Klonopin. That shuts my body down. I asked if I can take 5-HTP instead, he said yes. The internist ordered ferrous sulfate, 325, one every other day, with 500 Vitamin C. I feel very weak. The kidney doc ordered a diet of no meat or dairy of any kind. I have lost 20 pounds along with implant surgery. My Parathyroid level continues to be above 300. Doctor has not ordered dialysis. My lifestyle is impaired. What measures can I do? Most volunteer work is too taxing for me. Please assist. Thank you.

I am unable to suggest medical therapy without performing a complete history and physical examination. I do not identify any problems with your current management. I do not recommend that you completely avoid all meat and dairy. It is appropriate … Continue reading

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

On my annual physical yesterday, my general practitioner told me my GFR is 58 and that indicates stage 3 CKD. She didn’t recommend a nephrology consult. Just follow up in one year. Is that appropriate care?

In most cases, primary care physicians (PCP) are able to manage chronic kidney disease (CKD) in the early stages. Stage 3 CKD requires that your estimated glomerular filtration rate (eGFR) be less than 60 milliliters per minute per 1.73 meters … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist