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Very interesting.

Because his potassium level is low on a potassium sparing diuretic (triamterene) as well as an angiotensin receptor blocker (losartan) and a potassium supplement, I would strongly consider investigating for secondary hyertension, especially elevated aldosetrone levels because often hyperaldosteronism requires different medications which can be highly effective and perhaps reduce other medication requirement. In some cases, surgical correction of (benign) adrenal growths can dramatically improve blood pressure as well. There are other causes of secondary hypertension and I most definitely recommend referral to a nephrologist to assess this further.

Dr. Jordan Weinstein

Thank you for sending.

Kidney function can fluctuate in short periods of time, particularly related to medication use. I notice from the lab report that your husband has a low potassium. This could be indicative of him taking a diuretic such as hydrochlorothiazide for example. In that case, blood pressure and kidney function can fluctuate with use of this medication and before becoming too alarmed, I would repeat the creatinine to see if it is a persistent change (as an aside, in order to calculate your husband's kidney function more accurately can you tell me whether he is black?). I do also note that there is protein in the urine which if persistent does, by itself, indicate that he does have a form of chronic kidney disease.

It would be very helpful if you provided a list of his medication below. It also appears as though he has slightly elevated blood sugar. Is he known to be diabetic and is he on medication for that?

A referral to a nephrologist would be wise, but at a minimum I recommend a repeat of his urinary protein and kidney function as well as an abdominal ultrasound.

Dr. Jordan Weinstein

Hello,

Generally speaking, we do not remove simple cysts unless they are very large and thought to interfere with urinary drainage. The cysts seem to be maximum 1.6 CENTIMETRES, correct? If so, that likely would have no impact on your GFR including if it is is removed.

Dr. Jordan Weinstein

I am very sorry for this. But end stage kidney disease has two treatments - dialysis and transplantation. Your sister can have an excellent outcome with kidney transplant assuming her health is otherwise well. She can receive a kidney from a living or deceased donor and do extremely well - especially with living donation.

Dr. Jordan Weinstein