Category Archives: Treatments

My husband had a kidney transplant in 2015.  Kidney as today is perfect but as a side effect, he is been losing mobility. He has been having a lot of pain in his legs and feet. The nephrologist doesn’t see anything abnormal.  We saw 2 neurology doctors and they were unable to see anything abnormal. What we can do? Where we can look for help?

I am unable to make a specific diagnosis based on the information that you present.  Leg and foot pain are not common symptoms of patients with a successful kidney transplant.  In most cases, a neurologist is the best person to … Continue reading

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

Back in October 2017 I was dx with Stage 4 Kidney Disease. I have other health issues along with a connective tissue disease known as Ehler’s Danlos Syndrome. On January 9, 2018 I go in and see the nephrologist and he called me later that day about my low numbers and to come in two days later to his hospital for biopsies.  I had severe pain and burning afterwards and continued until discharge the following evening. They did do an ultrasound and found nothing. I left with the continued throbbing and burning by my incision sight. Last weekend I became weaker and weaker as the pain worsened over the regular OTC Tylenol I was prescribed and the burning was worse. I ended up in the ER out by where I live. While in triage they did labs, a urine sample, and CT of my kidney’s and abdomen area. They found bleeding you would not have found from an ultrasound. My labs showed lower GFR since the biopsy, lower iron and potassium. I have been extremely dizzy and with many headaches I have passed out twice and fell once.  As for my preliminary labs results I was told it was either an allergic reaction/and or an infection to medication. I do not take and have not taken ibuprofen or advil type meds in about two years.  The nephrologist on the unit here is prescribing me steroids for two weeks, do labs and then meet with him. I have other daily meds but will the steroids be my only chance here? I can easily gain weight over anything or nothing. 

I am unable to provide recommendations about treatment without knowing the exact nature of your kidney biopsy and performing a complete history and physical examination.  Allergic disease in the kidney is commonly treated with steroids.  I do not have any … Continue reading

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

I was recently diagnosed with Primary FSGS tip lesion. I was placed on 60mg of Prednisone, along with Lasix, Lisinopril, and potassium. After consulting with my nephrologist and researching on my own, it is my understanding that tip lesion is quite rare and does not have a standard treatment protocol. My question to you is based on current research and information available what type of treatment and length of treatment would you recommend? If I were to seek a second opinion, what doctors in the U.S. have the best understanding about FSGS tip lesion?

Focal segmental glomerulosclerosis (FSGS) is a chronic scarring disease of the kidney and has five different pathological classifications including “tip lesion or variant”.  You are correct that there is no universally recognized treatment for FSGS. The most common treatment is … Continue reading

Posted in Ask the Doctor, FSGS, Kidney-Related Health Questions, Treatments

Recently my Dr. ordered some blood work to determine my general health. I had not had any blood work done in 18 months. I am 88 years old and other than high blood pressure (135 or 140 over 70) and atypical glaucoma (low pressures) have no problems. She wanted to rule out diabetes 2 as this is a familial disease. I feel I am in excellent health. In our recent appt. she said my kidneys were at 43 and should be 60. I do not know what this meant. I asked her to explain but she ignored my question, mumbling something about not been critical. I have never been much of a water/tea (NO coffee) drinker, but I urinate 2-3 times a day at the most I drink juices and canned drinks without sugar and juices (orange, grapefruit, tomato, etc.) I am almost 89 and function well, driving my own car, playing duplicate bridge etc. I wear a pad liner for protection in case I have to urinate quickly and can’t get to a bathroom on time, but this seldom happens.

Kidney function has a tendency to decline with aging.  Hence, beyond age 40, there is a loss of about 1% of kidney function (as estimated by glomerular filtration rate or eGFR).  At your age, you would be expected to have … Continue reading

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

I am 73 y.o, 5’6″ weigh 140 lbs exercise 1-2 hours daily with weights and jogging. I have GFR of 57 last tested summer of 2015. My primary suggested I not worry. My blood labs, creatinine and ??? are normal. No protein in urine. I have been taking protein powder in shakes probably every or every other day which include avacodo, greens, nuts, coconut or almond milk, hemp seed, flax seed but now I am afraid to include protein powder so often and think I will cut down to twice weekly. I have read to take less protein, less dairy, less caffeine and I’ve seen renal diet including more veggies, fruits and grains. I am intolerant of gluten and have controlled HBP taking 20 mg Quinipril daily. Over the holidays, my BP went up and I am going to go back to 40 mg which I was on but HPB was very good and I decreased my dose with my Primary MD’s approval. If you have any suggestions or concerns to tell me I will be grateful. Thank you.

