| Author | Subject: need more info |
| april | Posted At 16:56:15 02/12/2002 Hi I am looking for information on kidney diseases. 2 years ago I had a pyloplasty done on my left kidney because of a blockage. Recently I have found out through followup visits to my urologist that I have no function in that kidney now. I am diabetic (type 2), starting to show some symptoms, I think, that I never had before. e.g. fatigue, up at night to the bathroom, weight swings (really weird, one day I can wear my jeans the next day I can't or vice versa.), puffiness in my face, blood in my urine. Now my urologist wants to remove that kidney. (apparently the surgery failed.) He says the other kidney is just fine and will take over for the non-functioning kidney. My primary physician thinks I should keep the kidney. I have never been referred to a nephrologist yet. Should I? My last serum creatinine was 3.8, and my BUN was 98. My Dr. said that was O.K. I can't seem to get enough information on any of this. I work casual and find that it really wipes me out. I seem to be sick more often now. One of my questions is if the other kidney is functioning for both, why do I have these symptoms? Sorry if this is so long, but it seems that I can't find anyone to discuss this with. My husband has been very supportive but I know it's hard for him to understand. My next appointment with the urologist is to go over my test results. Should I insist on seeing a nephrologist? |
| Beth Witten | Re: need more info (Currently 0 replies) Posted At 21:54:34 02/20/2002 I would strongly encourage you to seek referral to a nephrologist immediately. A nephrologist can evaluate your kidney function, its cause(s), and and suggest ways to slow progression of your kidney disease. Since you have diabetes and surgery for a past blockage, your creatinine is 3.8 and BUN is 98 (both of which are significantly elevated), plus you're experiencing common symptoms of kidney disease (fatigue, weight gain, increased urination at night, puffy face, and bloody urine), I think it's essential that you see a nephrologist quickly. To put things in perspective, most patients (and possibly some physicians) don't realize that even though normal creatinine is around 1.0, a creatinine of 2.0 means you've already lost about 50% of your kidney function. People with kidney disease need dialysis or transplant to survive when kidney function is 10-15% of normal. Many non-nephrologists don't realize how important a sign an increased creatinine is. About 40% of patients are not referred to a nephrologist until they are very near kidney failure. Delayed referral means that nephrologists can't provide treatment to slow or stop progression of kidney kidney disease or treat complications that can occur when kidney function worsens. As a result, patients referred late are more likely to be hospitalized longer, to not be educated about what's happening to them and the choices that they have, and to have to have a temporary access for dialysis because there isn't enough time for surgeons to place a permanent dialysis access and for it to develop enough to use when needed. This means that people referred late may have to have multiple access surgeries. Finally, a patient who is referred to a nephrologist late doesn't have time to talk with the transplant team to learn whether he or she is a candidate for transplant and if it might be possible to get a transplant before dialysis is needed. In addition to the information that you can find on the Life Options web site about kidney disease and treatment options, to find out more information you might want to check out the following web sites: * A new interactive education experience from Life Options -- Kidney School (www.kidneyschool.org) * In addition to a vast array of educational materials available in print from your local National Kidney Foundation affiliate, the NKF has published several brochures on the Internet in its A to Z Guide at http://www.kidney.org/general/atoz/ * Information from the National Institute of Diabetes & Digestive & Kidney Diseases at http://www.niddk.nih.gov/health/kidney/kidney.htm * Information on kidney function prior to kidney failure from the Nephron Information Center at http://nephron.com/fkgframeset.html I hope that you're able to find the answers to the questions that you have and to get what you need to preserve your kidney function as long as possible. |
| BERELS | Re: need more info (Currently 0 replies) Posted At 12:20:22 04/06/2002 I HAVE 2 PROBLEMS. IN 2 WEEKS I WILL START HEMODIALYSIS. I ALSO HAVE PARKINSONS DISEASE. MY PROBLEM IS MEDICATION. I USE A DRUG CALLED MIRAPEX FOR MY PARKINSONS AND AM MAXED OUT. WHAT HAPPENS NOW? DOES THE MIRAPEX REMAIN IN THE BLOOD? I AM AFRAID OF BEING EITHER OVER MEDICATED OR UNDERMEDICATED. THIS IS IMPORTANT SINCE MIRAPEX CONTROLS THE SEVERE TREMORS. BOTH NEPHROLOGIST AND NEUROLOGIST DO NOT HAVE PATIENTS WITH THIS COMBINATION OF PROBLEMS. I AM WORRIED WHAT WILL HAPPEN TO ME. I COULD BECOME DISORIENTED. |
| Beth Witten | Re: need more info (Currently 0 replies) Posted At 23:04:02 04/09/2002 I responded to this question under "Living with Kidney Failure." |
