Stage 3 chronic kidney disease (CKD): What specialists do I see?

Posted by rozalia @rozalia, Aug 24, 2016

My primary says I do not need to see a kidney specialist. Is this true. My blood chems are ok.

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@basslakebabe19. Your comment about whatever happened to Stages 1and 2 struck a chord with me. Think I will ask drs. next visit. If I'd not had cancer in one kidney, would I even know about my other kidney. I've collected a bit of information on the subject of diet, including @kamama94's fine work. The coronavirus, though, has created problems for me. Our store shelves are frequently empty, which, since I'm juggling three diets plus finicky husband's diet, has created some problems. Anyone have suggestions of protein sources if we are indeed to have a meat shortage? Other than eggs, tuna (which all but disappeared during Lent), and protein drinks, I'd love a suggestion or two.

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@trishanna, Covid-19 has created more challenges for us on restrictive diets and grocery shortages make it much harder to stay on point. Because of my stage 3 ckd, I’ve greatly reduced meat proteins in my diet by opting for some of the following. Of course each person’s diet requires fine tuning but these may help with alternative protein sources and a google search can provide other links for protein alternatives:
https://www.womanandhome.com/food/recipes/protein-rich-alternatives-to-meat-85951/

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@trishanna, since we CKD folks also have to limit phosphorus, potassium, and sodium, it's tricky to get enough protein even if you also are on a protein restriction as I am. And as I'm "almost" vegan and seldom use any animal products except eggs it can be challenging to find acceptable protein sources which aren't too high in the other minerals we must monitor.

Native Americans combined what is called the Three Sisters, corn, squash and beans to make complete proteins. Since dried beans also can be high in phosphorus and potassium I have to limit them and use green beans instead of dried beans and summer squash instead of higher phosphorus and potassium hard-shell squash. They did use sea salt but not a lot of it and chose other seasonings such as animal fat (not for vegans) and hot peppers, wild onion/wild garlic and other greens.

Similarly, peas and rice form a complete protein. 1/3 C Water Maid rice = 57.4 cal 22.7 mg P 18.5 mg K 0.5 mg Na 2.8 Gm prtn and ½ C snow peas has 60.4 cal 73.4 mg P 138 mg K 2.9 mg Na 2 Gm prtn

@fiesty 76 posted a link for good sources of protein but here again, many of them are relatively high in phosphorus and/or potassium. My personal answer has been to purchase Morning Star Farms and Gardein meat analogs despite the fact that these are highly processed foods. I do think they are safe for me in moderation. 3 Morning Star chicken nuggets have 9.8 Gm protein and 1 Gardein "fishless" fillet has 4.5 Gms protein. 1 MSF "sausage" link is 40 cal, 64 mg P, 25 mg K, 150 mg Na, <2.3 Gm prtn. A King's Hawaiian slider bun has 3 Gms protein and is relatively low in phosphorus, potassium and sodium as long as I watch other sources of those in my daily meals.

Corn itself has a fair amount of protein; 1 small homemade cornmeal tortilla has 2.2 Gm protein. 2 Azteca Tac Size Flour Tortillas have 170 cal, 119.1 mg P (est), 139.5 mg K (est), 360 mg Na, 4 Gm prtn and. 3 T canned mushrooms with no added salt are 25.5 cal, <153 mg P, <153 mg K, 22.5 mg Na, 4.2 Gm protein and 3 of their corn tortillas have 3 Gms protein..

Tofu also is a good source of protein; 1 block extra firm Mori-nu silken tofu (349 Gm) has 180 cal, 250? mg P, 516 mgK, 160 mg Na, 28 Gm prtn! Of course you wouldn't consume a whole block at a meal, it is so versatile and small amounts can be used for taco filling, breakfast scramble, etc. 4 T fat-free refrid beans has 3 Gm protein but it also has 235 mg sodium so moderation is the key here. 1 serving of skillet bread (recipe in my almost vegan cookbook) has 3.7 Gms protein but is low in phosphorus, potassium, and sodium. Although heat can lower nutrient value, ¼ C grits before cooking has 130 cal, 28.6 mg P, 53.8 mg K, 0 mg Na,3 Gm prtn.

The values given above can change as manufacturers alter their recipes and ingredients and amounts so it's always wise to read the labels.

Hope this helps.

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Not all processed foods are bad.

Today’s menu (for Mexican food lovers but not too spicy):

Bkfst Burrito 206.7 cal, 224.8 mg P, 345 mg K, 218.3 mg Na, 5 Gm prtn, 0 phosphates
1 Azteca® corn tortilla 46.7 cal, 66 mg P, 59 mg K, 1.7 mg Na, 1 Gm prtn, 0 phosphates
½ scr egg (fridge raw unused half for later) 35 cal, 45 mg P, 35 mg K, less than 25.6 mg Na, 3 Gm prtn
¼ sl ea Follow Your Heart® pepperjack and provolone vegan chse 30 cal, 1 mg P, 1 mg K, 90 mg Na, 0 Gm prtn, 0 phosphates
1C leached potato shrds 70 cal, 112.8 mg P, 250 mg K, less than 5 mg+96=101 mg Na, 1 Gm prtn
1 tsp EVOO 30 cal, negligible minerals, 0 prtn, 0 phosphates

Vegan nugget snd/spud pups lnch 291.2 cal, 92.1 mg P, 287 mg K, 563.7 mg Na, 9.9 Gm prtn
2 BBQ vegan chisken flavor nuggets 100 cal, est 66 mg P, 95 mg K, 250 mg Na, 6 Gm prtn 0 phsphts listed but nugs breaded so bkng pwdr w/phos?
½ Hy-Vee® Hy-Waiian bun 75 cal, 13.4 mg P, 20.2 mg K, 80 mg Na, 2.5 Gm prtn, 0 phosphates in yeast bread
1 sl on 11.2 cal 8.2 mg P 40.8 mg K 1.2 mg Na 0.4 Gm prtn 0 phosphates
½ T honey mustard 15 cal, 2?mg P, 12? mg K, 37.5 mg Na, 0 prtn, 0 phosphates
½ svg leached potato shred pups 90 cal, less than 2.5 mg P, 149 mg K, 195 mg Na,1 Gm prtn, 0 phsphts except possibly in fertilizer when grown
Sm amt EVOO 20 cal, negligible minerals, 0 prtn, 0 phosphates

3 red bn burrs/sm sal dnnr 269 cal, 271.5 mg P, 429.2 mg K, 200 mg Na, 6.9 Gm prtn
3 Azteca® crn tortlls 140 cal, 198 mg P, 168 mg K, 5 mg Na, 3 Gm prtn, 0 phosphates
¼ C Hy-Vee® 0 Na added rd bns 54 cal, less than 58 mg P, 152 mg K, 5 mg Na, less than 3.4 Gm prtn, 0 phsphts
¼ sl ea pprj & reg vegan chse 30 cal, 1 mg P, 1 mg K, 90 mg Na, 0 Gm prtn, 0 phosphates
1 C lett shrds 5 cal, 14.4 mg P, 102 mg K, 5 mg Na, 0.5 Gm prtn, 0 phosphates
1 T famous original red sal drssng 40 cal, 0.1 mg P, 6.2 mg K, 95 mg Na, 0 Gm prtn, 0 phosphates

Extras 154.4 cal or less, 51.6 mg P or less, 208.8 mg K or less, 58.8 mg Na or less, 1.8 Gm prtn or less
Vegan yogurt 130 to 140 cal, 15 to 30 mg P, 5 to 94 mg K? 10 to 30 mg Na, 1 Gm prtn or less, 0 phosphates
6 half-C cof 14.4 cal, 21.6 mg P, 114.8 mg K, 28.8 mg Na, 0.8 Gm prtn, 0 phosphates

Total for day not counting 192 mg added NaCl at bkfst and 2 half svgs diabetic/kidney friendly snacks
925.3 cal 640 mg P 1195 mg K 1040.8 mg Na 23.6 Gm prtn very minimal phosphates

*Error: Phosphorus amts for potato nuggets shld be 66 mg, add 63.5 to lnch totals and totals for day. Sowwy.

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Hello, all. Please delete your rough draft copies of the new recipe collection YES because a finished version will be coming soon. I appreciate your suggestions and was happy to include them.

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I was diagnosed with stage 3 kidney disease 8/4/2020. I have made an appointment with an Nephrology specialist. I would appreciate any symptoms the group could share. My symptoms include weak stream when urinating or drip drip. I'm drinking enough fluids. Syptoms can also include an urgent feeling to urinate and then wait minutes to start. Have had these symptoms for approx 3 months.

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@douglasebaker

I was diagnosed with stage 3 kidney disease 8/4/2020. I have made an appointment with an Nephrology specialist. I would appreciate any symptoms the group could share. My symptoms include weak stream when urinating or drip drip. I'm drinking enough fluids. Syptoms can also include an urgent feeling to urinate and then wait minutes to start. Have had these symptoms for approx 3 months.

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Hi @douglasebaker, you'll notice that I moved your message to this existing discussion about stage 3 kidney disease. There are many discussions about CKD in the Kidney group to help you prepare for your upcoming appointment with the nephrologist. For example:
- Chronic Kidney Disease (CKD): How do I stop progression? https://connect.mayoclinic.org/discussion/ckd/
- Confused About Diet for Stage 3 or 4 Chronic Kidney Disease (CKD) https://connect.mayoclinic.org/discussion/confused-about-stage-3-ckd-diet/
- Stage 3 Kidney Disease and Diet: What can I eat? https://connect.mayoclinic.org/discussion/3rd-stage-kidney-disease/

You'll also meet members who can share their experiences and answer questions you may have - members like @gingerw @kamama94 @rosemarya @cehunt57 @bdade59 @carnes @2011panc @sbshreeve and others. They can also share their most common symptoms.

Douglas, what questions have you ready to ask the nephrologist?

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@douglasebaker

I was diagnosed with stage 3 kidney disease 8/4/2020. I have made an appointment with an Nephrology specialist. I would appreciate any symptoms the group could share. My symptoms include weak stream when urinating or drip drip. I'm drinking enough fluids. Syptoms can also include an urgent feeling to urinate and then wait minutes to start. Have had these symptoms for approx 3 months.

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@douglasbaker Welcome to Mayo Connect! I am sure you will glean a lot of information from this forum, as we all journey this road of kidney disease. Stage 3 generally breaks down in to "a" and "b" based on the eGFR because it runs from 29 to about 54 percent. The thing about kidney disease is that it can be pretty darned sneaky, and quietly affect your life before you exhibit many overt symptoms. It may be caused by lifestyle choices, genetically predispositions, medications used to treat other conditions, or in combination. It will be valuable for you to have information as to the cause.

The symptoms you describe may also be related to prostate health, so you might ask to see a urologist. We'll be here to answer questions as we can, based on our experience. When is your appointment?
Ginger

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@gingerw

@douglasbaker Welcome to Mayo Connect! I am sure you will glean a lot of information from this forum, as we all journey this road of kidney disease. Stage 3 generally breaks down in to "a" and "b" based on the eGFR because it runs from 29 to about 54 percent. The thing about kidney disease is that it can be pretty darned sneaky, and quietly affect your life before you exhibit many overt symptoms. It may be caused by lifestyle choices, genetically predispositions, medications used to treat other conditions, or in combination. It will be valuable for you to have information as to the cause.

The symptoms you describe may also be related to prostate health, so you might ask to see a urologist. We'll be here to answer questions as we can, based on our experience. When is your appointment?
Ginger

Jump to this post

Much appreciated

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Hi, i am 67 years old,male, my routine blood work at primary showed kidney GFR dropping below 60-he then referred me to a nephrologist, then to urologist for cat scans. I have cancer in the left ureter. GFR is 45 and i am now scheduled to have left kidney and ureter removed.This all happened in period of 4-5 months. Drs see a GFR under 60 as a red flag. Best wishes.

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