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Mild kidney damage/stage 3a

Posted by livinglifeodb @livinglifeodb, Apr 7, 2023

I carried out some tests and did an abdominal pelvic scan because I was having persistent high blood pressure.The test showed I have mild kidney damage with a high level of creatinine.

My nephrologist prescribed two drugs for me: COVERAM & Bisoprolol fumarate and in a space of two weeks my creatinine went from 187µmol/L to 152µmol/L just on the drugs. Sadly, my creatinine went back to 163µmol/L last week and 160µmol/L when I checked today. How can I know from the Imaging scan result if my kidneys are injured or scarred ? Also, I found out that the egfr is not the best means to check for kidney function, what test can I possibly do to check how efficient my kidneys are functioning?

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Mentor
Ginger, Volunteer Mentor | @gingerw | Oct 17 10:54am
In reply to @rbennett "I am 55 and workout 6 days a week. i was taking creatine for a few..." + (show)
@rbennett

I am 55 and workout 6 days a week. i was taking creatine for a few months and dehydrated. I test at 57 GFR, but 3 weeks later it went back up to a 64 , which was my level over the past several years. My doctor recommended an ultrasound, but I am very nervous. I am super healthy, I think and very aware of what I put into my body. I was also eating a lot of redmeat at the time when it dropped to 57. should I be worried?

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@rbennett Welcome to Mayo Clinic Connect. We often wander through life, not always considering how our lifestyle and habits can affect our overall well-being. Understanding how interconnected things are, @collegeprof has raised good points for you to look at. It is natural for our eGFR to decline with age, but it is prudent to watch for big changes.

Diet seems to be the biggest factor in what we can do to keep our kidneys healthy. Watching sodium, phosphorous, potassium and calcium intake helps. Limiting red meat, dairy, refined sugars may sound harsh, but it is in our best interest. I myself followed a strict renal diet for many years, and was able to stave off additional intervention for a long time.

I suggest you ask your primary care for a referral to a nephrologist, and establish a relationship. Be mindful of trends in your labwork, not just a single test. It sounds like you are no longer taking over-the-counter creatinine supplements?
Ginger

REPLY
dutch4441 | @ditch4441 | Oct 18 5:28am
In reply to @collegeprof "@rbennett You paint a small picture of the problem. It sounds like you are working with..." + (show)
@collegeprof

@rbennett You paint a small picture of the problem. It sounds like you are working with a PCP, not nephrologist. Things to consider: 1) What about the rest of your labs? There is usually a reason for CKD. 2) Creatinine eGFR tests often vary. 3)You were dehydrated at the time of testing. When tested, always be hydrated.4)You were taking creatinine supplements. This may typically lower temporarily your eGFR score. 5)Eating an overabundance of red reat could have an effect as well.6) Taking an ultrasound may alleviate some fear. Summarizing, you appear to have all the symptoms of a lower eGFR only because of your habits prior to testing. One eGFR is wakeup call, but the true measure of CKD is your "trend" over time. I would follow up with your doc suggestion with an ultrasound. On your next test be hydrated, avoid large meat quantities, make an appointment with a nephrologist, and look at the whole lab picture and not one lab score. Our mentor, @gingerw, can add to my response in case I missed something.

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When I reach a low eGFR level my nephrologist says I must have been dehydrated. This is never the case. I believe some nephrologists blow off eGFR levels a lot.

REPLY
1 reply
collegeprof | @collegeprof | Oct 18 5:48am
In reply to @ditch4441 "When I reach a low eGFR level my nephrologist says I must have been dehydrated. This..." + (show)
@ditch4441

When I reach a low eGFR level my nephrologist says I must have been dehydrated. This is never the case. I believe some nephrologists blow off eGFR levels a lot.

Jump to this post

@ditch4441 There are a myriad of reasons why a creatinine eGFR can go down, and not always solely one. It could be one to many. On your next trip to your nephrologist, ask your doc to look at the overall picture of all your labwork. If you go to a particular lab, see if they can give you a recap of the last year or multiple years to establish a eGFR trend. Lastly, many docs also use a Cystatin C test to check eGFR. However, some insurance companies do not cover this test which is why the creatinine eGFR test is more commonly used.

REPLY
windyshores | @windyshores | Oct 18 6:12am

In terms of diet I have been told to increase salt and "push protein" which is different from what others may hear. My nephrologist ordered an echocardiogram and already knows I have low blood pressure. One possible reason for a lower eGFR is just that the filtration rate is lower due to lower blood pressure or heart function, she said. Another factor can be muscle loss. Meds too, like NSAID's, Reclast, others. And of course hydration. I am sure there are many others. Just want to say that dietary choices should not automatically be the typical "renal diet." Investigation of causes is important. That said, I didn't see a nephrologist until my eGFR dropped from 55 to 36 suddenly, along with a high positive for scleroderma (I already have lupus diagnosis). But my Cystatin C has remained pretty stable while my eGFR bounces around!

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