I have been diagnosed with H Pylori some 12 days back and as of current I am on triple therapy medication. Before this, I was given Razo 40 mg plus Ulgel three times a day for around 35 days as I have acute heartburn which was later confirmed by endoscopy as bacterial infection in stomach. In the mean time, I underwent some tests like Ultrasound, KFT, and LFT. In KFT, my creatinine level shows as 1.9 when 1.2 to 2 is considered as normal. Which means I am at the borderline. I need to know is it because of my medication plus the dryness that I have in mouth because I am not able to take enough water intake as that causes stomach irritation that my creatinine level is high or something is wrong? Shall I opt to consult a nephrologist?

I am unable to make a specific diagnosis based on the information that you present. You will likely need further testing and I suggest that you consult with your primary care physician (PCP) for an examination. You will need a urinalysis to test for blood, protein and infection and will likely need follow up blood testing of your kidney function. Your PCP should be able to perform this evaluation and I do not see a need for a nephrologist at this time.

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Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Nephrologist

My husband has kidney problems. He has low calcium. Please let me know which food he can take to increase calcium. I really appreciate it. Thank you.

Milk, dairy products, beans and kale are high in calcium.

For additional information about nutrition and kidney disease, please visit: https://www.kidney.org/nutrition/Kidney-Disease-Stages-1-4

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

Dear Doctor, I lost my father, 73 years of age, 4 months ago. He was diagnosed with CKD about 11 years ago and his creatinine level was between 2 to 3.5 for most of this item and increased to 4.5 in December 2017. He started dialysis in May 2018 and passed away in Dec 2018 due to upper GI bleed. I have been wondering why he was not recommended for preemptive kidney transplant. He did not suffer from any other co-morbidity. After entering into stage 5, he had a bout of pneumonia and COPD and was suspected of having TB later on. I feel he would have been qualified for transplant before entering into Stage 5 of CKD. Please throw some light on the subject.

Preemptive kidney transplantation is an option for patients who have progressive kidney disease and who have potential living donors. Tuberculosis (TB) and lung disease can be contraindications to transplantation, if these are active. Getting a cadaver donor can be a bit more complicated since the time of waiting can be of unknown duration. His age should not be a major consideration but is one consideration that would be weighed by the transplant center. Each transplant center determines criteria for being a transplant recipient and each one uses different criteria. Once his estimated glomerular filtration rate (eGFR) was consistently less than 20 milliliters per minute per 1.73 meters squared, he could be eligible for evaluation to become a kidney transplant recipient.

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Living Donation, Transplantation

Sir, I am feeling pain in one of my testicles for a long time. Urine discharge with burning. The pain has gone up side. A vein is little much swelled. What medicine do I have to take for it?

The problem that you describe needs to be evaluated by your physician. I am a nephrologist and I have no expertise with diseases of the testicle. You should consult with your primary care physician (PCP) or a urologist for examination and treatment.

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

My dad is 82 years old with bph, has a indwelling foley catheter. Over a few weeks his catheter has been leaking and had saturated his diaper. Nurses have changed out the catheter. Only for it to start leaking again. This has happened a lot. He has a history of UTI’s. He ended up in the ER with septic shock secondary to UTI and pneumonia. Renal failure and respiratory failure. He also had a clogged catheter. My question is at what point do you call for a urology consult? And how do you prevent septic shock?

Problems with the lower urinary tract are within the expertise of a urologist. I am a nephrologist and do not deal with Foley catheters and complications. If there are problems related to infection and a bladder catheter, then urologic consultation would be appropriate.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Nephrologist, Urinary Tract Infection/Pyelonephritis, Urological Issues

High elevated creatinine levels accompanied by normal 24 hour creatinine clearance, scans and BUN. No protein in urine. Should there be concern? Curious because serum creatinine is said to have many influences and muscle mass is one. But there are also massive 6’2″ 300 pound steroid using men’s lab results that come back normal. Big muscle mass like that with a normal creatinine cause concern to me when looking at a 5’8″ person with higher than normal creatinine and no steroid use. When you are much smaller should that cause someone to be concerned as well? Or is everyone different and you need to look at a person as a whole. Considering both the top tests are co-existing normal or if the tests were not yet taken.

A normal 24 hour urine collection for creatinine clearance is a strong indicator that kidney function is likely normal. As you mention, the serum creatinine tends to go up with increased muscle mass and this can be confusing for estimating the glomerular filtration rate (eGFR) which assumes a more normal muscle mass and does not take into consideration an increased creatinine generation rate associated with a high muscle mass. I suggest that you discuss your concerns with your physician for interpretation of your testing, but if the measured creatinine clearance was done properly, then your kidney function is likely normal.

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

I had an acute kidney diagnosis and a kidney biopsy two and a half weeks ago. I am feeling OK except for the side effects of my blood pressure medication. I have been a horseback rider my whole life. My question is, when is it safe for me to ride again after all this?

Horseback riding could be a problem after a kidney biopsy. Horseback riding could be associated with bleeding at the biopsy site. I suggest that you check with the physician who did your kidney biopsy and ask when to resume horseback riding.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions

My adult daughter had a kidney transplant in 2007. She has aura migraines and neurologist is wanting her to get Botox injections every 3 months for these migraines that are stroke like. ARE THEY SAFE FOR HER? Our Doctor said he does have much info on it.

I am not aware of any contraindication to the use of “Botox” injections in patients with a kidney transplant or in patients who are using immunosuppressant medication. Your daughter may want to check with her transplant center to see if they approve.

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

I am a 7 year dialysis patient. I no longer make any urine (1/4 cup per week). I am retaining fluid in my mid section and lungs (no swelling of legs or ankles). How can I move the fluid from my lungs and mid section tissues to my blood stream so it can be removed through dialysis?

Fluid removal from tissues such as your abdomen and lungs takes time. The heart is capable of translocating the fluid from the tissues into your blood space so it can be removed by the dialysis machine. This process takes time and in some cases, we have to add extra time to the dialysis in order to allow this fluid to translocate. In other cases, we add an extra dialysis treatment in order to just remove the fluid from your tissues. You should discuss this with your nephrologist and see whether you need extra time on dialysis to safely remove the extra fluid from your tissues.

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

Dear Dr., Greetings!! I want to know, whether some medicines are newly available to stop kidney damages or reverse it for CKD patients in stage 3? Or is a simple diet and lifestyle control helpful? If yes, what are those medicines? Best regards.

There is no new drugs for the general treatment of chronic kidney disease (CKD). Lifestyle changes including a low salt diet, exercise, achieving a normal blood pressure and maintaining a healthy body weight remain the goals for the general treatment of CKD.

In some instances, new drugs may be available for the treatment of specific kidney diseases. In this case, the important principle of CKD is that a specific diagnosis is necessary in order to suggest a specific treatment. In other words, it is necessary to know the cause of the CKD and the specific diagnosis leads to specific treatment. There have been many new tests that are available to diagnosing CKD including improvements in the interpretation of kidney biopsy.

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