DEAR DR. GOTT: In your column you’ve said people with kidney diseases should not take glutamine, but you don’t say why. I have GN with secondary FSGS and can’t find out why I shouldn’t take glutamine. Hopefully you can help me out.

DEAR READER: Before I get into the glutamine issue, I will first briefly explain what GN and FSGS are.

First, GN is an abbreviation of glomerulonephritis, a kidney disorder that causes inflammation of the glomeruli. These tiny filters are responsible for removing excess fluid, electrolytes and waste from the bloodstream for excretion through urination.

There are two forms, acute and chronic and a plethora of reasons why either may occur. Certain bacterial or viral infections, such as bacterial endocarditis, streptococcus and hepatitis B or C may be to blame. Some immune system disorders such as lupus, Goodpasture’s syndrome and IgA nephropathy or vascular conditions, such as Wegener’s granulomatosis or polyarteritis may lead to GN.

Symptoms vary in severity and may include hematuria (blood in the urine), high blood pressure, edema (swelling), fatigue due to anemia or kidney failure, and proteinuria (protein in the urine which may present with excessively foamy urine).

Treatment depends on the cause. For example, most acute cases caused by the streptococcus bacteria tend to improve without specific intervention. For those that do require treatment, anti-hypertensive medication may be beneficial. Treatment of the underlying cause, should one be found, will also help. For those with chronic disease dialysis (a procedure with a sort of external mechanical kidney to remove waste from the blood) or transplant may be necessary. Transplant is only an option for those with severe disease but who are still in good health otherwise.

Beyond that, a diet low in salt, potassium and protein is important to reduce the work of the kidneys. Maintaining a healthy weight and if diabetic, controlling blood sugar, will also be beneficial.

FSGS is focal segmental glomerulosclerosis. This condition is characterized by the development of scar tissue within the glomeruli. It is not a single disease, but rather a pattern of damage with several types being differentiated, based on which areas are damaged. It is relatively common, especially in the United States, and can only be diagnosed by kidney biopsy.

There are two forms, primary, which occurs on its own for no obvious reason, and secondary, which is caused by or is in association with another condition such as obstructive sleep apnea, sickle cell anemia, obesity, congenital kidney defects, urine backing up into the kidneys, certain viruses and more.

Many FSGS patients don’t have symptoms. Those that do may experience edema (swelling), increased blood creatinine levels, proteinuria, high blood pressure that is difficult to treat, sudden weight gain, have shoes that no longer fit, and more.

Treating FSGS can be difficult and it is important that those diagnosed be under the care of a competent nephrologist (kidney specialist). Regular monitoring of kidney function is vital. Immunosuppressant medications and/or certain types of anti-hypertensive drugs may be prescribed. With or without treatment, most will eventually require dialysis.

Now on to your question about glutamine. Glutamine is an amino acid, not only found in foods we eat, but that is also produced by our bodies. Deficiency is rare. Supplementation is not recommended for those with kidney disease or for anyone with reduced kidney function — such as the elderly — because it has been found to raise levels of certain substances which indicates stress on the kidneys. Those already experiencing kidney problems may speed worsening of functioning by taking this supplement.

Readers who are interested in learning more about the kidneys can order my Health Report “Kidney Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.