At night I get pains in legs anywhere from feet up to and including my thighs. Sometimes it is very painful and on a few occasions I have not been able to walk on my leg while the pain has been intense. It feels as if it could be muscle spasm or vascular spasms. I have to get out of bed when this happens and walk around until the pain subsides before I get back into bed. Could you please tell me what is causing this to happen and if there is anything I can do to stop this happening?

The cause of muscle cramps is often very difficult to diagnose with precision and can be very difficult to treat.  It is important that you see your physician and have testing for the common causes of muscular spasms including blood chemical abnormalities, diabetes, peripheral vascular disease, neurologic illness, anemia, and chronic kidney disease (CKD).  You should have a complete history and physical examination.  Once this is accomplished, your physician can possibly establish a specific diagnosis and then recommend treatment.

Posted in Anemia, Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney-Related Health Questions

Sir, my mother is a stage 3 ckd patient. DM for 21years, age 51, hypertensive, average bp 130/80 mmHg. We measured creatinine level 1.69 last December. Then 3 days ago she suddenly developed ureteric stone which passed spontaneously with hematuria. Before 1 hr of passing stone, her creatinine was 2.2 and after 24 hrs of passing stone, her creatinine was 2.9. Sir, can creatinine rise suddenly due to obstructive uropathy? Can’t it be normal?

The serum creatinine does rise in response to obstruction and the estimated glomerular filtration rate (eGFR) will fall in response to obstruction of the kidney with a kidney stone. Follow up testing will be necessary in order to determine if kidney function will return after the stone passage.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney Stones, Kidney-Related Health Questions, Serum Creatinine

Dear Sir, I have had kidney failure for about 12 years. My Doctor knew I had kidney failure and never told me. I kept complaining on different things. Now I have found out I was on the wrong pills. I am on stage 4 with my kidneys, I have a lot of pain in my thighs and it stops me from walking. I am only walking very slowly, I get out of breath very quickly I have gone very weak. I need a new shoulder and a new elbow. My left leg needs a knee replacement. I have had a cortisone injection and it helped. Can you help me?

I am unable to make a specific diagnosis based on the information that you present.  I recommend that you discuss your concerns with your primary care physician (PCP) and discuss your need for joint replacement. There are many things to consider if you are considering orthopedic surgery.  You and your PCP should discuss your risk of worsening your kidney disease by having orthopedic surgery.

Posted in Ask the Doctor, Kidney-Related Health Questions

I recently learned through a CT Scan and an MRI that I have no left kidney, the scans show no tube leading up either. However, there is “remnant fossa” on the left side. My gastro doctor did NOT inform me of this before or when I had my gallbladder out. I only learned through medical records. I made a huge fuss (all the meds I have been on some were dangerous to the kidney!) My gastro sent me to a nephrologist friend who tested me for some autoimmune diseases and couldn’t find anything in blood markers. I am still worried! The only advice he gave me was to go to my annual appointments and get blood tests, and not participate in dangerous sports, ride motorcycles, etc. He also told me to avoid NSAIDS. My blood levels are on the high side of normal. I have been having lots of side pain. But he says basically just live my life. I am on gabapentin for trigeminal neuralgia and I don’t trust this doctor’s advice. He didn’t even mention the gabapentin. Should I see a different nephrologist?

If no kidney tissue is present in the left kidney area, then you may have been born without a left kidney. There is no treatment for this. This is a finding that is often discovered incidentally while looking for something else. I suggest that you consult with your primary care physician (PCP). He or she should be able to put all of the information together from all of your consultants and see if any further testing is necessary. The absent left kidney should not be associated with any pain.

For more information on “Living With One Kidney”, click here.

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrectomy / One kidney

My (70 yo) wife had a MRI done to asses damage to her T-11 vertebrae. The MRI showed a burst fracture to T-ll and it is being treated with a TLSO brace. Within the radiologists report there was mention of left kidney atrophy. I was able to view the scans from the DVD provided by the imaging center. Some of the images show that the left kidney atrophy has reached a point where the kidney is 20% (+ -) the size of the right kidney. The renal artery shows atrophy as well. Patient has long term hypertension that has been controlled reasonably well over the past 20 years but she has had periods where the PB was not well controlled. She had complained of left side pain, on and off for the last year or so. My question to you is, does she need to attend to this matter immediately, or is it something that can wait until the fracture has healed? Thank you.

