Category Archives: Treatments

Have had swollen ankles, lower legs, and abdomen for almost 2 years now. I do have HBP but has been maintained. GFR is 60 with creatine 0.9. Both fluctuate. Lowest GFR 59. No 24 hr urine test done. I have hyperlipidemia and hypoalbuminemia (3) with elevated ESR 54mm. I am age 49 female white. History of kidney problems with right kidney backing up with urine. Was drained 2 times as an adult. I’m on mesalamine for Crohn’s disease. The swelling I have in my abdomen is on right side. PCP doesn’t seemed alarmed and doesn’t think kidney related. Do you feel I should seek a second opinion with a nephrologist? I appreciate your input.

I suggest that you have urine testing for blood, protein and infection.  If your urine test is normal, then I doubt that your swelling is related to your kidneys.  I am unable to make any other specific diagnosis based on … Continue reading

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

I noticed when you get questions about vitamin D deficiency you do not seem to mention going out in the sun 10 or 15 minutes several days per week, every week as a way to increase Vitamin D. Is there a reason you don’t mention that way ? Is sunlight harmful to the kidneys ?

You are correct that 10 to 15 minutes of sunlight exposure is enough for most individuals to get normal levels of vitamin D.  However, in patients with chronic kidney disease (CKD), despite sun exposure, they have low levels of vitamin … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Medication and Kidney Function, Symptoms and Side Effects, Treatments

Is working out affecting the creatinine level? Using gym supplements will do any harm? My creatinine last year was 1.37, this year 1.56 and this is was the highest. I have tested after a month later it’s between 1.31 to 1.48. No blood and protein in urine. Ultrasound is good, nothing abnormal. Do you have any suggestions to do more investigation? I’m 25 years, eGFR is 76.

The supplement “creatine” can cause an elevation in the serum creatinine.  This supplement is commonly used as a gym supplement.  In some cases, I have measured a 24 hour urine collection for creatinine clearance to determine if kidney function is … 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 have suspected Loin Pain Hematuria Syndrome. My pain went from occasional to severe/life altering 3 years ago after taking Miralax for about 8 months due to another health issue. This is when I started to realize certain medications had a direct affect to my pain. When I stopped using Miralax the pain improved but never went back to what it was pre-miralax. I had frequent flareups that would last from a few days up to 8 weeks, the pain would get so bad I could hardly get up to brush my teeth. I stumbled across your post that said “It is important to avoid non-steroidal anti-inflammatory drugs (NSAID’s) such as Motrin, Ibuprofen, Advil, Aleve, Naproxen and Toradol. These drugs will often make the pain worse.” After reading this, I stopped taking all NSAIDS. My flareups and general pain have greatly decreased. I KNOW not taking NSAIDS has made a huge difference. But interestingly, I have yet to find this advice anywhere else? I was wondering what the reasoning behind this is? And what other medications might cause increased pain? I just finished 3 days of Diflucan (fluconazole) and am now in my first flareup in several months. I’m wondering if there could be a connection? Thank you.

We do not know the cause of Loin Pain Hematuria syndrome.  It is thought that the non-steroidal anti-inflammatory drugs (NSAID’s) cause worse bleeding from the kidney and in that manner cause more pain.  Blood thinners may also cause worsening of … Continue reading

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

My EGFR is currently 44 and my most recent visit with PC she decided to put me on Atorvastatin Calcium 5mg every night. I know that is not much but when I read about the medication it says it can cause kidney disease so this really worries me. I would like to know your thoughts. Also, I have low Vitamin D levels at 24 on last test and I am unable to take a supplement as I have a horrible side effect of diarrhea when I take it. Is this a Kidney disease side effect or is it just me? I have tried several different tablet forms and same result with all. She said 24 is not very low but when it was at 27 my neurologist was not too happy and said I needed supplements. I have been asking my PC for the Vitamin D shots but I keep getting refused because it isnt “low enough”. I have to take a sublingual B6 and B12 supplement to keep my B12 where it should be. PLEASE OFFER ME ANY ADVICE YOU CAN!

