Dear Doctor, I have done kidney transplant 11 years back. Am urinating less in the day time – 2times. But in night time, am urinating 3 times. Is this normal? I did my routine checkup 1 month back and all parameters were normal.

This is a common story with kidney transplants.  I have never heard of a definitive explanation for this phenomenon but when the kidney is transplanted, all of the nerves to the kidney have been cut. Hence, the fact that the kidney has no nerve supply may be the reason the “kidney gets it’s days and nights mixed up”.  I know of no other explanation.

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

Hello sir, my creatinine level is 6.62 GFR 10 and my age is 23 years old.

The testing that you report would suggest that you have very advanced kidney disease.  I suggest you consult with a nephrologist in your country.  You likely need further testing in regards to your kidney disease.

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

I have done kidney transplant 11 years back. Am healthy now. My question is that sometimes my urine output in day time is very low but I urinate excessively in night time. What could be the reason? For example, day time 1-2 times am urinating but in night time 3 times urinating. Please advice.

This is a common story with kidney transplants. I have never heard of a definitive explanation for this phenomenon but when the kidney is transplanted, all of the nerves to the kidney have been cut. Hence, the fact that the kidney has no nerve supply may be the reason the “kidney gets it’s days and nights mixed up”. I know of no other explanation.

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

Hello. I have had blood in my urine for a couple of years now. They did a culture and all was fine. I then got a kidney ultrasound and it was fine as well. My kidney function continues to decline and now my BUN is elevated and my anion gap is low. I don’t have any swelling, pain etc. Also my folic acid is high. Any ideas? Thank you.

In some cases, when a diagnosis is not evident and kidney function has started to decline, a kidney biopsy may be necessary in order to know what disease you are dealing with and see if any treatment is available.  I suggest that you consult with a nephrologist about whether a kidney biopsy may be indicated.

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

My mother passed away in the middle of dialysis. I have been in stage 3 kidney failure for some time. The only reason I know this is from my tests results. Last test done June 28 shows creatine 1.36 and GFR 39. None of my doctors have addressed my kidney function with me and I am wondering why? I have HBP with congestive heart failure, emphysema and type 2 diabetes. Shouldn’t I be on some kind of program to help stop the loss of kidney function?

I am unable to make a specific diagnosis based on the information that you present. In most cases, it is not possible to completely stop the loss of kidney function.  There is a normal loss of kidney function that occurs as a result of aging.  You lose about 1% of kidney function per year, just on the basis of aging alone.  You have diabetes and heart disease, both of which are associated with chronic kidney disease (CKD).  Hence, in your case, careful management of your heart disease and diabetes should lead to stabilization of your CKD.  In other words, there may not be any specific treatment for slowing the loss of your kidney function other than carefully treating the disease that is causing your kidney disease (heart disease, diabetes and high blood pressure).  You should discuss this with your physician.

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

Hi Doctor, I am a CKD patient and my creatinine levels and GFR keeps fluctuating. My last reports were Creatininine 1.4 & GFR 49 and report after that was 1.6 and GFR as 40. I don’t know what went wrong. Please help me. I am 30 years old married woman living in SFO.

The variation in your serum creatinine and your estimated glomerular filtration rate (eGFR) could just be normal laboratory variation. The laboratory measurement of creatinine can vary by 0.2 milligrams per deciliter (mg/dl) from day to day. I am not able to make a specific diagnosis based on the information that you present.  I suggest that you discuss your concerns with your physician and see if any further testing is required.  I also suggest that you have urine testing for blood, protein, and infection whenever you have a creatinine test to follow up your kidney disease.

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

My brother has been put on the kidney transplant list at Cedar Sinai in Los Angeles. He and I are 2 years apart and share both mother and father and there is no denying we are siblings. I would very much like to give him a kidney. He is all I have left. Please tell me what I can do to better my health and be tested as soon as possible. I’m pretty healthy, just a little out of shape. Also he is 49 and I am 47. Please help me.

Since your brother is already on the transplant list, all you need to do is contact the transplant center and ask to be tested. Once your brother is on the list, then his insurance coverage should pay for your evaluation to see if you are a suitable kidney donor. To learn more about being a kidney donor, you can visit our web site at:  https://www.kidney.org/transplantation/livingdonors

Posted in Ask the Doctor, Kidney-Related Health Questions, organ donation

Is it really possible to use shock wave treatment when 8 cm stone were in the ureter? Is it not too risky for a patient who has a heart problem and is a senior citizen?

The question that you ask is a urological question. I am a nephrologist and have no surgical experience. An 8 centimeter stone is a very large stone to have in the ureter.  I recommend that you consult with a urologist regarding lithotripsy of such a large stone.

Posted in Ask the Doctor, Urological Issues

I a 48 year old caucasian male, diagnosed with Stage 3 CKD in 2017, biopsy confirmed IgAN in January of this year, was started on Prednisone and SoluMedrol for 6 months. With two more weeks of Prednisone treatment. For the first time in 18 months I have no Hemoglobin or RBC in my urine. However, my creatinine level has remained around 1.6 and my GFR is 47, it was 46 at the beginning of treatment in January. Is the resolving of hematuria (given no appreciable improvement in GFR) reason to celebrate? Or with no improvement in GFR has Prednisone not worked for me? I have not had an issue spilling protein, until I convinced my nephrologist to allow me to suspend Lisinopril for 2 months. Once I restarted the 10mg of Lisinopril my protein spillage resolved. I have read that hematuria and proteinuria are bad prognostic predictors for progression of IgAN towards ESRD. I remain hopeful with these resolved, however am confused why my eGFR or creatinine are not also showing improvement.

In the case of glomerulonephritis and in the specific case of Immunoglobulin A nephropathy (IgA nephropathy), once glomeruli have been destroyed by disease, it may not be possible to repair old ones and it is NOT possible to build new ones. Hence, the estimated glomerular filtration rate (eGFR) may not improve with treatment. The improvement in urine protein (proteinuria) and blood in the urine (hematuria) are good signs of response. The goal of treatment may not be to return the eGFR to normal but rather to stop destruction of the kidney and maintain current function.

Posted in Ask the Doctor, GFR, Glomerulonephritis, Hematuria, IgA Nephropathy/IgA Dominant Glomerulonephritis, Kidney-Related Health Questions, Proteinuria

I have mild fullness of right pelvicalyceal system and left renal calculus.

I am unable to provide a specific diagnosis based on the information that you present. The problem that you describe may be a kidney blockage with a kidney stone. This is a urological problem. I suggest you consult with a urologist.

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