Dr. S. Smiley Thakur
Nephrology and Dialysis
Seattle, WA
32 years experience male
Locations
Office
Seattle, WA
My office hours
Wednesday: 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 30-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
In/out/shift: The approach is as follows:
1. Not enough in: this is not likely
2. Too much out:
a) urine: can occur with diuretics, low magnesium
b) gi: ... Read More
4.9k viewsReviewed >2 years ago
A member asked:
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Approach: 1. Too much in: unlikely by mouth, can occur iv
2. Not enough out: occurs in unsuspected kidney dysfunction or urinary obstruction, aldosterone tumou... Read More
4.9k viewsAnswered >2 years ago
A 38-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Diagnostic Process: The first goal is to verify if you have diabetes insipidus. This done through a history, physical, and tests done on simultaneous samples of blood an... Read More
4.9k viewsReviewed >2 years ago
A 21-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Testing: Patients are anemic (low hemoglobin), with small cells (microcytosis).
A hemoglobin electrophoresis confirms the diagnosis.
These tests are done aft... Read More
4.9k viewsReviewed >2 years ago
A 21-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Donor healthy: Other investigations include making sure the donor doesn't have, or is at risk for having, the same disease as the related recipient.
Donor motivatio... Read More
4.9k viewsAnswered >2 years ago
A 47-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
YES: This is a scenario where the kidney is trying to hold on to water (appropriately) when the sodium amount may be lower than usual.
Thus the sodium/p... Read More
4.9k viewsAnswered >2 years ago
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Electrical: The concentration of sodium outside and potassium inside cells is important to the resting membrane charge on the cell surface. This has implications... Read More
4.9k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Tag team approach: This is a good question to ask him/her.
Some nephrologists assume all primary care issues for their dialysis patients.
Others work in a team.
You ... Read More
4.9k viewsAnswered >2 years ago
A 54-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Kidney + Other: Flank pain may be due to the kidney, a stone being the major concern.
The differential diagnosis is wide: the presence of fever (pyelonephritis)... Read More
4.9k viewsReviewed >2 years ago
A 32-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 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
4.9k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
In-line filters: The liver and kidneys both filter metabolites and detoxify the blood stream as it passes through.
4.9k viewsAnswered >2 years ago
A 37-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Diagnosis First: The cause of the renal failure needs to be determined. For example, hypertension. This will lead the physician to evaluate other organs i.e. Heart, ... Read More
4.9k viewsAnswered >2 years ago
A 43-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Nurses being nice: The total fluid removal target is programmed at the beginning of the dialysis run.
Fluids consumed on dialysis are added to the total weight targ... Read More
4.9k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Diagnosis first: Hyperkalemia can cause cardiac arrhythmias at levels greater than 6.5 meq/liter. Your physician can evaluate or refer you to a nephrologist for an opi... Read More
4.9k viewsAnswered >2 years ago
A 42-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
On ultrasound: The white spots are calcifications in the material of the kidney (nephrocalcinosis) or stones (nephrolithiasis). Chronic kidney disease can also give... Read More
4.9k viewsReviewed >2 years ago
A 25-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Yes: Some kidney diseases are hereditary. Your description indicates your father had a nonfuncitoning kidney and developed pyelonephritis in the other. T... Read More
4.9k viewsReviewed >2 years ago
A 38-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Slightly abnormal.: The normal range for sodium is 135-145 mmol/l. A better indicator is how long it has been in this range, is it stable, and are you on any medications... Read More
4.9k viewsAnswered >2 years ago
A 46-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Yes: An xray may miss some. An ultrasound is less expensive than and MRI and will give you the same information, regarding the presence/absence of stones.
4.9k viewsAnswered >2 years ago
A 46-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
No: Respectfully, calcium restriction is no longer thought to be of benefit in the prevention of kidney stones.
Patients with calcium-oxalate stones, ... Read More
4.9k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Clean & Squeeze: Dialysis is both about cleaning (dialysis) the blood of toxins and squeezing (ultra-filtering) excess fluid out. Both functions are done constantly in... Read More
4.9k viewsReviewed >2 years ago
A 27-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Not clear: I'm not sure on the units in your value or if there is a decimal missing.
A creatinine of 4.80 mg/dl is abnormal and requires investigation.
