I actually got answers to most of my questions. My doctor spent more than an hour with me. So Thank you.
1: My Estimated Glomerular Filtration Rate (eGFR) is less than 30, my kidneys leak protein and i have metabolic acidosis. Why is my Kidney failing; is it being rejected?
Answer: The Kidney is failing, but not being rejected. It is a damaged kidney from the death of the donor, the trauma of surgery, the time in me.
2: Is there a specialist in Toronto, Montreal, anywhere really who specializes in transplants where the serology was mismatched leading to EBV viremia?
Answer: No, none.
3: Based on current blood work, my compliance, what is your best guess based upon similar cases to mine, what is the mean time to dialysis.
Answer: As of June 2022 two to five years depending on my lifestyle and diet.
4: What is the process to get a second kidney transplant? Assuming I have a living donor arranged.
~At the present time I am not eligible for another transplant because of active EBV viremia.
~Follow up: Can you understand how that would piss me off as you gave me the EBV in the transplanted kidney? Follow up answer: Yes I suppose so but based upon the risk assessment this was the best course of action for you.
~At a subsequent discussion with a different doctor who was a professor of medicine at Ottawa University he said it active EBV viremia was not a contradiction.
5: Is active EBV a disqualification? Would a period on dialysis without anti rejection drugs lead to a reduction in my viremia?
Answer: Yes to the first and probably to the second question.
6: My URINALYSIS indicates Protein Urine 2+, There is an increased risk of graft failure with greater urine protein concentration (hazard ratios 2.85). Study can be found here. I am watching my weigh, 0n blood pressure medication, have made the recommended dietary changes. I avoid foods that are high in potassium and magnesium. Would dialysis extend the kidney life by lowering my protein levels.
Aswer: Not advisable at this time.
7: The goal of treatment of metabolic acidosis in patients with chronic kidney disease is to achieve a venous plasma or venous blood bicarbonate concentration equal to or greater than 22 mmol/l (recommendation based on results of interventional studies).
What is my venous blood bicarbonate concentration?
8: I read an advertisment for Calcitriol; an active form of vitamin D, used to treat kidney disease with low blood calcium, hyperparathyroidism due to kidney disease, osteoporosis, and familial hypophosphatemia. It is a prescription vitamin D and is not sold over the counter. It can drastically improve your kidney function if you deal with proteinuria. Link here
Does this have any relevance to me?
Answer: If you want we can put you on it but its not as advertised. My response: Okay thanks I want to take your lead and not the lead of advertisers on the internet.