How to improve kidney issues with diabetes, BP, and edema?
Hello doctor,
I have kidney related problem associated with diabetes, hypertension, and pedal edema. Currently, I am on prescribed medication for diabetes and hypertension. I have undergone a full medical check-up, including lab tests. Please provide me with guidance.
16 Apr 2024 - 1 min read
What does my blood report for autoimmune disease show?
Hello doctor,
I received CBC and CMP blood test results. Info points to kidney issues but dismissed as nothing by my doctor. I would like your opinion. Key points outside normal range: WBC 12.66, hematocrit 45, eosinophils .5, absolute neutrophils 8.76, absolute monocytes .91, BUN 26, creatinine 1.4, calcium 10.6, EGFR 58.29. Note that tests were performed for autoimmune disease.
05 Dec 2023 - 1 min read
There is prominent column of Bertin in kidney with abdominal pain. Why?
Hello doctor,
I have abdominal pain, USG shows prominent column of Bertin noted at left kidney.
29 Nov 2023 - 1 min read
What causes nil urine output in a diabetic?
Hello doctor,
My father-in-law is aged 77 years. He has diabetes and blood pressure. His creatinine level is between 3.6 and 3.8. Has high levels of albumin in the urine and high levels of urea (129). He is admitted to the hospital following less to nil urine output. They have placed a catheter and are observing the urine output. However, it is still less. Around 600 ml for 24 hours. For now, the doctors are running an infusion to reduce acidosis. Does he need a dialysis? Is this a case of CKD? If yes, what could his stage of CKD be? What would be the further line of treatment?
18 Aug 2023 - 1 min read
I have right-sided heart failure with raised creatinine and low potassium. Will it affect my kidney?
Hello doctor,
I am a 48-year-old female. I have LMNA related cardiomyopathy and right sided heart failure (HF with preserved EF) and psoriatic arthritis. I have a dual chamber pacer/ICD. I am paced 100% in both the upper and lower chambers. I take Amiodarone, Metoprolol, Ranexa, Warfarin, Bumex, HCTZ, Spironolactone, Leflunomide, Methotrexate, Remicade, potassium, Folic Acid, Oxycontin, Lyrica, Satellite, Zolpidem, Hydroxyzine, Melatonin, feSo4, Vitamin E, Vitamin D3, and L-Carnitine.
Three weeks ago, I went to ED on orders of cardiologist. I have been quite SOB with activity, substernal CP, severe fatigue and muscle weakness, headache all worse than my baseline. In ED it was noted that I had potassium with a critical value low 2.9 (3.5-5.1). Other abnormal labs at that time were as follows.
Na+ 134 (136-145).
Chloride 94 (98-107).
BUN 20 (7-19).
Creatinine 1.07 (0.55-1.02).
eGFR 62 (60-120).
CBC was normal as was procalcitronin, BNP, magnesium and troponin.
I was repleted with K+ via iv and oral dosing. And discharged to home. One week later serum K+ was rechecked and found to be 3.3 (3.5-5.1) and I was ordered to take 20 meQ TID instead of BD my usual dosing.
Today, one week from the last recheck, again labs were drawn and several are concerning to me. K+ is now 3.4.
Chloride 94
CO2. 35 (22-30)
BUN. 25
Creatinine 1.20
Albumin 4.2 (3.5 - 5.0)
Total Protein 8.1 (6.3 - 8.2)
Tot Bilirubin 0.4 (0.2 - 1.3)
Direct Bilirubin 0.2 (0.0 - 0.4)
All Phos 75 ((38 - 126)
ALT 52 (0 - 34)
AST 50 (14 - 36)
eGFR 47.95
My question is, are these readings concerning? My primary provider posted those labs with no comment other than to now doubled my Spironolactone dose to 25 mg BD in order to raise my K+. The CMP was requested from a Bariatric surgeon. I received a call from that office after labs resulted to them. Told I was being removed from the program until the surgeon had time to consider my case and decide if I was a good candidate.
My eGFR has never dipped below 60. And while I do take a fair amount of diuretics, my potassium has never been low. I have noticed my CO2 is climbing, chloride dropping. CT chest notes ground glass nodules in the left greater than right upper lobes. Etiology felt to be infectious. My WBC has been perfectly normal and no fevers. So I am asking a nephrologist about this liver/kidney stuff. Maybe it is all related? Do I need to do anything about these labs? Is it fine to just ignore them as long as I am urinating? Any information is greatly appreciated.
17 Jul 2023 - 1 min read
Nephrology