Dr. S. Smiley Thakur
Nephrology and Dialysis
Seattle, WA
33 years experience male
Locations
Office
Seattle, WA
My office hours
Thursday: 9:00am - 5:00pm
Show moreInsurances accepted
Aetna
Premera Blue Cross
UnitedHealthcare
Transplant and Nephrology Northwest
Seattle, WA
About
SpecialtiesDoctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Nephrology and Dialysis
Internal Medicine
Languages spoken
English, German, Gujarati, Hindi
Doctor Q&A
226 Answers
89 Agrees
The number of answers this doctor has agreed with.
A 34-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
RBC origin eval: You need an evaluation to determine where the blood is coming from. It may be from the filtering units, kidneys, ureters, bladder, prostate, or ureth... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
1 comment
A 44-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Different modes: Capd involves 4-5 manual exchanges from 8am to 10 pm, i.e. When one is ambulatory.
Ccpd, or continuous cycler peritoneal dialysis, involves being a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 21-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
RRT options: There are five renal replacement therapy options i always discuss with patients who are about to start dialysis.
1. Blood dialysis
a) in cent... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 25-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Liver Risk: Recent trial results highlight concern regarding liver toxicity:
http://www.Fda.Gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalpr... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
In the extreme case: If the urine protein loss is sufficient to cause a drop in serum Albumin below normal (3.0 g/dl), then there isn't enough oncotic pressure to keep flu... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Diabetes (2): Both mellitus and insipidus. Both are associated with hypernatremia. Have your chemistry checked to see if this is present.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Related: If a kidney is obstructed, it can dilate (hydronephrosis). The blockage causes the urine flow to decrease, making infection possible (pyelonephritis)... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Complete the course: Finishing a course of antibiotics is essential to ensure the bacteria isn't just partially treated. It could reemerge, and the second time, be resist... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 44-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Unclear: Serum creatinine is "normal" below 1.2 mg/dl for most labs. What it means for an individual depends on the gender, age, and weight. 1.1 for a man of... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 29-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Excess Loss: Protein is an expensive commodity for the body. The kidneys are entrusted to return protein back to the body during filtering, and not lose it to the... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 49-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Good question: Creatinine in the urine, like in the blood, comes from the muscles. The urine creatinine can be collected for 24 hours to calculate the creatinine cl... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 46-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Doppler: A regular ultrasound shows shades of black and white to identify kidney sizes and structures.
A doppler senses flow to (red) and from (blue) the pro... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 70-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Is the same: Egfr is a calculation to estimate glomerular filtration rate. The GFR and creatinine clearance can be predicted from the serum creatinine. Your fluc... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Risks vs. Benefits: Patients with kidney stones benefit from drinking enough to void 2 liters a day. Patients with a disease called diabetes insipidus, lose large volume... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Dialysis kidney?: The membrane is similar to the glomerulus where blood toxins are filtered across a membrane into the urine compartment.
Created for people with ongoing healthcare needs but benefits everyone.
4.7k viewsReviewed >2 years ago
A 34-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Multiple walls: Complex cysts, vs. Simple cysts, share common walls with other cysts, have solid components in the walls, or calcifications.
A multiseptated cyst h... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Vit D analogue: Not regular vitamin d. You need calcitiriol, zemplar, or Hectorol which are already partially activated and don't require the kidney's final hydroxyl... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Diagnosis needed: Serum creatinine is affected by protein intake, gender, age, race, muscular build, and renal function. A rising creatinine is always of concern. "no... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 43-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Yes: Samples that are left on the counter too long can hemolyze. This raises the measured value of the potassium. Abnormal labs that are unexpected shoul... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 37-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Glomerular disease: Blood in the urine can come from the kidney blood vessels (glomeruli) or from any anatomic structure along the pathway from urine formation to its exi... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 36-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Prognostic finding: 40% of type 1 diabetics and 10% of type 2 diabetics go on to have renal dysfunction. The early marker for both is the presence of proteiinuria.
Th... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Complex: The two are exchanged for each other in the distal aspect of the kidney filtering units.
Kayexalate is a resin that does exchange sodium for pota... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 45-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Part answer: With no renal function, a patient will fall into a uraemic coma in 7 to 10 days and die within 14 to 21 days.
I defer the liver question to a hepatol... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
No: Pain in the back after lifting may be due to disc disease or muscle strain. See your physician if pain persists.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 32-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
10-14 days: If a patient with zero renal function stops dialysis, he/she will fall asleep in 7-10 days and die within 7-14 days.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Multiple features: Complex cysts, vs. Simple cysts, share common walls with other cysts, have solid components in the walls, or calcifications.
The radiologist will o... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 34-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Nope: Not from rope. Or any other activity (except extreme contact activities i.e. Punches to the kidneys).
