Dr. Steve A. Burka, MD

Painless hematuria (blood in the urine) is always something to be concerned about. You should see your physician ASAP. The possibilities include kidney or urinary tract tumors and acute kidney disease. This needs to be investigated immediately!

Steven A. Burka, MD, FACP, FASN

Blood in the urine is never to be ignored. You should see your primary physician ASAP. You should be referred to a urologist and, if needed, a nephrologist quickly.

Steven A. Burka, MD, FACP, FASN

I would suggest that you see your primary care physician or your urologist as soon as possible. If that is blood in your urine it could be a consequence of a problem with your bladder or prostate, especially in light of your weak urinary stream it is likely to be your prostate. I would not delay seeing your physician as this could be a malignancy.

Steven A. Burka, MD, FACP, FASN

That’s a very good question. Young & otherwise healthy patients can live for very long periods on dialysis. I actually have a patient currently who had been on dialysis for 25 years. Older, otherwise sicker patients don’t live as long on dialysis. Generally, 50% of all dialysis patients die within 5 years & 50% of diabetics on dialysis die within 3 years, but there can obviously be wide variation. The most common cause of death for patients with chronic kidney disease (CKD) is cardiovascular complications (heart attacks & strokes). With proper attention paid to Blood Pressure, anemia management, & bone metabolism, as well as the traditional risk factors, the risks for heart attacks and strokes can be decreased.

Steven A. Burka, MD, FACP, FASN

One of the many functions of the kidneys is to produce a hormone called erythropoietin that stimulates the bone marrow to make hemoglobin & red blood cells. When kidney function is decreased, the production of erythropoietin is also decreased. As a result, anemia is a common concomitant of chronic kidney disease (CKD). It is important that any nutritional deficiencies (iron, B Vitamins) be detected & if present, corrected. Once that is done, the anemia of CKD can be treated with injection of Erythropoiesis Stimulating Agents (ESAs) - erythropoietin & others.

Steven A. Burka, MD, FACP, FASN

Not likely. Improving your blood sugar control may be helpful in preventing many complications of diabetes. If your kidneys have thus far not been affected by diabetes, improving your sugars may help prevent kidney disease. If your kidneys are already damaged by diabetes, better sugar control will not improve your kidneys. Using insulin will not likely hurt your kidneys.

Steven A. Burka, MD, FACP, FASN

It is normal to have a low creatinine level when pregnant. So it seems that your kidneys are doing the normal thing!

Steven A. Burka, MD, FACP, FASN

Nephrotic Syndrome most commonly is caused by diabetes. In the abnormalities of the filters in the kidneys called the glomeruli. Commonly this is caused by diabetes but it can also be caused by other diseases that have an effect on the filtering membrane in the glomeruli. Often these are issues with autoimmune diseases (syndromes where one is allergic to himself). I would suggest that you have a thorough evaluation by a nephrologist that may include doing a kidney biopsy.

Steven A. Burka, MD, FACP, FASN

Pregnancy can impact the kidneys in many ways. Patients with preexistent kidney diseases can have worsening of their disease with pregnancy. Also, their are kidney diseases that can be induced by pregnancy. The normal physiologic changes occurring in the kidneys during pregnancy can result in some protein appearing in the urine & some fluid retention. Pregnant patients often have frequency of urination because of pressure put on the bladder by the expanding uterus.

Steven A. Burka, MD, FACP, FASN

Dark yellow urine may be the result of a variety of different factors including, but not limited to, dehydration, or injesting some medications such as multivitamins. You could see your primary doctor to have a simple urinalysis done which may clarify the issue.

This depends on the particular mode of dialysis you are on. In-center hemodialysis is generally done 3 times/week (though I have at times treated patients 1 or 2 times per week under special circumstances. Home peritoneal dialysis is done daily. Home hemodialysis is done 6 or 7 days per week. Studies have shown that patients do best with more frequent dialysis, which makes sense because normal human kidneys work 7 days per week. With dialysis, the closer you get to normal physiology the better

If your mother is short of breath & has chronic kidney disease I strongly suggest that you contact her physician ASAP to get his advice. She may require immediate care.

Each kidney is composed of ~1 million functional units called “nephrons”. The first part of the nephron is the “glomerulus” or filter. “Glomerular disease” pertains to issues with the glomerulus. There are a number of different types of glomerular diseases with a variety of different treatments.
Depending on the specifics of your mother’s clinical situation, it may be appropriate for her to have a kidney biopsy. I strongly suggest that your mother see a nephrologist (kidney specialist) who can evaluate her & determine what specific treatment(s) is/are most likely to benefit her.

Steven A. Burka, MD, FACP, FASN