My daughter was born with two kidneys, but lost one after birth. She is very healthy as far as we know with the one kidney life style she is leading. We go see her kidney doctor every year. My concern is that all he wants to check is her blood pressure. He doesn’t ever take a urine sample or a blood test. I was just wondering why? Thank you.

Both I and the National Kidney Foundation would recommend that blood and urine testing for kidney disease to be done annually in anyone at risk for chronic kidney disease (CKD).  If your daughter is still a child, and she has had a prior blood test for kidney disease, then annual blood testing may not be necessary.  I would still recommend annual urine testing for blood, protein and infection.

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

Hi Doctor. I wanted to ask about hydronephrosis. My son has hydronephrosis in both kidneys. Does he need surgery? One Doctor said he needs surgery because of kidneys are swelled but one Doctor said he doesn’t need surgery. He has reflux and he will be fine with time. Please help me. I’m confused.

Blockage of the kidney (hydronephrosis) is within the expertise of a urologist. A urologist is a surgeon and deals with surgical diseases of the kidney. I am a nephrologist and have no expertise in surgery. I suggest that you consult with a urologist. If there is a conflict between two physician opinions, then you may need to consult with your primary care physician (PCP) for advice regarding the conflicting opinions.

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

Hello Dr. Spry, I am a 66 year old female with retroperitoneal fibrosis. I was diagnosed in 1984. My right kidney was blocked to the point it blew up to 3x’s the normal size. The damage was extensive to my right ureter and it had to be wrapped with tissue from my bowels. Now, I have hydronephrosis in the right kidney and my doctor wants to stent me every 6 mos. He feels additional surgery is not an option. I am looking for a physician who specializes in retroperitoneal fibrosis. They are not easy to find. I want to see if I have any other options.

The diagnosis of kidney disease from retroperitoneal fibrosis is a disease that causes blockage of the kidney. A urologist is the best physician to deal with blockage of the kidney. I am a nephrologist and I have no surgical expertise. You need to consult with a urologist, who is surgeon, about any treatment for blockage of the kidney as a result of retroperitoneal fibrosis.

For more information about hydronephrosis, please visit our website at:


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

My husband, 73 years of age, diagnosed with kidney failure; Stage 5 creatinine 4.9, BUN fluctuate from 55 to 65, today is 80. All the other blood and urine test in the range. Still has no symptoms at all. He is scheduled for Fistula. How serious is it to have BUN number that high?

The Blood Urea Nitrogen (BUN) is just another aspect of kidney disease but the absolute number is not of any particular significance. The most important thing that you present is that your husband is not having any significant symptoms. That is the best way to characterize the severity of your husband’s illness.

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

My father had BP last five years. He doesn’t take any medicine for BP. Recently, he has some problems. He walks on some distance (2-4 mins); starts pain in left hand fingers to left chest. After few minutes, take rest to support to go forward. Recently I consulted couple of doctors with my dad. They wrote some test and follow all of them, everything is positive in heart side. They suggest to go for angiography. We prepared, but one of the blood result in the level of serum creatinine comes to 2.3. So doctors said to now angiography is not well because its affect to kidney. Can you give any suggestion and alternatives for this case?

There is going to be some risk associated with any treatment of your father. Your father will need to see a kidney specialist to see if this kidney problem is permanent or if this is potentially reversible. Once the cause of the kidney problem is determined, then there can be planning about how to limit damage to the kidneys and yet treat your father’s heart disease. The dye that is used to take pictures and treat the heart disease can be toxic to patients with chronic kidney disease (CKD). I recommend that your father consult with a local nephrologist.

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

Hi Dr. Spry, I have PKD and have lots of calcifications in both kidneys. Frequently they break off and pass, and this seems to cause bladder and kidney infections. Is lithotripsy recommended for PKD patients? I do have a very good doctor. Thank you!

I am a nephrologist and I do not have any expertise in lithotripsy. A urologist is a surgeon has expertise in lithotripsy and kidney stone disease. I do not believe that lithotripsy is advised in polycystic kidney disease but I suggest that you consult with a urologist who has expertise in this area.

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

Dear Doctor 45 yrs old, Female. Recently went for blood tests and very concerned with the results; especially those in RED. May you please check the test results and advise me if I have any kidney issue/disease? Thanking you in advance and looking forward to your advice.

I did review your laboratory results on line, however, I am unable to make any specific diagnosis without performing a complete history and physical examination. The abnormal laboratory results that are noted here include an elevated blood chloride level, which I suspect is probably not significant. Your creatinine test is normal, however, your urine test for microalbumin is abnormal at 93.5 mg/gram creatinine (normal is less than 30). If this test remains abnormal for more than 3 months, this could suggest chronic kidney disease (CKD). Your total and LDL (bad) cholesterol are mildly elevated but your HDL (good) cholesterol is within the normal range. The remainder of the testing was normal.  I am unable to offer any diagnosis or prognosis without examining you in person.

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

I am a 39 year old female. I’m 5’1′ and my weight is about 165. I received my GFR which is 83. On the GFR Reference Range, it stated GFR’s between 60-90 is considered stage II mild decrease in GFR. Should I be concerned? Currently, I do not have health insurance and cannot afford to see a doctor. Any detailed information will help. Thank you.

In order to make a diagnosis of Stage 2 chronic kidney disease (CKD), your estimated glomerular filtration rate (eGFR) must be between 60 and 90 milliliters per minute per 1.73 meters squared and you must also have abnormalities in your urine such as blood, protein or infection. All of this must be present for at least three months before the diagnosis can be made.  Hence, you will need urine testing and your will need repeat testing in order to make a solid diagnosis of Stage 2 CKD.  If your urine is normal, then this may a normal eGFR for you.

For general information about kidney disease, please visit our website at:

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

Dear sir, My mother is suffering kidney disease from October until 7 dialysis done. But sir, it shows in sonography report kidney size is normal and shows parenchymal damage. The urine come proper as ordinary. BP is ordinary. The creatinine level after 5 days is 8.8. Please advise?

Your mother appears to have very advanced kidney failure but I am not able to provide any other specific diagnosis. I suggest that you continue to consult with the physicians who are caring for your mother. Further dialysis treatments may be needed.

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

Dear Dr. Spry, I am a male 53 years old diagnosed with kidney disease almost 3 years ago. Now Stage 3 GFR 21 with no symptoms at all. Creatinine level 3.1. I have daily tablet Aprovel 150 mg. Sometimes I have leg swelling. I take tablet Lasix 40 mg. My treatment is check up last one year before. Please let me know.

The medications that you are taking are Aprovel (irbesartan) and Lasix (furosemide). These medications are commonly used in chronic kidney disease (CKD) in order to treat high blood pressure and control edema. If your blood pressure is well controlled to less than 130/80 and your edema is controlled then I would have no other suggestions. Your treatment appears to be appropriate.

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