Dear doctor, my son is 10 years old. He has protein in urine between 0,15 – 0,45g for 24 hours. In the morning, before he gets up from the bed and we collect urine, there in no protein. But after movement he has protein. He has this problem from one year and the doctors can not understand what is the reason. Now they want to make biopsy and I am afraid. They say all checks are normal, only he has a little high cholesterol and GFR a little high – 187ml/min 1.73. What do you think? Please, be so kind to help us. Thank you in advance! Best regards.

There is a finding in children known as “exercise induced proteinuria” or “orthostatic proteinuria”. This is characterized by excess protein in the urine when the child is active and the protein is not present when the child is supine and sleeping. This is a normal variant and the child should grow out of this finding in their 20’s. You should discuss this diagnosis with your physician and see if your son fits this description. If he has this finding, this is a normal variant and I would not perform a kidney biopsy in this situation.

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

I am at Stage 5 kidney failure, 71 years old and have been called in twice to guys to be sent home twice (once the kidney had a “hit” in the car accident and next one advised lesions on the lungs of heart attack lady probably cancer) which from here takes over 3 hours each way and is really emotionally traumatic for a couple of days after. Both times I was prepared to go ahead but subsequently advised (at 0300) not to do. I understand it is a lengthy process securing the kidney but worried about going through it all again if called. Are there a series of questions I can ask when I get the call to minimize all the heart ache please? Would really appreciate your help as I can not find any information on the web after extensive searching.

I do not know of any way to simplify the transplant process. As a kidney transplant becomes available, it is common to call in two people for each kidney that is available so as to make sure that someone is immediately available to receive the kidney transplant. Each transplant donor is unique and there are unique considerations for each donor. Hence, I can only suggest that you discuss your concerns with your transplant coordinator.

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

I suffer from rental tubular acidosis and take high volume of potassium chloride SLOW K & sodium bicarbonate. Both of those, I think, are time release or slow release meds. Well my question is, if I have bariatric surgery specifically RNY BYPASS which creates malabsorption will that affect my intake of potassium and sodium medication??? If so, is there any immediate release medication available??

The sodium bicarbonate is immediate release and the Slow K (potassium chloride) is delayed release. There are forms of potassium, including potassium citrate and potassium bicarbonate that are immediate release. You should discuss this with your physician. Your physician would have to decide if these forms are appropriate for your situation.

Posted in Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions, Medication and Kidney Disease

Can someone donate a kidney here?

In order to be considered as a kidney donor, you must contact your local transplant center to be evaluated as a potential kidney donor.

You can go to our web site and learn about how to find a transplant center at: https://www.kidney.org/atoz/content/how-find-transplant-center

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

Respected Sir, I have done 3 tests for kidney immediately after 30 minutes of taking lunch @10AM on my own decision in a reputed research lab and found below observations : 1) Micro Albumin by (Auto Analyser) =========================== Urinary Micro Albumin 10 mg/l. Urine for creatinine 10. M : C Ratio 100 mg/g 2)Serum Uric Acid =================== Serum Uric Acid 7.3 mg/dl 3)eGFR ============================ TEST NAME TECHNOLOGY VALUE UNITS EST. GLOMERULAR FILTRATION RATE (eGFR) CALCULATED 119 mL/min/1.73 m2. I am afraid now. Is my kidney damaged? Let me know what should I do now?

The normal for a urinary microalbumin to creatinine ratio is less than 30 milligrams per gram (mg/g) of creatinine. The value that you mention is 100 mg/g. This is abnormal. The estimated glomerular filtration rate (eGFR) that you mention is normal at 119. The uric acid test at 7.3 mg per dl is above the normal range of up to 6.0 mg/dl. I suggest that you discuss this with your physician to determine if treatment is warranted. I am unable to make any other specific diagnosis or treatment recommendations based on the information that you present.

Posted in Ask the Doctor, GFR, Kidney-Related Health Questions, Serum Creatinine

I am 42 years old. I am diabetic since the age 25. I do regular checks for my kidney test but since 6 months, my protein in kidney goes higher and higher. Recent test shows 1034 protein leakage in kidneys. I am wondering what should I do to stop or lower my kidney leakage for protein? What do you suggest for medicine or diet to fix that problem? How serious is that problem right now? My kidney test is normal as per doctors say but I am very worried about protein in my urine. Doctor advised me to take Lisinopril for 2.5 but now I increased my dose for 10Mg. Any thing else you recommend me to fix this issue? Thanks.

