I am a 56y/o diabetic male. I take 70 units of Lantus daily, and am on
a sliding scale of humalog (usually average from 20 50 units at meal
times). I am on 3 blood pressure pills, an am a chronic pain patient. I
have severe peripheral neuropathy in both feet and legs. Two years ago
I was getting anesthetic spinal injections 1 - 2 times DAILY to numb
the pain. The doctor finally put in two spinal cord stimulators - one
for my feet the other for my upper legs. I used the stimulators
regularly for 1 1/2 years then stopped, as it wasn’t doing any more good. It
DID help. I was taking 25 methadone 10mg BID - now I take 4 in the AM
and 6 in the PM. I also WAS taking around 18 ACTIQ pops daily. Now I
am taking 9 daily. I still have pain, still use the same amount of pain
pills for 2 years now, not having to up on the dosage, but also not
being about to go down on the dosage.
About 2 weeks ago I developed severe swelling in my left leg, from
right above the knee to the foot. An ultra sound was done - negative. Had
an echo-cardiogram - negative. Yesterday had a CT scan of the abdomen.
The nurse has told me, (haven’t seen the doctor yet) there is atrophy
in one kidney. An ultrasound of the abdomen is being ordered.
What is this? Could this be causing the swelling in my Lt leg? Is
this atrophy related to diabetes? Is there treatment for this?

Dr. Joshua’s Answer:

I find it unlikely that your leg swelling was related to the renal (kidney) atrophy. In your case, diabetes and related damage to blood vessels may be the cause of renal atrophy. Other possible causes exist; one important cause is renal artery stenosis, which means that the blood vessels bringing blood to the kidney are narrowed and the kidney is suffering from chronic lack of blood and oxygen. Renal artery stenosis can be diagnosed by a renal angiogram.

If renal artery stenosis is found, the treatment options include angioplasty where the artery is dilated with a balloon. Medical and surgical treatment options are also available. There is no guarantee that the kidney will recover after treatment.

Since you have diabetes with complications, it is very important to examine the kidney function and circulation and to take every possible measure to preserve the function of the healthier kidney.

Good luck!

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