A cre... Read More
4.9k viewsAnswered >2 years ago
A 41-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Diagnosis first: Ask for a referral to a nephrologist who will investigate if there are reversible causes. If not, the goal is to preserve your kidney function at it'... Read More
4.9k viewsAnswered >2 years ago
A 47-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Plumbing/salt: As we age, the return venous pumping and valves don't work as well. This results in swelling as day progresses. This is worse with high salt intake.... Read More
4.9k viewsReviewed >2 years ago
A 49-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Depends: In a person with normal kidney function, the exceess/unneccessary/free water is easily excreted.
In patients with abnormal function (low gfr), pa... Read More
4.9k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Interpretation: Serum creatinine is affected by gender, age, race, muscular build, and renal function. A rising creatinine is always of concern. "normal" on lab tes... Read More
4.9k viewsReviewed >2 years ago
A 45-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Unrelated: These two symptoms are not related.
4.9k viewsReviewed >2 years ago
A 37-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Depends: 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
4.9k viewsReviewed >2 years ago
A 37-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Diagnosis First: It depends where it is coming from. It may be from the filtering units, kidneys, ureters, bladder, prostate, or urethra. The presence of other facto... Read More
4.9k viewsReviewed >2 years ago
A 30-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Complex: You may also have kidney chemistry abnormalities.
Some cystic diseases have cysts in the liver and kidney.
4.9k viewsAnswered >2 years ago
A 47-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Depends: Ramipril is used for blood pressure control, to improve heart function after a heart attack, and to preserve renal function. Each of these indication... Read More
4.9k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Interpretation: 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
4.9k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Sallow complexion: Dialysis shouldn't change the color of one's skin.
As patients approach needing dialysis, the skin can turn a non-shiny yellow/brown, which is ca... Read More
4.9k viewsAnswered >2 years ago
A 41-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Hips?: Most people point to the bony part at the top of their leg. This is the greater trochanter, and not related to the hip. Hip pain is felt in the groi... Read More
4.9k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
No correlation: I'm assuming you mean can any physical activity you perform cause a kidney stone.
4.9k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
4.9k viewsAnswered >2 years ago
A 32-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Part-time job: Dialysis enables a patient, who would otherwise die, to continue enjoying life. Attention to early dialysis access placement, treatment of anemia, an... Read More
4.9k viewsAnswered >2 years ago
A 39-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Surface Tension: Everyone makes bubbles when voiding. The stability (how long they last) depends on what is in the urine to affect the surface tension of the bubble. E... Read More
4.9k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Urine smell: The uremic toxins, at the near end stage of kidney failure, are exuded through sweat and breathing.
4.9k viewsAnswered >2 years ago
A 38-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Urine Volume: Your question is can someone who is on dialysis have lots of urine still (polyuria). The clearance of toxins and water functions of the kidney are di... Read More
4.9k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 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
4.9k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Much different: Cystitis refers to an infection in the bladder. Nephritis is an inflammation and disruption of the microvascular anatomy in the kidney, expecially of... Read More
4.9k viewsReviewed >2 years ago
A 56-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 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
4.9k viewsReviewed >2 years ago
A 37-year-old male asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Good Company: Yesterday's study results, lead to today's questions, and then tomorrow's better study design. Errors in methodology along the way get perpetuated un... Read More
4.9k viewsAnswered >2 years ago
A 60-year-old female asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Low sodium concent'n: Hyponatremia describes a low (<120) sodium to plasma volume ratio.
This happens rarely due to low sodium intake, but most commonly is a problem ... Read More
4.9k viewsAnswered >2 years agoMerged
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
No: A shunt, or graft, is a piece of synthetic tubular material inserted under the skin that dialysis needles insert directly into.
A fistula is a conn... Read More
4.9k viewsReviewed >2 years ago
A 34-year-old female asked:
A 35-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Ultrasound cloudy: The increased echogenicity generally means there is some chronic process going on. Knowing the sizes of the kidneys, whether there are stones, cysts... Read More
4.9k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Yes: Take care not to compress your fistula access while lying down. Catheter exit sites need to remain covered.
If a pd access, keep your exit site c... Read More
4.9k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. S. Smiley Thakuranswered
Nephrology and Dialysis 32 years experience
Clean & Squeeze: Dialysis is both about cleaning (dialysis) the blood of toxins and squeezing (ultra-filtering) excess fluid out. Both functions are done constantly in... Read More
4.9k viewsReviewed >2 years ago
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
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
219
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
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