Dear Doctor, my problem is frequent kidney stones formation that became more frequent recently. I had to make ESWL once yearly in the past 4 years, stone formation became faster. I formed 2 stones 8 mm and 1cm in 3 months. I analyzed it twice and its formed of ca oxalate. I need to know what to do to prevent stone formation. Please help.

Posted on June 30, 2016 by

I would recommend that you see a nephrologist and have a 24 hour urine to determine why you are forming calcium oxalate stones.  There may be a specific treatment for your problem but you must have further testing before specific treatment can be prescribed.  In the meantime, you should follow a low salt diet.  The DASH diet is a good diet to follow in order to prevent calcium oxalate kidney stones.  You can learn about the DASH diet at:  https://www.nhlbi.nih.gov/health/health-topics/topics/dash

You should drink plenty of water and do so until your urine is clear to light yellow.  I commonly recommend that you drink enough water so that you get up during the night and pass urine.  When you get up at night, you should drink a glass of water during the night as well.  If you do these things and see a nephrologist, you should be able to prevent future kidney stones.

For information on kidney stones click here:

Posted in Ask the Doctor, Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions, Symptoms and Side Effects, Treatments

My aunty had kidney failure 8 years ago. Her kidney was transplanted in India. Her mother donated her a kidney. Recently we found that the donated kidney is also getting disabled. She is suffering from severe liver problem. Her doctors are planning to transplant her kidney and liver unitedly. But her body is so weak to face such operation. But her doctors are allowing her to have such heavy meals like Ice cream, Coffee, sandwich, tikka masala etc as they want to encourage her to have nutrition. Do you think having such food is okay for her?

Posted on June 30, 2016 by

I am unable to provide medical advice without performing a complete history and physical examination.  The diet that you describe could be used to increase energy and provide for weight gain.  I suggest that you follow the advice of the physicians caring for your aunt.

 

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

I was taking PPI on and off for over 7 years and was on Pantoprazole for 2 years straight. I took antibiotics with the PPI many times. I had 9 eGFR test ranging from 60-80. I had ultra sound that measured kidneys before I started taking Pantorazole for 2 years and after . The second time they measured it, kidneys swelled up and got bigger 1.2 cm in length left and 0.8 in right. Can you help me? I am a veteran and the VA said stage 2 kidney disease is normal and I can not see a kidney doctor until I get on dialysis.

Posted on June 30, 2016 by

Pantoprazole and other Proton Pump Inhibitors (PPI’s) do not cause swelling of the kidney.  Kidney measurements from test to test on an ultrasound can be variable and the changes you mention are within the margin of error for ultrasound testing.  Hence, I am not able to make a diagnosis of chronic kidney disease (CKD) based on the information that you present.  I suggest that you continue to consult with your physician and follow his or her advice.  I do not believe you need dialysis.  The estimated glomerular filtration rates (eGFR’s) that you mention (60 to 80 milliliters per minute per 1.73 meters squared) are normal and do not suggest CKD to me.  You should also have urine testing for blood, protein, and infection in order to determine if you have any kidney disease.

 

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Medication and Kidney Disease, Symptoms and Side Effects, Treatments

My daughter has stage 4 renal problems. She is also a diabetic with high blood pressure. Her doctor is running blood work because of the high levels of white blood cell count. There is also a water pill that is making her swell in her legs. She is suppose to start classes to start her dialysis. Would Triferic ( the iron maintenance therapy) be good for her?

Posted on June 30, 2016 by

I am not able to recommend medical treatment without performing a complete history and physical examination.  Patients with chronic kidney disease (CKD) can have problems with low blood iron.  The specific treatment for the iron deficiency must be based on a complete knowledge of your daughter’s medical history, laboratory testing, and the other drugs that your daughter is taking.  Triferic is a new form of iron that can be added to dialysis fluid for treatment of anemia in patients with CKD and kidney failure.  Her nephrologist must determine if she is an appropriate candidate for Triferic treatment and whether her dialysis unit uses the dialysate with Triferic added.

For more information on HBP click here:

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Dialysis, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Medication and Kidney Disease, Symptoms and Side Effects, Treatments

I am a 43 yr old woman with high blood pressure and GERD. I’ve been taking Prilosec for about 6 to 7 yrs now. I’m concerned on all these findings of taking Prilosec and kidney problems. How would I go asking my doctor to check me out. I do get swollen alot but he says it’s my blood pressure and me being over weight. I’ve been with weight problems since 11 yrs old. My heartburn is really bad. Please help.