Diabetic kidney disease is present when someone with Type 2 diabetes start spilling excess protein in the urine, when previously they had no protein in the urine. In most cases, this is associated with diabetic eye disease and high blood pressure. The treatment includes using ACE-inhibitors such as Lisinopril to control the high blood pressure and keeping the diabetes under very tight control.  This means keeping the Hemoglobin A1c between 6.5-7.5% and keeping blood pressure less than 130/80. You should follow a low salt diabetic diet, exercise regularly and maintain a healthy body weight. You should not smoke and you should avoid non-steroidal anti-inflammatory drugs (NSAID’s). You should discuss all of these issues with your physician.

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

My husband is 39 yo and obese, and is looking to make a serious lifestyle change, but wants to do it right, rather than take GNC supplements and go on a fade diet. We just discovered he only has 1 kidney. What type of diet should he follow, and is there any safe meal replacements to consume?

I recommend the DASH diet.  You can review the DASH diet at: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

I recommend exercise and calorie restriction for weight loss.

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

Can you please explain to me why a DR. doesn’t seem concerned when you are stage 3A CKD? This has turned my world inside out, but they act like it’s no big deal. Why can’t I seem to find any clear answers on what I should be eating to prevent further damage? Please help, and also I was on 100mg Losarten. I pulled myself off of it recently and my BP has remained within normal limits. My Dr. agrees to stay off of it for now, but then I read where it helps protect the kidneys from spilling protein. Seems like I can‘t trust the Dr’s. :(

I am unable to establish a specific diagnosis based on the information that you present. You should discuss the specifics of your diagnosis with your physician. In many cases, there is not specific diet that should be recommended. I am a strong proponent of the low salt DASH diet for people with Stage 3A chronic kidney disease (CKD). There is often no specific treatment for CKD Stage 3A except to treat underlying high blood pressure and treat any protein that is present in the urine. I do recommend that you have urine testing for protein. Any further testing should be determined by your physician. Treatment will usually require a healthy lifestyle, exercise on a regular basis, avoid smoking and non-steroidal anti-inflammatory drugs.

You can review the DASH diet at:  https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

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

One of my family members did their regular test and we found that his CREATININE SERUM is 4.68 mg/dL. I want to know the following: 1) How much we should worry about? 2) What should we be doing now to control it? As weight seems to be going down very fast. Any help would be very helpful.

The serum creatinine that you quote is very abnormal and should be investigated further by your family member’s physician. I am unable to make any specific diagnosis based on the information that you present. I suggest further testing to see if this is acute kidney disease or chronic kidney disease (CKD).

Posted in Acute Kidney Injury, Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

I have had a GFR around 55 for 12 years. I am a 58 year old female. My blood pressure is 96/60, I don’t have diabetes, heart disease or any other health problems except IBS, and gluten intolerance. I have had multiple GFR readings, the lowest is 37 three months ago (and 5 years ago) and recently a GFR of 42. I don’t understand the huge drop as I have been disciplined on my kidney diet. If anything I just need to watch salt. I eat little to no red meat and am careful with meat (chicken) portions. The doctor says he’s not surprised to see my drop after 12 years of a GFR around 55. My question is, why the sudden drop and if this drop happened so quickly, could I drop another 13 as fast? I don’t feel like there is much I can eat being gluten intolerant and now doing a vegan diet as my doctor suggests. Should I go that drastic (by eating a vegan) diet? Should I do anything else to help my kidneys? I want to do all I can to prevent dialysis. One further note is that I have one kidney smaller than normal. If we can live on one kidney, why would one smaller kidney be a problem?

The estimated glomerular filtration rate (eGFR) is subject to some variability as a result of variability in laboratory testing. Hence, the increase or decrease of the eGFR by plus or minus 10 milliliters per minute per 1.73 meters squared (ml/min) is a phenomenon of laboratory variation. I would not place a great deal of emphasis on a single laboratory determination. I don’t think your dietary adjustments are warranted and would continue to monitor and chart the overall trajectory but not place emphasis on a single laboratory test. I believe your current dietary intake should be adequate for your health and does not require further adjustments.

Posted in Ask the Doctor, Diet/Nutrition, GFR, Kidney-Related Health Questions