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Nephrology/fertility at 20-25% kidney function


My husband is in renal failure caused by high blood pressure. he is 42 years old. His kidneys are functioning at 20-25% (as of May, 2013)We have had two children, our first child was born severely premature and lived for two weeks (Oct.2008) We concieved our son on the first try, about three months later (Jan.2009) Also premature, but lived and is healthy! I have P.C.O.S and lost a lot of weight an finally after 2 1/2 years (after losing 98lbs)became pregnant with first.
We are trying again and I have lost 70lbs, am on clomid and ovulating. This is the first cycle and I did not become pregnant.(I do understand there is only a 25% chance each month) my question is, could my husband's fertility be an issue? His kidneys were fine in 2007, he had a test to see if a tumor on the adrenal gland could be causing the high blood pressure. In 2011, he had a stroke, which is how we found out he was in stage 4 renal failure. At that point, he was at 30-35% kidney function. Blood pressure is stable. So he lost about 10% kidney function in about 1 year....He is able to perform sexually, no problems with erection or ejaculation.

Lab results in May 2013:
Glucose mg/dL 97
BUN mg/dL 38H
Creatinine mg/dL2.92H
Sodium mmol/L 138
Potassium mmol/L 4.2
Choride mmol/L 105
Carbon Dioxide mmol/L 19L
calcium mg/dl  9.5
corrected calciummg/dL 9.2
Phosphorus mg/dL 4.4
albumin g/dL 4.4
BUN: Creatinine ratio 13
Anion Gap mmol/L 14
estimated GFR mL/min/1.73mE2  26L

white blood count  7.0
red blood count 3.99L
hemoglobin 12.8
hematocrit% 36.8
MCV fL 92
MCH pg 32.1
mchc 34.8
rdw% 13.5
platelet count x10E3/uL  203
neutrophlls% 60
lymphocytes % 28
monocytes% 9
eosinophils % 3
basophils% 0
neutrophills (abs)x10E3/uL  4.2
lymphocytes "  "  1.9
monocytes  "   "  0.6
eosinophils   "  "  0.2
basophils "   "   0.0
immature granulocytes%  0
immature grans  0.0

creatinine, urine mg/dL
protein, urine  18.1H
protein:creatinine ratio mg/g 145

My husband is taking blood pressure meds and sodium bicarb 2x daily. He gets tired, muscle fatigue, some muscle spasms, swelling in legs. Sometimes he takes tonic water and vitamin e if he has spasms.

We are going to try preseed fertile lubricant in case his sperm are having problems with motility. Is there anything he can take to help with fertility that will not hurt kidney function?
We are going to continue trying to concieve for one more year, or until he starts dialisys (because this causes/or at this point men are sterile?). I have read where his fertility MAY be effected because of kidney failure. Is that ALL males in kidney failure, a certain percentage? Is it absolute, probable, or maybe?
Any information I can get on male fertility in stage 4 renal failure would be helpful! Thank you for your time!


Thanks for asking my opinion on Allexperts.

Fertility may be affected because your husband is suffering from chronic kidney disease (CKD). The best way to find this out is to get a semen analysis done.

If the sperm count or motility are affected, you can try IUI - Intra uterine insemination. Good Luck!


Dr. Shah


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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow


I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

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Ten years as a Critical Care & Transplant Nephrologist

International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association

- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182

MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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