Category Archives: Transplantation

Is the diet plan “Golo” safe after transplant?

I am not familiar with the GOLO diet but I did review the fact that they recommend a dietary supplement as part of the diet regimen. This dietary supplement has never been tested in a scientific study with transplant patients … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Transplantation

Dear sir, my father is suffering from kidney disease. Kidney transplantation was done in 2007. Now we have some serious complications. Though creatinine level is fine, but the urea level is quite high. The tacrolimus level was high, so our nephrologist lowered the dose to 1mg per day. Still the urea level is not coming down. Several edema occurs at hand, chest and face. Now the only nephrologist in our hometown has left. Kindly suggest what we should do. Kindly help sir.

I am unable to recommend medical treatment without performing a complete history and physical examination. I would suggest that you review your father’s status with his primary care physician (PCP) and see what other options are available for your father … Continue reading

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

Is there a time frame following renal transplant for the patient to safely have an elective upper endoscopy or colonoscopy? I’m wondering how long after transplant the patient can be scheduled for an elective procedure. What labs are recommended for evaluation prior to elective procedures for the post-renal transplant patient? Thanks!

Each transplant center has different recommendations regarding post transplant care. There are no nationwide guidelines that are used for post transplant care. I have generally suggested that my transplant patient wait at least one year before scheduling any invasive procedure. … Continue reading

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

My uncle diagnosed of acute CKD. He’s a known diabetic and hypertensive with background RVD. 3 months ago his creatinine was 3.8 mg/dl and urea was 114 mg/dl, PCV 28% and he rejected dialysis, so I started him on Lasix IV 80mg, normal saline 1 litre, iron sucrose 100mg and epo 4000 IU twice weekly for 3 months, and the urea and creatinine dropping with the treatment on weekly basis and PCV also increasing weekly till urea and creatinine became 45mg /dl and 1.6 mg/dl, respectively, and PCV 38% and I stopped the treatment for two weeks and creatinine shot up to 2mg/dl with urea 55mg/dl and PCV 35%. Please, what do we have to do?

I am not able to recommend medical treatment without performing a complete history and physical examination. Your uncle should be seen by a nephrologist. It is first necessary to determine if his kidney disease is related to his diabetes and … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Nephrologist, Transplantation

My creatinine is 274, up from 176. eGFR from 38 to 23 in the past 6 months. I saw an Internal Medicine specialist 6 months ago but may not be able to see them for another month or two. Should I be pushing for an appointment faster? My GP seems unconcerned but I remember the specialist telling me its not so much the number but any change in the numbers that may be of concern. To me I see that as an alarming rate and that I will be in kidney failure in a few months or less. Thanks.

I typically recommend seeing a nephrologist when your estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared, which is also consistent with Stage 4 chronic kidney disease (CKD). At that point, planning for … Continue reading

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

Hi Dr. Spry, My GFR has been fluctuating between 14 and 9 kidney disease due to med. The only symptom that I have right now with GFR 9 is fatigue; still walking 1/4 of mile 4 times a day. I know I am near dialysis anytime now but blood pressure is 120 over 60 with no med; glucose 110, potassium 3.7, sodium 142, eating well. I am maintaining weight of 173, not taking any medicine to control these numbers, but I am on a very strict diet. Dr’s can’t believe that I still do not have the symptoms of kidneys that only work 9%. I do not want to start dialysis till I am no longer able to maintain normal life. My question is for you, Dr. Spry, should I start dialysis now so I do not have any complication in the future with dialysis or does it matter when I start? I need your advise on this matter. Thank you.

The decision to start dialysis must be a joint decision between you and your nephrologist. If you are not having many symptoms and do not mind the strict diet, then there is likely not much benefit to you for starting … Continue reading

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

My mother, age 48, has high bp for more than seven years. Her creatinine level is now 2.6 and had a renal biopsy. (Result shown focal global glomerulosclerosis 3/16 with ischemic changes. Moderate to mild IF/TA 50% and prominent vessel changes consistent with accelerated on benign hypertension). Her creatinine level in Dec-2015 was normal at 0.6 and within three years it reached to 3.0. Please suggest how serious my mother’s kidney health is at present and how to stop the progression of kidney damage?

Focal and global glomerulosclerosis is a scarring disease of the kidney that does not have any known treatment. In general, it is important to keep the blood pressure less than 130/80 and ACE-inhibitors or ARB agents are the most common … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Dialysis, FSGS, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Transplantation

I just recently dropped from 38 to 26 GFR. I do not have insurance right now. At what point do they put you on a donors list? I lost one kidney in 2007 due to renal arterial stenosis. I also have a stent in my remaining kidney.

You are eligible to be considered for transplant evaluation and listing for kidney transplantation if your estimated glomerular filtration rate (eGFR) is consistently less than 20 milliliters per minute per 1.73 meters squared.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Nephrectomy / One kidney, Transplantation

My brother had kidney failure and just started on PD at home. I am considering donating my kidney if it’s a match but was wondering if my daily glass of wine will be a problem with my kidney donation?

Drinking one glass of wine per day should not be a concern for a prospective kidney donor. This can even be a healthy thing to do as long as the wine drinking does not become excessive. Men may safely drink … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions, Living Donation, Transplantation

I may soon need a kidney transplant. My daughter would like to be a donor, but had dermatofibrosarcoma protuberans (a rare skin cancer) 7 years ago. The cancer never spread, was treated with surgery alone, and she’s been cancer-free for 7 years. Would she be an eligible donor?

Each transplant center has the responsibility to determine who can and who cannot be a kidney donor for their center. There are no nationwide criteria used to determine who can and cannot be a kidney donor. In my experience, transplant … Continue reading

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