Category Archives: Nephrologist

I am on dialysis. I started about a month ago. My question is why am I sweating so much everynight?

I am not able to provide a specific diagnosis based on the information that you present. Sweating at night is not a normal response to dialysis. There are many causes of night sweats that are not related to dialysis.  I … Continue reading

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

In 1996, I was found to have hematuria. In 2000, I started experiencing ulcers on my legs diagnosed as the result of leukocytoclastic vasculitis. I should I just go with this? In 2005, I had proteinuria. A few years later I allowed a biopsy of my kidney. Results showed a damaged kidney. Some unidentified autoimmune cause. Only treatment my nephrologist could give me is blood pressure control. Now, I am told peritoneal dialysis is next.

I am not able to establish a specific diagnosis based on the information that you present.  It is possible to have leukocytoclastic vasculitis of the kidney.  It is commonly called Henoch Shonlein vasculitis or purpura (HSP).  It can be an … Continue reading

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

My son 12 years, intermittent hematuria with loin/flank pain bilaterally. Pain begins 4-7 and quickly hits 10. The pain can come early and after without hematuria. He has been to 4 hospitals, no diagnosis. Help.

I am an adult nephrologist and do not see children.  I am unable to offer a diagnosis based on the information that you that you present.  I suggest that you consult with a pediatric nephrologist.

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

My kidney function tests have changed dramatically in the past year. My eGFR has gone from 80 to 55 mL/min/1.73m2, creatinine from .75 to 1.02 mg/dL and BUN from 14 to 25 mg/dL. I am a 72 yr old white female, 5ft 4in 128 lbs, do not have diabetes, HBP or any family Hx of CKD. I doubt if this has any thing to do with it but I did have 2 cups of coffee w/cream before the lab work. I have moderate COPD that was diagnosed 5 years ago and use ANORO. My PFT’s have not gotten worse since being diagnosed. In fact they have improved. I do not smoke or drink. I do have severe back problems which restrict my ability to exercise. I take atorvastatin and all cholesterol & triglyceride levels are within normal ranges. My GP did not seem to be very concerned and did not suggest any further testing or action. I myself am very concerned. Should I see a nephrologist due to these dramatic changes over only 12 months, especially since I do not have any of the classic causes for CKD?

I do suggest that you have urine testing for blood, protein and infection. This will help to understand if you qualify for chronic kidney disease (CKD).  In some elderly females, the estimated glomerular filtration rate (eGFR) can be misleading.  I … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Serum Creatinine, Urinary Tract Infection/Pyelonephritis

I had a PCNL procedure a month ago for my stone,measuring 24mm. I had a history of two stone removal in 2005 and 2013. The chemical analysis of stone shows 40% calcium oxalate monohydrate, calcium oxalate dihydrate 30% and struvite 30%. Now I had an ultrasound which shows stone about 4mm. What should I do sir? Please answer me.

I am a nephrologist and do not have any surgical expertise.  Stone disease, such as you describe is treated surgically, such as with percutaneous nephrolitotomy (PNCL).  A urologist is a surgeon and treats kidney stones with surgical methods.  I suggest … Continue reading

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

Since starting dialysis, my legs have become very weak. I have been on since May 2019. What might be the problem?

I am not able to make a specific diagnosis based on the information that you present.  Dialysis should not cause leg weakness. There are many different causes of leg weakness including high blood potassium, neurologic injury, stroke, muscle injury, and … Continue reading

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

My husband and I are expecting our first child. We just received our genetic testing results back and we were told that we are both carriers for congenital nephrotic syndrome. We are being told that there is a 25% chance that our baby will have the syndrome and if he or she does then he or she will need a kidney transplant. Is a kidney transplant for a newborn with this syndrome done right away? If so what is the survival rate for this type of procedure? Are there any other treatment plans or is there anything that my husband and I could do now to better prepare for that potential possibility that our baby may need a transplant?

Most transplant programs will require the infant to achieve a specific weight prior to performing a kidney transplant.  This has to do with the infant achieving a sufficient weight and size so that the transplant can technically be performed.  The … Continue reading

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

My daughter (currently 11 years old) was diagnosed with multicystic dysplasia of one kidney during a prenatal ultrasound. Over her first few years of life, my daughter’s kidney was resorbed and we were discharged from her nephrologist. Compared to her three siblings, my daughter is overweight (her siblings are very lean), has noticeable excessive body hair, a very round face, and has borderline high blood sugar. I am worried that these are signs of excess cortisol production, but I also feel that I am most likely being paranoid. Is there any correlation between Cushing’s and MCDK? Is it possible that the adrenal gland is still active despite resorption of my daughter’s kidney? Thank you so much in advance for your help and your response.

The adrenal gland may still be active despite the fact that the dysplastic kidney is no longer functioning.  I do not know of any association between Cushing syndrome and multicystic dysplastic kidney.  I suggest that you review your concerns with … Continue reading

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

I am a dialysis patient. I am 18 yrs old. My urine is almost block. What I do to urine out?

If you are on dialysis, urine output may decline but it is rare that no urine is produced.  I suggest that you review this with your nephrologist and see whether you need further examination.  This would be very unusual for … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Dialysis, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Urinary Tract Infection/Pyelonephritis

Why would a nurse practitioner and dialysis educator be so vague in giving me the information I need to know when it is time to start dialysis? My case manager FINALLY got some real information, such as the filtration level (8 or so) and how that, along with the Nephrologist opinion and my overall health (does that include mental health?). Now that I know this and the fact that it’s theoretical, I feel more at ease in waiting on dialysis. But why do the professionals keep the cards close to the vest? It makes me feel like I am unintelligent and unable to understand the situation (for whatever it’s worth, I have a PhD). This situation has caused me to not trust the nurse practitioner. I will reconstruct a quality of life that was all but destroyed with the waiting process, and carry on as I should, personally and professionally. But why was i treated this way?

In general, the decision to start dialysis is not based on any number.  It is based on a discussion between you and your nephrologist about the risks and burdens of starting dialysis versus the benefits of treating any symptoms that … Continue reading

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