I paid another visit to my Nephrologist a few weeks ago and asked him all my questions. His responses were:
- A biopsy isn't very useful when there is chronic (permanent) damage to the kidney's as the treatment is the same regardless of the cause.
- It would be worth getting another ultrasound to see if there is any physical change in the kidneys. I've been curious to do this.
- To test the blood bicarbonate level, and hence determine if treatment with sodium bicarbonate would be helpful, requieres an arterial blood sample and is not very common. It is a treatment that is considered at more advanced stages of disease.
- It is possible that an intolerance to wheat caused the damage to the kidneys. Unfortunately he didn't give me any pointers about how to investigate this further. This is frustrating as obviously I don't want to eat wheat if it may cause further damage but on the other hand it is a major sacrifice to avoid it for no good reason!
- He has seen cases of kidney function improving, and has even seen patients come OFF of dialysis, even though there is no medical explanation for this.