Atrophy of her left kidney should not be associated with any pain. I am unable to make any other diagnosis based on the information that you present. Her high blood pressure could be associated with the atrophic left kidney but if her blood pressure is well controlled, no intervention should be required. I suggest that you consult with her primary care physician and see if any other problems could be present that would have caused the atrophy of the left kidney. I do not think this is an urgent problem.

Posted in Ask the Doctor, Hypertension/High Blood Pressure, Kidney-Related Health Questions

Hello Doc, Good day! I was diagnosed that I had a kidney stone and galbladder stone and was undergone a major surgery last 2011. When they run some test, they found out that I have high serum calcium. I’ve been taking medicine for 6 years now as a maintenance. I would like to ask doctor, is it okay if I am going to take glutathione even if I am taking some medicine? Does glutathione affect my urine and serum calcium or my kidney? I asked my urologist but he said it is better not to take glutathione to avoid the risk. My maintenance are Ural that contains sodium bicarbonate- 1760mg Sodium citrate-630mg Citric acid-720mg Tartaric acid-890mg Prescription 3x a day before meal Hydrochlorothiazide 25mg Prescription 3 tablets a week (MWF).

I am unaware of any studies that have tested the use of glutathione with other medication or in patients with kidney stone disease.  No such studies have been done to my knowledge.  While glutathione is generally recognized as safe in the general population, we don’t know what it will do in patients taking other medications or in patients with kidney stone disease.  Hence, I agree with your physician that you would be taking some risk by taking an herbal supplement while taking other prescription medication.

Posted in Ask the Doctor, Herbal Supplements in Kidney Disease/Failure, Kidney-Related Health Questions, Medication and Kidney Function

I have renal problem and now my creatinine level has gone up to 5.48. Kindly advise if there are any medications without having to undergo dialysis. I am 54 years old. Thank you.

I am not able to make a specific diagnosis based on the information that you present. You have very poor kidney function, but I am not able to recommend treatment without performing a complete history and physical examination. You should consult with a nephrologist to determine the cause of your kidney disease and this will lead to a specific diagnosis and specific treatment recommendations.

Posted in Ask the Doctor, Kidney-Related Health Questions

I have an enlarged prostate. I have limited my fluid intake to avoid urinating so often. Some weeks ago, I thought I pulled a muscle in my lower back, it turns out that it is my left side kidney that is hurting from being dehydrated. My question: is my kidney going to repair itself and stop hurting or have I damaged the kidney permanently. Thanks for your help.

The problem that you mention is a urological problem. A urologist is a surgeon and deals with diseases of the prostate. I am a nephrologist and would suggest that you discuss your problem with a urologist. If the prostate problem can be relieved, then your kidney function should improve. One the blockage of the prostate is relieved, I would expect your kidney function to improve.

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Urological Issues

When is it decided that dialysis is needed? Stage 4 is the number I was given – what does that mean? Dialysis was said I needed and I chose in the gut. How long can I be on this until a transplant is needed?

The decision to start dialysis is based on a discussion between you and your nephrologist. It is not based on any number or stage. When your symptoms become significant and dialysis is felt to benefit those symptoms, dialysis is often indicated. Dialysis through your stomach (“gut”) is known as peritoneal dialysis and this is often a gentle way to start dialysis so that you can be prepared for a kidney transplant. You should ask your nephrologist if you can be evaluated for listing on the transplant list. You do not need to start dialysis or be on dialysis to be evaluated or listed for a kidney transplant. Your estimated glomerular filtration rate (eGFR) must be less than 20 milliliters per minute per 1.73 meters squared to be considered for a kidney transplant. If your kidney function is less than 20, I suggest that you discuss transplantation with your nephrologist.

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

I have Stage 3 kidney damage. I need to take meds for reflux. I am being told by PCP and GI to take PPIs. I am worried about the safety of taking them. Is there something safe for reflux? I have lost weight and that has not worked. I don’t see a nephrologist because the ones I saw said I can be managed by my PCP. Both nephrologists are no longer in practice. I have no one here to ask about this so I am grateful you are willing to take questions. Thank you.

The short term use of Proton Pump Inhibitors (PPI’s) is generally safe and often effective in the treatment of gastro-esophageal reflux disease (GERD). The long term use of PPI’s has been linked to chronic kidney disease (CKD). One alternative is to take older H2 blockers such as famotidine, ranitidine, and nizatidine. These are older agents often can be effective in treatment of GERD and have not been associated with CKD. I recently wrote a blog on the Huffington Post about this particular issue. You can access this article at: Heartburn and Kidney Disease

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