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 31-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
See below please: Glaxosmithkline consumer healthcare does not add aluminum during the manufacturing process of the tums® tablets but one of the raw materials used in t... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Age of Majority: One must be of legal age to consent to donate one's own kidney. There have been legal exceptions made in the case of a child twin donating to another... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 51-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Acidosis: This is a complex problem that requires investigation. There are many causes other than kidney failure.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 46-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Days: A creatinine clearance less than 10ml/min is consistent with end stage renal failure. Patients at this level are physically ill and need to start dia... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 39-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Depends: Fishoil 2-3 grams twice a day has been shown to be effective in slowing renal decline in patients with a creatinine clearance between 30 and 60 ml/min... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Co-tango usually: A patient with one kidney should have a creatinine less than 1.0 mg/dl still. The BUN should be less than 10.
The BUN is usually 10 times the crea... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
UTI treatment: Tmp/smx commonly known as bactrim, (sulfamethoxazole and trimethoprim) is usually effective. You should have a urine culture set up to identify if th... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Can occur: Pain from obstruction in the lower ureter may seem to be coming from the labia (vaginal folds).
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Sallow complexion: Dialysis shouldn't change the color of one's skin.
As patient's approach needing dialysis, the skin can turn a non-shiny yellow/brown, which is cal... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Complex: Chronic immune mediated inflammation of the glomeruli (filtering units), does them in over time and causes loss of ability to clear the daily toxin an... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Multiple causes: Straining on voiding urine is unlikely to be the cause. You need a diagnosis. See your pcp first.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Wound healing: Once the surgical site has healed, you can go swimming. Should be about 2-3 weeks. Get a final ok from your surgeon.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 31-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Working full time: The glomeruli function as in-line filters to your bloodstream, receiving 22% of the cardiac output. This translates into ~ 1.1 liter of blood being f... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Fistula +/- aneurysm: Dialysis patients need a mature vein that can withstand repeated puncture which is created by diverting arterial flow into a nearby vein.
Needling th... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Most likely: Bilateral flank pain can be from kidney stones, infection, pneumonia, rib pathologies and other causes.
Muscle strain is the most common, however.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Diagnosis needed: Serum creatinine is affected by protein intake, gender, age, race, muscular build, and renal function. A rising creatinine is always of concern. "no... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Yes: Although the kidneys are protected by strong back muscles and the ribs. It would take a severe injury to cause hemorrhage to the kidney. Pain is lik... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 38-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Dose doubling: Yes. If your blood pressure isn't well controlled on 10mg and the potassium is normal with an acceptable creatinine, this should be fine. A
sk yo... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 31-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Co-tango usually: The BUN is usually 10 times the creatinine. When the creatinine goes up, the BUN goes up similarly to roughly keep this proportion, in most kidney dis... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 59-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Side effects: Inspra is now available as generic eplerenone. I prefer it to spironolactone in men due to (breast enlargement). Otherwise i think they are both simil... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 59-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Complex: The differential diagnosis includes lack of sufficient arterial flow, side effects from medications e.g. Statin, electrolyte deficiencies i.e. Low po... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 51-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Yes: Your drop in creatinine is very encouraging.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 43-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 33 years experience
Risk of obstruction: Nausea may indicate your kidney function is becoming impaired from dehydration and possibly obstruction.
Infection and fever due the obstructing st... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
TestimonialsRecommendations and Thank you notes are endorsements given from patients or other doctors.
Recommendations and Thank you notes are endorsements given from patients or other doctors.
8
Recommendations
225
Thank you notes
Jan 21, 2013
Dr. Thakur is a well respected nephrologist in Seattle. He has an extraordinary ability to make difficult concepts understandable to his patients. He took wonderful care of my husband during his end-s...Read More
HealthTap member
Dec 16, 2012
Dr. Smily Thakur has been my mother's Nephrologist for over seven years - seven years she would not have been alive to enjoy if not for Dr. Thakur! She has been a patient from about 2004 and continue...Read More
HealthTap member
Dec 16, 2012
Dr.Thakur inspires immediate confidence and for good reason. He approches patients as people rather than cases and his level of respect is apparent from the first conversation. I was referred by my ...Read More
HealthTap member
This was very helpful. Thanks! What you wrote coincides with info the ER gave my husband & recent research...My husband took Tums for many, many years but suddenly after he stopped taking them, within...Read More
HealthTap member
Thank you, your answer was very helpful! I coul noy explain this to my family. This is what I was told I had.
HealthTap member
Your answer made me feel good! Thanks :) Thanks Doc...i will carry out the test as directed.
Education & Training
Medical/Graduate school
University of Saskatchewan College of Medicine
Graduated 1990MD
Residency
Royal University Hospital
Residency
London Health Sciences Centre
Awards
Top Doctor, Seattle Metropolitan Magazine
Excellence in Teaching, Providence Seattle Medical Center
Excellence in Teaching, Providence Seattle Medical Center
Affiliations
American Society of Transplantation
Royal College of Physicians and Surgeons of Canada
Washington State Medical Association
Publications
Education Influences Dialysis Choice
Why the doctor can't see you now
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
Answer emailed
in 24 hours or less
