DEAR DR. DONOHUE: My father died of kidney failure. He was 94. I realize that’s a long life, but his death was unexpected. He lived alone, drove a car, planted a garden and kept his house immaculate. He was alert mentally, too.

I was called to the hospital and told my dad was in a coma and that his kidneys had failed. Isn’t there a warning that the kidneys are failing? There wasn’t with my dad. Or did his doctor miss it? — K.P.

ANSWER: The kidneys have many important functions. They keep the minerals sodium, potassium and calcium at their proper levels. If the body becomes too acid, the kidneys fix that problem. They manage the amount of fluid that stays in the body and the amount that must be gotten rid of.

Kidneys do fail slowly. In the early stages, people might not notice anything wrong. As it becomes more pronounced, then failing kidneys make people feel tired all the time. Anemia develops. Sodium, potassium and calcium are nowhere near where they should be. These things can be greatly improved through dialysis and medicines. Treatment can go on for many, many years, with people living an active life. This is called chronic renal failure.

Kidneys also fail rapidly. That’s acute renal failure. An overwhelming infection, a sudden and precipitous drop in blood pressure, and diarrhea so voluminous that it depletes the body of fluid are examples of illnesses that cause swift and often fatal kidney failure.

I’d say your dad had acute renal failure. I can’t tell you the cause. He might have had a heart attack that caused his blood pressure to plunge so low that his kidneys couldn’t function. At any age, an unexpected death is disturbing. You and your family have my sympathy.

DEAR DR. DONOHUE: In my family, we were taught to drink at least eight glasses of water a day. I have done so all my life. I am now 68.

I’ve been wondering if all this water drinking is necessary for good health. My parents told us it flushed poisons out of the body. Does it? Are eight glasses of water overdoing it? That’s eight glasses of water in addition to coffee, tea and sometimes pop. — G.R.

ANSWER: Humankind, in its long history, has adopted many behaviors that were designed to lengthen life. The water-drinking ritual is one of them.

Flushing the body with water or any fluid doesn’t purge it of poisons. The body is endowed with the capability to cope with internal changes that occur on a daily basis.

You are overdoing the fluid bit. It’s not hurting you, but it’s not helping, either. You know if you are sufficiently hydrated if the color of your urine is pale yellow.

DEAR DR. DONOHUE: All my lab reports from recent blood work came back normal, except for creatinine. What is it? What does it mean? Mine is a bit over the normal value, and it was highlighted. — M.D.

ANSWER: Creatinine is a byproduct of muscle metabolism. It’s produced daily in as close to predicted amounts as is possible with biological functions. A rise in creatinine indicates that the kidneys are not working perfectly.

A “bit” over normal isn’t a matter of concern. That’s especially so if your doctor hasn’t brought up the matter.

DEAR DR. DONOHUE: I’ve been told never to have surgery for cancer. Supposedly surgery causes it to spread. Any truth to this? — H.H.

ANSWER: Surgeons go to great lengths when removing cancerous tissue not to spread cancer cells. If surgery were a cause of spread, it wouldn’t be done. Rarely, if ever, does it lead to dissemination of cancer cells.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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