I was referred to Nephrologist dr. Toby Gottheiner because my urine has become foamy and colorless.
Dr G learned my family's history of kidney disease, but was unconcerned. He assured me that there's 'nothing wrong' with my kidneys. He did not order any tests to clarify what's going on.
I went back to my primary care doctor, who is really great. He ordered an additional test of urine osmolality with fluid restriction for 12-14 hours. That test came clearly abnormal: 372 mOsm/Kg with the normal reference of at least 850 mOsm/Kg.
The test pointed to inability of my kidneys to concentrate urine, which is associated with kidney failure, or other significant kidney disease.
Based on abnormal finding, I was asked by primary care to go back to see nephrologist.
3 months later I'm back to Dr. Gottheiner, reasonably expecting the differential work up on the cause of a problem. Instead the conversation turned different direction.
Vaguely admitting abnormal finding, doctor started vigorously looking for an unusual dietary pattern in my eating habits. When that failed, because my diet is well balanced, contrary to his previous admission, he suddenly said that he doesn't see anything wrong(?) and honestly(?), doesn't know how to help me!
Than he asked me, 'Why do you worry'?
I tried to patiently explain that I've had both flanks pain, coupled with significant progressive changes in a urine. He said that my urine changes unrelated to flank pains (?). At this point it has become clear doctor wasn't interested in making any honest diagnosis. You don't have to be a nephrologist to know that flank pain indeed can be caused by kidney problems.
I told him that both my urologist and primary care referred me to see him (nephrologist). He said that they referred me only because they 'didn't know what to do'!!
Than he asked me again, 'why do you worry'?
What was I supposed to say?
It's like asking diabetes patient why would he/she worry so much about high glucose levels?
And he is absolutely right in a sense: if doctor doesn't care, why should a patient get worry??
After first appointment, Dr. Gottheiner failed to order correct tests to evaluate the abnormal symptoms.
At second appointment, when presented with abnormal findings (extremely low osmolality), dr G completely ignored them. Moreover, he ignored other significant changes (high lactic acid, anemia, peripheral neuropathy) which could be related to a kidney disease as well. Finally, Dr. G failed to order any workup on the abnormal findings to make a differential diagnosis, let alone any treatment.
All in all, if you dare to 'worry' about your health, and need a diagnostic workup of your kidneys condition from a competent, intelligent doctor who cares, please don't waste your time and look somewhere else. Good luck!