The normal for vitamin D levels is greater than 30 nanograms per milliliter (ng/ml).   Your level is a very mild deficiency.  If you can take calcium with vitamin D that is an over the counter preparation, this could be … Continue reading

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

Hello, My mom is suffering from Chronic Kidney Disease stage 4. We were looking for treatments besides managing strict kidney diet and lifestyle. I have couple of questions: 1. We recently found out about treatment through probiotics, specifically ‘Renadyl’ and vitamin ‘ProRenal’. We have read a lot about it, where CKD patients have reviewed this probiotic and have had good experience with it. So we wanted to consult with a nephrologist who have had experience with Renadyl probiotics and ProRenal vitamin, or know how effective and safe Renadyl is. 2. Also, we were wondering what is the status with stem cell based kidney regeneration therapy. If this is already a viable option ? Any guidance would be appreciated with regards to the above treatment options. Thank you.

There are currently no stem cell treatments that are approved by the Food and Drug Administration (FDA) for treatment of any kidney disease. I have no experience with “Renadryl” and am not aware of any randomized controlled trials with this … Continue reading

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

My 26 year old son is on the transplant list. He was born with Hirschsprung’s Disease and as a result of multiple surgeries he was left with no large intestines and a latex allergy. For a year he has been at end stage renal failure but managed to stay off dialysis with a very strict vegan diet. Looking at the side effects of his meds post transplant, I am wondering how much water he can drink to avoid GI issues. Although he’s always been an athlete, he has chronic dehydration due to his body’s inability to absorb fluids. I believe this is what caused his kidney problems in the first place. His BP is also off the charts requiring medication. The doctors he has spoken to don’t seem to factor his medical history into their diagnosis or treatment. Are you aware of any studies that discuss fluid intake in people with no large intestines?

The requirement for fluid intake can be assessed by having your son weigh himself every day and then drink sufficient fluids to maintain his body weight.  This is what I do with patients who have high fluid requirements and have … Continue reading

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

I’m a 47 year old white female. I donated a kidney to my sister in Dec > 2017 and have not had any problems. No chronic diseases, 0 meds, 0 > alcohol/tob. Been feeling off for a few weeks, with slight urgency, > then 3 days ago woke up with worsening urgency and frequency, nausea > and vomited once. I’m an FNP so ran a UA expecting leuks or maybe a > little blood, but leuks and nitr. Neg, small bili., trace blood and > ketones, 1+ prot., sg >1.030, ph 5.5. My PCP was full so had a > colleague prescribe Macrobid. Now on day 4 urgency and frequency much > better after day 1, but can’t get rid of the nausea. I would say it > was just the Macrobid if the nausea hadn’t started before taking. Just > worried only having 1 kidney. Hoping all the above is just a nasty > bladder infection, but with no leuks. Can the other positives on my > UA be caused by infection? Haven’t had a bladder or any kind of > infection in over 20 years. Drink good amount of water. This just came > out of nowhere and the UA has me freaked out. Is the nausea Macrobid > or infection? Does the UA reflect infection or kidney issue?

I am unable to make a specific diagnosis based on the information that you present.  I can only suggest that you be seen and have a complete examination.  It is often said that “people who treat themselves often have a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Living Donation, Medication and Kidney Function, Symptoms and Side Effects, Treatments

I’m doing home Hemodialysis I’m taking Aranesp injections 40 mcg. I have had 8 doses of iron while on dialysis. I feel very tired all I want to do is lay down or sit. It is hard to wake up. I feel like sleeping all the time. I also feel like I’m thinking very slow and not understanding simple things. Is this normal? How long until this will get better? I feel like doing everyday things?

I am not able to provide a specific diagnosis based on the information that you present. There can be many causes of fatigue and tiredness in a dialysis patient, including heart disease, depression and other considerations. I suggest you review … Continue reading

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

I’m 66 years old. My Creatinine op is 1.36. My EST GFR is 52. Protein OP total is 9.2 Is this a concern? What are my next steps to correct this? Thank you.

I am unable to make a specific diagnosis of kidney disease based on the information that you present. There are many causes of chronic kidney disease (CKD). Treatment requires a specific diagnosis and then attempting to delay the progression of … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, dabetes, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Disease, Treatments