Category Archives: Treatments

Hi I have wanted to donate a kidney for years. I was diagnosed with stage 1B squamous cell lung cancer in 2012. The left upper lobe was removed and I had one dose of chemo which almost killed me. It will be 5 years on Aug 20 2017. Can I donate a kidney or is it to risky? My age is 58 yr old female otherwise in decent health.

It is unlikely that you could be a kidney donor with a history of lung cancer.  It is your right to offer to donate, and each and every transplant center determines who can and cannot be a kidney donor.  There … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Living Donation, Symptoms and Side Effects, Transplantation, Treatments

My brother is awaiting a second kidney transplant. His first transplant was 7 years back. Dr’s are saying his PRA levels are very high. He has HLA Class I PRA -7% and HLA Class II PRA -91% (tests done in Feb 2017) What are options to reduce PRA and can continuous dialysis for some more time reduce PRA? He started dialysis again in Feb this year and he had few blood transfusions in Jan & feb this year.

Panel reactive antibodies (PRA’s) are immune proteins in the blood that are non-specifically directed against potential kidney donors.  In some cases, the exact Human Lymphocyte Antigen (HLA) type can be detected, but in some cases, we do not know the … Continue reading

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

Hello Dr. Kindly, I have a question about “men’s multivitamins”, especially (One A Day Men’s Health Formula).? I have a kidney transplant in 2010, a good creatinine rate at 1.3 and stable. Is it safe to use One A Day® Men’s Health Formula?

A multiple vitamin sold over-the-counter is safe for a kidney transplant patient to take.  This particular vitamin is common and should be safe for you.  

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

I started home hemodialysis about 10 months ago and I’m concerned about shortness of breath that I’m having recently. I am trying to figure out a number for the amount of fluid I can safely remove in a run of dialysis. I found a formula that says under 10mL/kg/hour is safest but I tend to break medical formulas. I am 7 feet tall and my dry weight is approximately 173kg; I am about 25% overweight (my ideal weight as far as anyone can tell me would be about 135kg). Using this formula I calculate I can remove almost 7L of fluid in a 4 hour run and still be in the safest range for CV complications. I am currently removing a maximum of 4L in a 4 hour run but recently this doesn’t seem adequate as I have had to have several “catch-up” dialysis sessions to keep my fluid weight down. Does this formula work for me? If needed can I safely remove more than 4L during a run? I should add that I have high blood pressure that never goes low after HD.

Very large individuals, such as yourself, have a very hard time maintaining fluid balance with dialysis only three times per week.  While the formula that you mention is one that I also use, it may not be appropriate for large … Continue reading

Posted in Ask the Doctor, Kidney Failure, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

What is the best solution to use for a cleanse before a colon exam?

Before a colon examination, such as a colonoscopy, I recommend use of laxatives that contain polyethylene glycol plus electrolytes (such brand names as Miralax, Golytely, Nulytely and many others).  I do not recommend Magnesium Citrate or Fleets Phosphasoda.

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Treatments

I am male 82 years old. I tested today for 2.0 creatinine. I have been taking for a long period of time 3mg a day of Ativan and 400 mg of Ibuprofen. Could these medicines affect the creatinine level and if so would it raise them that much? About a year ago, it was less than 1.3 and I have only tested again this year to find the high increase.

Ibuprofen can reduce kidney function and should not be taken long term.  I suspect that the abnormalities in your kidney function may be related to the ibuprofen.  I suggest that you stop this medication and then see your primary care … Continue reading

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

I am at stage 4 kidney disease. My question: If I take a multivitamin, like Centrum Silver, will this hurt my kidneys more?

A multiple vitamin such has Centrum is safe for patients with chronic kidney disease (CKD).

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Medication and Kidney Function, Treatments

I am a healthy 24 year old white male taking 1 gram of Valtrex/day for the last 18 months. I have no symptoms but on a routine blood test my kidney functions were Cr of 1.87, BUN of 27, BUN/Cr ratio of 14 and a eGFR of 49. Urinalysis shows no protein. I discontinued Valtrex 5 days ago and will have a second blood test plus a 24 hr urine collection. My question is: is increasing intake of fluids and possibly consuming cherry juice as it’s done for gout help my kidneys recover from crystal deposition? I have no medical problems, my BP is 110/70.

The testing that you describe, if it remains abnormal for more than 3 months, does suggest that you have chronic kidney disease (CKD).  I am unable to make a specific diagnosis based on the information that you present.  If you … Continue reading

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

I underwent a nephrectomy on April 3 whereby my left kidney and large tumor was removed. I have had a number of blood tests since then and have noticed that my BUN and creatinine are not within normal ranges BUN (35) creatinine (1.70) and my egfr is currently (June 13,) at 40. Should I be concerned at this point? I assume that without one kidney it would be low.

After undergoing removal of a kidney, your kidney function tests will be abnormal and the estimated glomerular filtration rate (eGFR) will be low.  After removal of one kidney, I would expect the eGFR to be in the range of 50 … Continue reading

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

Hi Dr. Spry — 39/yo amateur bodybuilder here. I learned a couple years ago that I have kidney dysplasia, one side completely polycystic kidney and the other mildly hypertrophied. I am used to my creatinine running high (over 1.3) and GFR just shy of 60. However some recent labs have disturbed me! Serum Creatinine 2.0 — note that I weigh ~100kg/225lbs largely muscle, this has crept up over time correlated with my weight gain (1.3, 1.5, 1.7, 1.8…) 24 hr urine contained 2.3g protein! — note that I didn’t know not to train, and trained legs (intensely) the day of sample collection eGFR 35-40 — could this be related to creatinine? BUN 44 — Note that I have been on very high protein diet, upwards of 4g/kg (400-450g total) I have been on Losartan for hypertension for about a year and a half. My BP is usually well controlled. Due to some other chronic illness (HIV, well controlled CD4 healthy normal range) I track my lab values in a spreadsheet. I can see a correlation between my weight/muscle gains from 200-220lbs and the increased serum creatinine and reduced eGFR. When I learned that I had the kidney dysplasia I had a proper radioactive measurement, and all I have in my notes is that GFR was fine and healthy for one kidney. Questions: 1. Is it possible/believable that this is all caused by my atypical muscle mass and intense training? (High creatinine, thus low GFR, exercise induced proteinuria) 2. With the kidney dysplasia, do I technically have CKD with basically 50% of a normal person’s kidney function? I am freaked out thinking that I’ve suddenly in the last 9-12 months had some sudden kidney injury!

By definition, you have chronic kidney disease (CKD) because the dysplastic polycystic kidney has been present for at least three months.  Hence, you do have reduced kidney function.  The body building that you are doing will increase the serum creatinine … Continue reading

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