Dr. Adriana Cano

The symptoms you describe are strongly suggestive of infection and yes they may involve the stents or the bladder only. You need to see your urologist as soon as possible and if you have any fever or pain go to your pcp ASAP or seek emergent care.

Adriana Cano.

Blood in the urine and back pain in the lower ribs area needs to be taken seriously. They may or may not be related but to determine this and a specific cause you need urine studies and imaging studies. Please consult with your doctor to begin the diagnostic process.

That is not normal. There are several potential reasons and they all require medical attention. Rather than provide a list of worrisome information I suggest you take your son to a his pediatrician for evaluation. One needs to know if he is having other symptoms, evaluate blood and urine chemistry and urine microscopy and probably have imaging studies to be able to determine cause and possible treatment. Good luck.

Adriana Cano.

Generally cloudy urine indicates infection, your son needs to be seen by a physician promptly. I recommend going through his pediatrician and if he can’t be seen today then go through urgent care. Urinary tract infection is very uncommon in boys his age and it may mean he has another problem as well. A urine culture needs to be obtained.

Adriana Cano.

Yes. Depending on the type of dialysis you do you will need to make changes in your life. In my opinion the most demanding type of dialysis is incenter hemodialysis. Because it’s done 3 times a week this type of dialysis tends to leave patients tired after the procedure so if you work it’s best to choose a dialysis shift late in the day do you can go to sleep after treatment.
If you do PD or home hemodialysis you do them either everyday (PD)or 5-6 times a week (home Hemo) you are less likely to feel so tired but you need to make time to do the procedure at home. Either way there will be changes you need to make in your daily activities to do your treatment.

Adriana Cano.

Yes, a healthy person needs regular check ups that generally include physical exams and blood and urine tests. The blood tests are a complete blood count, blood chemistries that mostly include electrolyte levels, markers of kidney function, protein levels and liver function tests. The urine test is usually a urinalysis that is used to screen for abnormal loss of protein or blood in the urine. These tests screen for abnormalities but also help establish individual baselines. These are important in evaluating each individual when there is a disease process.

Adriana Cano.

She has stage 5 chronic kidney disease and is very close to needing dialysis for survival. She needs to decide if she will accept dialysis and choose the type of dialysis she wants. Other alternative is renal transplant which requires extensive evaluation to determine is she is a candidate for and takes a few months to complete, then if listed may take up to 7-8 yrs to receive. Last is conservative management which means she has limited survival and received symptomatic and supportive treatment.

Adriana Cano.

The size of the stone really means there is likely surgical intervention indicated.
Management of kidney stones depends on stone size, composition and location of stone and every case needs to be assessed individually. For a stone that big a stent is not uncommonly recommended. The stone is fragmented with ultrasound waves and the stone fragments then pass into the bladder and then out but they may get stuck. A stent makes passage easier.

Adriana Cano.

A patient can survive with 20% kidney function if the kidney function is stable (no further decline) and if the patient is receiving supportive care to keep complications of kidney dysfunction compensated.

Most patients continue to decline and require dialysis for survival. A patient needs to be prepared to do dialysis when the time comes and preparation takes time. Prepared patients do better in terms of quality of life and survival; that is the reason to discuss and prepare for dialysis

Adriana Cano.

For chronic kidney disease slowly progressing to end stage kidney disease there are only 2 treatments available that preserve life at this point in time. Dialysis and renal transplantation. There are 2 forms of dialysis: hemodialysis and peritoneal dialysis. Renal transplantation is an alternative that requires a thorough pre transplant evaluation and not everyone is a suitable candidate. Specifics of these treatments should be discussed on individual basis with the patient’s nephrologist.
If a person does not wish to receive dialysis the only other alternative is conservative support until the patient reaches the point where she/he needs hospice care and comfort measures.

Adriana Cano.