Posted on June 30, 2016 by

As far as we know the proton pump inhibitors (PPI’s) such as Prilosec can be associated with kidney disease but we do not know if they cause kidney disease.  An association does not prove that it causes a particular disease.  Only your physician can tell you if the risk is worth the benefit of treating your gastro-esophageal reflux disease (GERD).  You should discuss your concerns with your physician.

For more information on HBP click here:

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

I am a diabetic 66 year old male and my A1c is 6.6 and My Albumin is 4.3 g/dl , Bun is 17, Microalb is 1.1 and Creatinine random is 286.5 and creatine is 1.04 mg/dl and Microalbumin/creat ratio is 4 ug/mg. My GFR(MDRD) is 71.67 . The nurse at my doctors office said all these tests are normal. My question and concern is the GFR test . Is a 71.67 for my age ( 66 male) something that should be looked at closer and if yes, what are the next tests to be looked at ?

Posted on June 30, 2016 by

All of the information that you provide is normal for a 66 year old diabetic.  I recommend that you follow the advice of your physician and have testing done at least once per year.

For more information on CKD click here:

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

I am going to be doing my first Peritoneal Equilibration Test. I understand I manually do one fill before bed and then go to my morning appt where they have me drain. Does this sound correct? Am I okay to do one fill that dwells 8-9 hours?

Posted on June 30, 2016 by

You should follow the instructions of your peritoneal dialysis nurse.  The general instructions before a Peritoneal Equilibration Test (PET) is to have a 2.5% solution in your abdomen for at least 8 hours prior to the infusion of your test solution.  You should consult with your nurse for any other specific instructions.

For more information on Peritoneal Dialysis click here:

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

I have been taking 300 mgs of Allopurinol for 30 years for gout. Creatinine level is 2.7 now CKD level 4. I tried Uloric Acid bad reaction. I think the 30 years of gout and Allopurinol have created the CKD. Any other treatments I can use for gout that help kidneys with Uric acid. What came first the gout or CKD? I have had gout since I was a senior in high school. Doctors didn’t diagnose until I was 24.

Posted on June 29, 2016 by

I cannot make a specific diagnosis based on the information that you present.  Kidney disease and gout commonly occur together and which causes which cannot often be determined.  If you have gout deposits in your skin, joints or in other areas (known as tophus), then you may have kidney disease secondary to gout.  If you do not have such deposits, then the kidney disease likely is responsible for the gout.  It is important that your blood uric acid level be less than 6.0 milligrams per deciliter (mg/dl).  Your dose of Allopurinol should be adjusted to achieve this level of uric acid in your blood.  A low salt diet and drinking plenty of water will also help to prevent further gout attacks and slow the kidney disease.  Allopurinol should not cause chronic kidney disease (CKD).

For more information on Gout click here:

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

I have PKD and my left kidney has been removed at birth and I am now 43 years old and the right remaining kidney is at 30% function and full of cysts. My father died related to kidney disease complications. I am unable to find out if my mother has kidney issues. I am wondering if I have ADPKD or ARPKD?

Posted on June 29, 2016 by

I cannot tell if you have Autosomal Dominant Polycystic Kidney disease (ADPCKD) or Autosomal Recessive Polycystic Kidney Disease (ARPCKD).  Genetic testing can be done, but it is very expensive.  On the basis of your age and your parent’s history, it is most likely that you have ADPCKD but I am unable to say that with 100% certainty.  You may have to consult with a nephrologist for further testing.

For more information on PKD click here:

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

I have a 9 mm kidney stone. Please tell me what truly is a low oxalate diet. There is so much conflicting info on the internet. I’m taking chanca piedra too. Please help. I don’t want to all those procedures. The stone is my ureter.

Posted on June 29, 2016 by

A low oxalate diet is generally not very effective in treating a kidney stone that is already present.  In most cases, a urologist is the best person to consult for treatment of an existing stone.  Once the stone is passed, then you can consult with a nephrologist to try and prevent further stones from forming.  You should follow a low salt diet and drink extra water to keep your urine light yellow.  A DASH diet is the best diet to follow for prevention of kidney stones.  You can review the DASH diet at: https://www.nhlbi.nih.gov/health/health-topics/topics/dash

Once you pass the stone, you can then have a 24 hour urine to learn why you are having recurrent kidney stones and then treatment can be specific about preventing further kidney stones.

 

Posted in Ask the Doctor, Diet/Nutrition, Kidney Stones, Kidney-Related Health Questions, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis