Kidney function

@wgj I will also be curious what the eGFR shows after 2 weeks off the Farxega! Please let me know! Many of us who have had friends or family members with kidney issues, are more aware and in step with being very proactive for kidney care, given we have already seen it first-hand!
Ginger

@collegeprof You are absolutely right in your response! Kidney function and daily life are closely tied together.

@jodyschmidt First, welcome to Mayo Clinic Connect. Seeing a dramatic change in numbers is concerning for anyone, to be sure! I hope you read the response from @collegeprof and the education there. There are a few other factors that can result in differing values than you normally see. Your level of hydration at the time of testing [dehydration is not a good thing!], your immediate diet and what you have eaten, time of day, even the different testing machines used to process your blood samples can all play a part.

High blood pressure and diabetes appear to be the leading causes of chronic kidney disease. Controlling those health issues can go a long way to keeping your body healthy, but it can be a constant battle. Doctors seem to gloss over those concerns. My chronic kidney issues are from a rare autoimmune disorder. There are also genetic or lifestyle factors that can play into it.

When you go to the nephrologist next week, you may hear a lot of new words. If you have a second set of ears [friend, spouse, partner, family member] to go with you, please do so. Ask questions, take notes. If something is unclear, ask to have it repeated. Write out any questions you have ahead of time. All of this will be a new experience, so take a deep breath. You got this! And, remember, we will be here to answer questions as we can. We are not medical professionals, but we do have experience to share, and support to offer.
Ginger

@wgj Farxiga is used for both diabetes and kidney disease. The difference is the strength meaning that endocrinology use 5 mg and nephrologists use 10 mg. With both, there can be multiple severe side effects such as urinating frequently at night causing lack of sleep. I went off of it twice and my creatinine eGFR improved but there are others who continued with Farxiga with good results. As others have said, good daily hydration levels and watching intake of sodium, potassium, and phosphorus go a long way to improving your eGFR score. You may also wish to use a 24 hour urine test which many nephrologists like for kidney function in complimenting eGFR.

Thank you. I have stopped the Farxega for the next two weeks and will be tested again then. I had also upped my protein a lot when I started Forteo; maybe that contributed. I didn't know GFR could rise and fall so dramatically with CKD. I have adjusted to the slow decline, but 40 to 26 in four months is pretty scary.

In many cases, the reason for large variations in creatinine eGFR is due to hydration levels and/or medication. That is why you follow up with your PCP or nephrologist, and get a Cystatin C test for better eGFR consistency as that looks at your cells as compared to muscle mass.

Cheryl, My nephrologist tests every three or four months. My GP tested once a year, but since starting on Forteo, he will test again when I have been on Forteo for 4 months. Your GFR has bounced around from 14 to 42?? There is hope then that mine can go up again?? I do not have high blood pressure or diabetes--just osteoporosis. I am thankful for this forum. Just replies from the two of you have made me less stressed today. Thanks.

wgj, what you said is interesting. My GFR is 27 and I'm monitored every 3 months. I am not diabetic, weigh 130 lbs, normal BP. Every time a medicine is suggested, a lot of thought goes into it, even antibiotics. When I took antibiotics for a UTI, I took less over a longer period. My kidneys don't clear meds, sodium, potassium, etc efficiently at my GFR level. I do not take supplements and eat a mostly vegetarian diet. Maybe you're taking too strong a dose of Forteo? I take very few meds. I do take lorazepam as I have tinnitus that keeps me up at night. Lorazepam is not a concern for kidney function and I've taken it for years. Only a small dose, only at night.

Cheryl, My nephrologist tests every three or four months. My GP tested once a year, but since starting on Forteo, he will test again when I have been on Forteo for 4 months. Your GFR has bounced around from 14 to 42?? There is hope then that mine can go up again?? I do not have high blood pressure or diabetes--just osteoporosis. I am thankful for this forum. Just replies from the two of you have made me less stressed today. Thanks.

Cheryl, My nephrologist tests every three or four months. My GP tested once a year, but since starting on Forteo, he will test again when I have been on Forteo for 4 months. Your GFR has bounced around from 14 to 42?? There is hope then that mine can go up again?? I do not have high blood pressure or diabetes--just osteoporosis. I am thankful for this forum. Just replies from the two of you have made me less stressed today. Thanks.

@wgj the operative word is “bounce”. Think of a red rubber child’s ball at recess or gym class. (What goes up does eventually tend to come down.) I’m 67, have had diabetes since my teens and a history of hypertension controlled by meds. I was hospitalized with nephritis when I was 5 years old. No one can tell me if that is related to the stage 4 chronic kidney disease (CKD) that I have now. I also have anemia and osteoporosis. I have a primary Dr. (Internal Medicine), an endocrinologist and a nephrologist. These people prescribe my meds and over the counter (OTC) things too. I am blessed that they are part of the same healthcare system and can collaborate on my overall treatment plan. I also have access to nutritional services who are well versed in diabetes and renal diets. I’m thankful that we are all on the same page. I see the GP as needed. I see endocrinology and nephrology about quarterly. The doctor’s in endocrinology and nephrology alternate between themselves and nurse practitioners. I see endocrinology later this month and nephrology in May. My last eGFR was in the low 30’s. It is important to remember that a single lab result is less important than the overall trend.