| gal | Re:laproscopy 0r cutting pyloplasty (Currently 5 replies) Posted At 17:56:38 04/25/2002 What are the pro's and con's of each? |
| Beth Witten | Re: need more info (Currently 0 replies) Posted At 11:19:26 05/16/2002 You've asked a question that is outside the expertise of the Life Options program. However, I found information from the Mirapex package insert that's available to help professionals prescribe this medication. The full package insert information can be found at www.mirapex.com/professional/prescribing_info/. Renal insufficiency: The clearance of pramipexole was about 75% lower in patients with severe renal impairment (creatinine clearance approximately 20 mL/min) and about 60% lower in patients with moderate impairment (creatinine clearance approximately 40 mL/min) compared withhealthy volunteers. A lower starting and maintenance dose is recommended in these patients (see For BerelsPRECAUTIONS and DOSAGE AND ADMINISTRATION). In patients with varying degrees of renal impairment, pramipexole clearance correlates well with creatinine clearance. Therefore, creatinine clearance can be used as a predictor of the extent of decrease in pramipexole clearance. Pramipexole clearance is extremely low in dialysis patients, as a negligible amount of pramipexole is removed by dialysis. Caution should be exercised when administering pramipexole to patients with renal disease. |
| Mrs. R. Gupta | Re: need more info (Currently 0 replies) Posted At 21:12:34 05/22/2002 I have Lt. non functioning kidney? Nephrologist and Urologist have different opinion regarding kidney removal? my B.P. is under control but S. Creatinine is slightly higher. Please guide me regarding this matter. |
| Beth Witten | Re: need more info (Currently 0 replies) Posted At 10:23:42 05/24/2002 In years of working as a social worker with people with kidney failure, most never had non-functioning kidneys removed. The reasons why people did usually related to other conditions besides the fact that the kidney wasn't working, such as infections, uncontrolled blood pressure, cancer, huge kidneys full of cysts due to polycystic kidney disease. Non-functioning kidneys are not even removed for transplant in most cases. Ask the doctor who is suggesting removing the kidney his/her reasons for doing this. Ask both the nephrologist and the urologist the pros and cons to removing your non-functioning kidney, including risks, cost, and recuperation. I would need this information so I could make an informed decision. |
| Ann Deignan D.C. | Re: need more info (Currently 0 replies) Posted At 15:05:46 03/15/2003 Does dietary protein intake affect the uptake of Mirapex as with Levadopa? Are there any cardiac risks with the drug for a patient initiating treatment at the age of 57? Thanks for your help. Ann Diegnan |
| Ann Deignan D.C. | Re: need more info (Currently 0 replies) Posted At 15:06:09 03/15/2003 Does dietary protein intake affect the uptake of Mirapex as with Levadopa? Are there any cardiac risks with the drug for a patient initiating treatment at the age of 57? Thanks for your help. Ann Diegnan |
| Beth Witten | Re: need more info (Currently 0 replies) Posted At 18:19:37 03/16/2003 These are definitely questions that I would ask my doctor when he/she prescribes a medication. Many times people don't think to ask about how diet affects the effectiveness of drugs are whether over-the-counter (OTC) medications interact with a new medication. They also often forget to tell their doctor if they're taking medications prescribed by another doctor or if they're taking OTCs or herbal products. It is essential that you keep an up-to-date list of everything that you're taking so your doctor can treat you effectively. Your pharmacist should give you an information sheet when you get any medication. It generally tells you how to take the medication, common side effects, whether to eat or take the medication on an empty stomach, whether to avoid certain foods or alcohol while taking the medication. The doctor or pharmacist can also answer questions about risks. Another source of information about medications is the Physicians Desk Reference that you can find in the reference section at your library. The PDR web site for patients is www.gettingwell.com. If you choose to find out about a drug, you will get a field that you can type in. Type in the drug name you will get understandable information about that drug, including: * Why it's prescribed; * Most important fact about the drug; * How to take it; * Side effects; * Why it shouldn't be prescribed; * Special warnings; * Special food/drug interactions; * Info about pregnancy & breast feeding; * Dosage; * Overdose; You can even see a picture of what it looks like. |
| jean | Re: need more info (Currently 0 replies) Posted At 20:21:23 03/31/2003 hi i had a right sided pyloplasy done 10 years ago the kidney was very damaged but my surgeon(urologist)was the best he was my 4th opinion all the others wanted to remove it , i simpathise with ur being worn out and tired but u really should seek more than a couple of opionions. removing the kidney is not always the answer hope this help jean |