You are taking very good care of yourself.  I am not an advocate for protein restriction in patients with chronic kidney disease (CKD).  I do advocate for the DASH diet.  You can learn more about the DASH diet at:  

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

Is there a recommended procedure to reduce kidney damage due to iodine based contrast agents used for CT scans. I have a single kidney and my latest GFR is 52. I have scans every 6 mo as follow up for stage 3a clear cell renal carcinoma. If you can point me to a current technical paper that would suffice.

The most important thing to do is see if contrast dye is needed to make a diagnosis with the computerized tomogram (CT) scan.  If the CT scan can be done without contrast and yield good information, then this should be … Continue reading

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

I wanted to know about the best treatment option available for Polycyctic kidney disease.How effective is the surgery option? Can a cyst of size exceeding 3.5 cm be operated upon?

Surgery on the cysts of a patient with polycystic kidney disease (PCKD) should rarely be necessary and has generally been abandoned as a treatment for patients with PCKD.  I would recommend that your blood pressure should be very carefully controlled, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Polycystic Kidney Disease, Symptoms and Side Effects, Treatments

I am currently 24 weeks pregnant. My baby has been diagnosed with BMCDK. I am looking for a doctor who is willing to offer amnioinfusions and provide care with a result not ending in death of the fetus. If you can provide recommendations that would be amazing.

I will assume that the acronym BMCDK stands for Bilateral Medullary Cystic Dysplastic Kidneys.  This is a congenital disorder where both kidney are usually small, full of cysts and generally are not functional.  I am unaware of anyone performing such … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Chronic Kidney Disease, Kidney Cysts, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Pediatric Issues, Pregnancy / Kids, Treatments

My father is 74 years old this year. He is at end stage renal failure. He has had kidney diseases for slightly more than 10yrs and have been on medication and lifestyle change to slow down the deterioration of his kidney. He is not overweight and neither does he have diabetes. He is on hypertension medication for as long as he had the kidney disease. Recently, his serum creatinine shot up from 900 to 1800 and had started to be symptomatic. He feels very weak and having problems to eat, drink or even stand. He’s now admitted and the nephrologist started him on hemodialysis daily to bring down the waste in his body. What I want to ask is whether hemodialysis or peritoneal dialysis is a better choice (in terms of survival rate or life expectancy) for elderly patients above 70 years old? If it was your father (you being the nephro), which would you recommend?

The decision between hemodialysis and peritoneal dialysis is one of lifestyle difference rather than one of survival or life expectancy.  Hemodialysis can be done at home or in-center and has several different modes of delivery but is most commonly done … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, GFR, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Treatments

I am a 61 year old female who has sustained damage from 25 years of lithium treatment. Although no longer on any such medication since 2003, my GFR is 53 and my creatinine 1.1 which I maintain through an abstemious diet. Concomitant with this damage, I my bladder has hypertrophied to contain over 2,000 ml due to having withheld the urge to urinate in order neither to arrive late to myriad adjunct teaching assignments, nor to leave the classroom. I have, consequently, lost control over my bladder and now wear diapers pads which I routinely soak (such that the urine rolls down my legs, into my shoes, and ultimately onto the floor) several times per day. Are there any physicians who might be able to ameliorate my situation, possibly even either to reverse, or to repair this damage? I have read that lithium damages the renal tubules’ ability to be sensitive to aquaporin. If this is so, is there either an analog or a means through which an exogenous administration of aquaporin, similar to that of insulin for diabetics, available.

I know of no way to repair the damage done to your bladder.  I am a nephrologist and have no expertise in bladder diseases.  Diseases of the bladder and lower urinary tract are within the expertise of a urologist.  Hence, … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis