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Doctors' Answers to "Frequently Asked Questions" - Kidney Problems
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Could These Recent Kidney
Problems be Due to Ibubrofen [posted 12/02/98]
Question: I have taken large doses of ibuprofen over a
rather long period of time for a chronic pain condition.. (approximately 6 years, at least
1000-3200mg. per day. The dosages have tapered off, due to gastric distress, though not
completely. However, I am experiencing some problems with fluid retention and experience
some sharp thought intermittent pain in the kidney region. Urine has been extremely
concentrated, though large amounts of fluids (water and herb teas) have been taken. What
are the symptoms of renal damage from ibuprofen. Would a CBC test identify any problems?
How would I know if damage has been done to kidneys.
Answer: Renal damage done by the NSAIDS is
usually painless and occurs slowly over 10-20 years. I would look for other causes of your
Question: After having had microhematuria for almost 9 years (and which was
untreated), I had to go to the physician for something which was at first diagnosed as
urinary infection (because of the sympotms of frequency, bouts of chill, and, of course,
blood in the urine). As the medicine I was given, Trimethoprime 160mg x 2 for 7 days, did
not work, I was given Amoxicillin 500mg x 3 for 10 days, then again Cyproxin 500mg x 2 for
5 days, and then, with the suspicion of prostate infection, Abboticin (Eryhromycin) 500mg
x 4 for 4 weeks (which I quit after 3 weeks), then Tarivid (Ofloxacin) 200mg x 2 for
7 weeks (which I quit after 3 weeks), then Azitromax (Azitromycin) 500mg x 1 for 7 days
(which I quit after 4 days). None of these medications seemed the right kind of medicine.
(Medicines given by different doctors.) And this has lasted for the 4 past months. During
this time I have, naturally, taken some tests: Urography with sonography, Ultrasonic of
prostate, Cystoscopy, PSA, and all the usual blood and urine tests in such conditions. All
these tests have been normal, the sole finding being again blood in urine (6-8 red). Now
after 4 months I am still having the symptoms- while I have never been as bad as I first
was: chill, irritation and pain in the bladder-region, irritation in the urters, pain and
discomfort on semen-discharge, and general weekness and illness of the body. It is
important to add that these problems come intermittently, in intervals (mostly in the
evenings after a day's work), and there are times, as brief as some hours, and,
occasionally, as long as some days, which I feel I am getting well again (am almost
syptom-free). But the symptoms do return. I have no pain on urine-discharge and I do not
get up during the night to go to the bathroom. What can be the cause of microhematuria
without infection? Several doctors which I have visited despair now of other solutions.
May you please help me and tell me what is the next step for me to take. What shall I do
Answer: Well, I would see a nephrologist to see if the blood is from the
kidney. This would usually require a kidney biopsy. However, this would be unlikely to
cause any problems with urination, semen etc. Has a culture been done of prostatic fluid?
What is the result ? Some organisms need high doses of particular antibiotics, usually
dictated by culture. An Infectious Disease specialist would be my next choice if the
nephrologist comes up empty.
Interstitial Cystitis [posted
Question: I have interstitial Cystitis. I am in a geat deal of pain all the time on
a scale of 1 to 10 most of the time it is 10. I have been to a urologist and they have
given me DMSO treatments and I had a bladder distention nothing seems to work. They will
only give me darvocete for the pain and diazepam 5 mg at night. but wll only let me stay
on the diazepam for 2 months at a time. And the davocete does not give me much relief.
When I had the bladder distention they gave me percoete that seems to help. I have bad
insomnia because of the frequent urination is there something they can give me to sleep
that I can stay on all the time? I had bad insomnia before this bladder problem. I am
exhausted all the time and many days can barely function. They had given me hydrocodone
but that mad me itch very bad. What doctor can give me different medications for these
problems. I sure need to get some sleep.I think if I could get some sleep and some pain
relief my life would be 100% better. Thanks again.
Answer: Try melatonin and if that doesn't work Benadryl 50 mg an hour before
bedtime. Occasional patients will experience urinary retention symptoms with Benadryl so
watch out;but, non-addicting.
Effects of Serzone & Lortab on
the Kidneys [posted 10/22/98]
Question: Can you tell me if Serzone affects the kidneys? I have been on it for
about 6 months and have bad lower back pain plus stomach pain on left side when urinating.
I am also taking Lortab for the back pain. Could this combination make it worse?
Answer: Shouldn't be a problem, check for a stone or obstruction.
Kidney Pain [posted 8/13/98]
Question: Four years ago, I had surgery for a ureter blockage. I was told that I
was probably born with it, but I went 19 years without any symptoms. I was at my doctor's
office for a rountine exam when he noticed that my blood pressure was abnormally high and
then the problem was found a few weeks later. For years prior to the surgery, I seemed to
have lower right back pain. A few months before my problem was detected, the pain became
worse and radiated to my lower abdomen. I had always attributed this to muscular problems.
Shortly before my surgery, I asked my doctor if the pain could be associated with the
ureter problem. He said there was no real way to tell, but if the pain stopped after the
surgery, then it must be the ureter. If not, then it had to be attributed to some other
problem. I have been withouth pain for 4 years, but have had symptoms recently. Is it at
all possible that the ureter is obstructed again? Can it be from the damage that my kidney
substained from the years of having the problem(the lower quadrant of my right kidney is
non-functional due to the fact that I had the ureter problem from birth)? I am a very
active person and it would not be entirely impossible for it to be muscle related, but I
am very worried given my past history.
Answer: A blocked ureter will often produce the pain distribution that you are
describing. With any onset, I would recommend an evaluation to ensure that your ureter is
open and not fibrosing with scar tissue or progression of your basic problem. However, be
aware that if it were to stop functioning completely that one only needs 1/4 of one kidney
to avoid kidney failure.
Kidney Pain [posted 8/13/98]
Question: I have been having a problem with mainly my right and sometimes my left
kidney. The pain has been around for several months and seems to be getting worse. It
seems to only bother me in the early mornings after sleeping. The pain is worse the harder
the surface that I sleep on. I am 33 years old and believe to be in good health.
Answer: Probably related to muscle cramps/spasm and not your kidney, but you
will need a urine analysis as well as a back exam. You might be able to avoid this by
changing/increasing the firmness of your mattress. This is most easily accomplished by
putting 1/2 inch or 3/4 inch plywood sheet between the box springs and mattress and see if
it changes. If so, it is clearly mechanical and your back.
Kidney Failure/ESRD [posted
Question: How long can a person live on dialysis? What is the life expectancy of
patients diagnosed with End Stage Renal Disease?
Answer: This varies a lot from patient to patient depending on the cause for the
renal failure and their underlying health. For example, end stage diabetics commonly have
strokes, heart attacks, etc., which reduces their survival on dialysis. Patients with
isolated renal failure with underlying systemic disease (especially if younger) do much
better. Ten years is a long time, but not unheard of and many will go 15-20, although
uncommon. Renal transplant also affects this survival curve.
Kidney Stone [posted 7/16/98]
Question: I have had a stent inserted to help move a large stone over 5 weeks ago.
Is it normal to have increasing amounts of blood and small pinhead-sized clots in my
Answer: The bleeding will likely last as long as the stent is in place. This is
a foreign body which is used to keep the ureter open, trauma from the stent and/or the
stone is responsible for the micro bleeding, which normal and usually unavoidable.
Question: I am a 65 year old male. Within the last 3 weeks I had kidney stones in
each kidney , at separate times. The right side stone passed in about 5 hours without
hospitalization. The left side was more severe, first being confirmed when passing dark
brown urine one time. However, pain continued and the emergency room treatment with
painkillers in a drip eliminated the pain. IVP indicated presence of stone and drainage of
both kidneys to be no problem. They strained urine and collected several small specks that
will be sent in for testing. These are the only attacks that I have had in 37 years when a
stone was removed by surgical means. Prior to that I had two other attacks that occurred
two to three years earlier and both passed with much pain all occurring in left kidney.
About one year ago I went on 10 mg of Vasotec, which is working well to control blood
pressure. About 3 months ago I was placed on 50 mg of Precose to improve my blood sugar.
Can either of these drugs cause my new kidney stone problems? It seems strange that
stopping all consumption of sweets, beer, deserts etc., and starting these drugs seem to
coincide with the reoccurrence of kidney stone attacks after 37 years with out any kidney
Answer: Kidney stones are caused by hypersaturated urine causing crystals to
form in the kidney. Once the original crystal forms, growth of the "stone" is
easier than the original formation. This whole process can be prevented by keeping the
urine dilute. This is the basis for recommending high water intakes to stone forming
patients. Diabetes mellitus is notorious for keeping patients dehydrated. This occurs as
glucose draws free water out the kidney. Initially this produces dilute urine, but as
dehydration occurs more and more concentrated urine occurs. Prevention of your stones can
be achieved by drinking more free water and avoiding high glucose levels. Vasotec and
precose should have no appreciable effects.
Question: Is there any way to "register" at several different hospitals
for a transplant? I am already registered at one hospital.
Answer: There is supposedly a national match once you enter one program. You
should ensure that your hospital cooperates in this program. If so, you're entered.
Question: My husband read that there was some kind of link between kidney damage
and the use of water pills. Is there a link between the two? How can we find more
information about kidney damage?
Answer: There doesnt appear to be any special link between diuretics and
renal damage. It is true that many people who take diuretics suffer renal insufficiency,
but this is most likely due to their underlying hypertension (the reason usually for a
diuretic) not the diuretic.
Question: I'm seeing a kidney specialist in Seattle and he says I have a kidney
disease called IGA nephrology. I have looked up several books and none of them reference
this disease. I think I have Brights disease marked by blood and protein in my
urine. I'm really into bodybuilding and need help with a few questions. Are anabolic
steroids bad for my kidneys, and if so, why? Are certain anabolics worse then others? How
does one get Brights kidney disease? Once you have Brights disease does it get
worse, stay the same, or get better? What are my options for treatment?
Answer: Bright's Disease is an old term used to describe kidney disease 40-50
years ago. This is not a term that is currently used due to its lack of specificity. IGA
nephropathy is well described and probably is the cause of your renal problems.
Steroids are widely used illicitly for developing muscle growth and strength. Many
weight lifters and different athletes use these banned substances to enhance their
performance. However, use of these drugs for this purpose is illegal for several reasons.
The improvement in performance only lasts while the steroids are being used.
Discontinuance will result in pre-existing strength and performance levels. These drugs
have potentially severe long and short term side effects. It takes a professional
knowledgeable in these side effects to monitor liver function and other potential
problems. These include liver toxicity, edema or fluid retention, liver cancer, markedly
elevated blood counts leading to strokes and thrombosis(clots), and an increase in risk of
prostate cancer. Also, feminization can occur. This is an unfortunate side effect which is
irreversible. It produces breast development and shrinkage of the size of the testes.
Although I am aware that many individuals use these substances the benefits really
don't outweigh the risks in my opinion. I would strongly advise that your physician at
least monitor you if you decide to use these substances-they are not simple nor risk tree.
I would strongly recommend that you avoid these substances with your kidney problems.
Question: A friend of mine, 73 yrs old, got kidney damage from some kind of heart
medication, he is now on kidney dialysis every second day. He was also on a diuretic for
several months, another doctor took him off the diuretic and told him he shouldnt
have been on this drug, ever. This man has about 5% of his kidneys functional, he noticed
that since he stopped using the diuretic he now has some pressure when he urinates, which
he didnt have before going off the diuretic, which to him seemed to be an
improvement. My question is this, do you think there is a chance his kidneys can somewhat
rejuvenate so he doesnt have to be on the dialysis machine so often?
Answer: Some types of renal insufficiency are reversible-some are not. I suspect
he has both a fixed and a reversible component. Most drugs do not last in terms of
toxicity -but, there are exceptions. Usually when you get below 10% or so you'll wind up
on dialysis. Only time will tell, but, he may get better kidney function over 6 months.
Question: I am a peritoneal dialysis patient. (11 years) I have been experiencing
extreme itching due to high phosphorous levels. It is not accompanied by a rash. It feels
like the itching is inside. Topical treatments do not work. What can be done to relieve
this? I am extremely careful with my diet, etc hence, I have managed to live 11 years on
Answer: Most patients on dialysis will take oral phosphate binders to help this
problem. Has this been suggested by your physician?
Question: I had a ct scan and it showed a mass on top of the right kidney. There is
an irregularly enhancing mass at the right upper renal pole as described above with
amputation of the right upper pole calyceal system and a small fleck of internal
calcification. The findings are highly suspicious for a right upper pole renal carcinoma.
Answer: Suspicious for certain- you need surgery or a biopsy.
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