Doctor is concerned about Kidney GFR numbers: Should I be?

Posted by pamphillips1 @pamphillips1, Sep 25 3:08pm

Hello
My Dr. is showing concern about my GFR numbers, 1 year ago it was 122, half year 112, Aug.2024 90 and Sept 79. Should I be concerned?

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@gently

Semiglutide improves kidney function in some and decreases kidney function in othershttps://www.kidneymedicinejournal.org/article/S2590-0595(20)30269-7/fulltext.
https://www.nature.com/articles/d41586-024-01564-w#:~:text=Semaglutide%2C%20the%20same%20compound%20in,death%20for%20people%20with%20diabetes.&text=The%20blockbuster%20diabetes%20drug%20Ozempic,list%20of%20maladies%20it%20alleviates.
It is so good that you are watching your dad's labs. Can you get the opinion of the MD overseeing the NP.

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Interesting! The literature I found was for AKI (sorry, should’ve mentioned that!)
which was the concerning part of his labs to me.
I just don’t think semaglutide agrees very well with him given the lack of improvement in his labs & management of his type 2 diabetes.

Thank you for suggesting to have the overseeing MD advise! Even being a nurse I forgot that!

I found what seems to be a credible site (third party tested with reports and great reviews) for a berberine supplement I think would be great for glucose metabolism. Will likely purchase after discussing with his NP!

Also, I feel obligated to state I am in no way affiliated with this company and this is not to be taken as professional medical advice. Please always do your own research and talk to your provider!!

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@mrainne

That is interesting. I was in the ED twice in the last 2 years for UTI, Covid, and sepsis. Both ED DRs were only concerned with creatinine #s, but my nephrologist always looks at eGFR. Aren't they related? A calculation of both? My BUN is around 30 and creatinine 2.2, eGFR 23 (but changes from test to test). Are these the numbers I should be concerned about? I drink a lot of water, 60+ oz a day. But my disease has me in a state of dehydration due to tubules not retaining water. My urine is always very light, like a light lemonade.

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The GFR is a mathematical calculation based on creatinine, gender, and ethnic background. It's not as accurate as a 24 hour urine test, but obviously more convenient once a pattern has been established. Your numbers are close to mine. My creatinine has been in the 2.2-2.4 range for years. My nephrologist is concerned that I stay in that range, and is not so concerned with BUN, which fluctuates more than the other numbers.

Only one time has my GFR dipped below 20. The upside is that it qualified me to pre-emptively get accepted on to the kidney transplant list. I am inactive status, since I'm relatively stable, but am gaining seniority for when/if I need to transfer to active status. It was not my nephrologist who suggested I get on the transplant list; it was a nurse from my insurance company.

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@diannemr3

The GFR is a mathematical calculation based on creatinine, gender, and ethnic background. It's not as accurate as a 24 hour urine test, but obviously more convenient once a pattern has been established. Your numbers are close to mine. My creatinine has been in the 2.2-2.4 range for years. My nephrologist is concerned that I stay in that range, and is not so concerned with BUN, which fluctuates more than the other numbers.

Only one time has my GFR dipped below 20. The upside is that it qualified me to pre-emptively get accepted on to the kidney transplant list. I am inactive status, since I'm relatively stable, but am gaining seniority for when/if I need to transfer to active status. It was not my nephrologist who suggested I get on the transplant list; it was a nurse from my insurance company.

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Last blood work, BUN jumped to 48! Creatinine 2.4. My disease is Nephrogenic Diabetes Insipidus. Not related to sugar diabetes. It's from long-term use of lithium (40 years). I am so fortunate my kidneys survived this long but wish a smart DR along the way would have put me on Lamotrigine which is so much safer. I am healthy, weigh 134, eat whole foods, exercise...basically take care of myself, water, low sodium etc. This lifestyle has not stopped my declining kidney function. My eGFR is at 21 today. I'll keep living as normally as possible...avoiding UTI's!!!! Had 2 this year but antibiotics are bacteria killers, good and bad. I appreciate your information, so helpful. Seeing my Neph next week.

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@mrainne

Last blood work, BUN jumped to 48! Creatinine 2.4. My disease is Nephrogenic Diabetes Insipidus. Not related to sugar diabetes. It's from long-term use of lithium (40 years). I am so fortunate my kidneys survived this long but wish a smart DR along the way would have put me on Lamotrigine which is so much safer. I am healthy, weigh 134, eat whole foods, exercise...basically take care of myself, water, low sodium etc. This lifestyle has not stopped my declining kidney function. My eGFR is at 21 today. I'll keep living as normally as possible...avoiding UTI's!!!! Had 2 this year but antibiotics are bacteria killers, good and bad. I appreciate your information, so helpful. Seeing my Neph next week.

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BUN can fluctuate based on the amount of protein intake and hydration status prior to a test. It's the big picture that counts. You are so smart to avoid UTI's at all costs, since they have the potential to turn into kidney infections if unchecked. All the best to you, and let us know how your nephrology visit goes.

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@mrainne

Last blood work, BUN jumped to 48! Creatinine 2.4. My disease is Nephrogenic Diabetes Insipidus. Not related to sugar diabetes. It's from long-term use of lithium (40 years). I am so fortunate my kidneys survived this long but wish a smart DR along the way would have put me on Lamotrigine which is so much safer. I am healthy, weigh 134, eat whole foods, exercise...basically take care of myself, water, low sodium etc. This lifestyle has not stopped my declining kidney function. My eGFR is at 21 today. I'll keep living as normally as possible...avoiding UTI's!!!! Had 2 this year but antibiotics are bacteria killers, good and bad. I appreciate your information, so helpful. Seeing my Neph next week.

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@mrainne Medication side effects can take years to manifest. I don't think doctors set out to place us on the road to long-term kidney concerns, they are trying to help us with the primary problem. I have known several people with the lithium use issue, like you have. My cousin also went through kidney disease due to a cardiac medication many years ago.

Good for you to staying as healthy as possible, and understanding what works best for you in your case! Everyone is different, definitely. We'll be anxious to hear about your nephrologist visit next week.
Ginger

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@gingerw

@mrainne Medication side effects can take years to manifest. I don't think doctors set out to place us on the road to long-term kidney concerns, they are trying to help us with the primary problem. I have known several people with the lithium use issue, like you have. My cousin also went through kidney disease due to a cardiac medication many years ago.

Good for you to staying as healthy as possible, and understanding what works best for you in your case! Everyone is different, definitely. We'll be anxious to hear about your nephrologist visit next week.
Ginger

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Thanks, Ginger. The lithium treatment was a godsend. No regrets, other than the lamotrigine alternative which I'm on now. My bi-polar disease developed in the early 1970s. I was blessed to find a smart psychiatrist who prescribed lithium. I lived a happy normal life, married to a wonderful man for 40 years. I followed the plan religiously, taking follow-up tests every 6 months for all those years. Then, in 2014, the kidneys simply got tired. I'm grateful and fortunate they held up that long. We'll see what comes next. It's all good. I trust my Nephs, one at my local healthcare and one at Mayo.

Yes, even NSAIDs taken over time create the same dilemma. I have a first cousin who took the maximum dosage daily for pain. There is no warning about this. Her eGFR has been floating @ 20 for years after she quit the NSAIDs. No dialysis.

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