Please help! need some info--thank you

[robinsond63@comcast.net]

My mother age 65 was just diagnosed with hydronephrosis of both kidneys.
I have been researching kidney disease ( on the internet-of course), and need to know just how serious this is. I know there are different "stages" of the disease. The problem is...the doctors office got the results (kidney ultrasound) two months ago, and she just found out about this yesterday by a fluke--she had to go in ( doc office) to get her blood pressure meds refilled. (So, sorry for all the details but i have a few more). The doctor told her she needed a Nephrologist and would refer her right away. My mother is extremely upset, as am I. When she called the doctors office today to inquire about the specialist, the nurse told her she had not received the "order" yet, and when she does she will call the specialist. So my question--while we are "playing games" with the doctors office, how long should this be left unattended? Is this a life threatening disease? I think she should see a Nephrologist asap! Am I over-reacting? Please help! Thank you!

[DoriSchatell]

Hi RobinsonD,

Hydronephrosis isn't something we know much about--like you, we need to go online and research to learn about it. The National Library of Medicine's Medline Plus site has good information about this problem: http://www.nlm.nih.gov/medlineplus/ency/article/000474.htm.

Basically, it's not a disease, it's a symptom. So, the word is big and scary, but it boils down to your mom having a blockage at some point that is keeping the urine from coming out the way it should. To me, the key question right this minute for your mom to ask the doctor is, "At what level are my kidneys functioning?". Even before she gets a referral to a nephrologist, you would know a LOT more if you can find out her glomerular filtration rate (GFR)--the % kidney function, or at least her serum creatinine level, which can be used (online) to find out her GFR.

Once you know that, then you know how urgent the situation is, and how much to push to get an appointment sooner rather than later. Your mom's GFR or serum creatinine level should be information that is already in her chart.

[Beth Witten MSW ACSW]

If your mother has a blockage in the flow of urine out of her kidneys to her bladder, this can be treated. Although it is not urgent, it's apparently been two months since the condition was discovered so the sooner this is corrected, the better. Here's information from a medical dictionary about this condition:
http://www.merck.com/mmhe/sec11/ch148/ch148b.html

As you've found, doctors offices get busy and things like orders and referrals can fall through the cracks. It's important that your mother continues to push to get an appointment with a nephrologist.

What insurance does your mother have? If she has Original Medicare, she can go to any nephrologist and doesn't need a referral. If she has other insurance, she may need a physician's referral. She could ask her insurance company for a list of nephrologists that they contract with. It's nice to have a name vs. choosing someone off a list or out of the phone book. She might want to call the doctor's office and ask to speak to the doctor to find out which nephrologist the primary doctor recommends. If she must talk with the nurse, ask the nurse to please find out from the doctor which nephrologist to call before the close of business that day. Your mother should provide alternate phone numbers and/or the best time to call back if she doesn't have an answering machine. Hopefully this will move the process along and get her the treatment she needs to protect her kidneys.