Can Low Blood Sugar and Too Much Water Decrease EFGR?

Good questions for the nephrologist next week.

I have been told the eGFR that is creatinine based is affected by several factors, and the Cystatin C version is more stable. So you or he might ask for that test in the appointment.

@sultanvr It sounds like your husband has the double whammy of high blood pressure and diabetes, the two most common causes of chronic kidney disease. Getting both of those under control may go a long way to helping his kidneys. But, it is not an easy battle, as you are finding out! It can be a fine balancing act, and from what I have read, having changes in either condition can make for some stressful times as you watch the eGFR value seem to bounce around.

Ask what amount of fluids the Dr is suggesting, and let them know how much your husband is getting in each day. I am not a doctor, nor a diabetic. Have you asked the endocrinologist who handles his diabetes about the sugar crashes? Logically [to me, anyways] it seems like a wide range of sugar values, and crashes, can't be good for a body.

I was on Amlodipine for a while, but it wasn't doing what they wanted. Now, I am not on any blood pressure meds.
I will be looking for your update after the 2/3 appointment.
Ginger

@sultanvr I am diabetic (50ish years) and have a history of high blood pressure, as Ginger said these are the two most common causes of kidney disease. I also have been diagnosed with chronic kidney disease (CKD) stage 4.
I have an endocrinologist for the diabetes and a nephrologist for the CKD. The nephrologist has prescribed blood pressure meds (Amlodipine, Losartan and Torsemide) plus an OTC antacid because he felt my urine was too acidic. The Amlodipine is the smallest dose possible. I haven’t had any med changes in a long time and my blood pressure is now well controlled. I have a BP cuff at home to test and I keep the record to show my nephrologist at office visits.
My endocrinologist and nephrologist are in the same health care system. They can collaborate on my care and can share records. I also have seen a dietician/ nutritionist who is well versed in diabetes and renal nutrition requirements. This has been very helpful. There are dietary requirements for both conditions and for hypertension as well that you should be aware of.
For your questions:
1) Hydration - As Ginger said, your nephrologist can advise you on the proper amount of hydration.
2) It is the high blood sugars of Diabetes that is hard on the kidneys. My nephrologist said “it is like expecting the kidneys to filter syrup. It clogs them up over time and is damaging.” The “crashes” or low blood sugars aren’t harmful to the kidneys but are dangerous in so many other ways and can be life threatening! 47 is way too low!
3) Reduced flow of urine and enlarged prostate are concerns and questions for a urologist. I’m not sure if that would affect the eGFR.
4) Amlodipine - mentioned this above. There are lots of options for blood pressure meds. You can review it with your nephrologist on 2/3. If it isn’t working for you the doctor can probably recommend something else.
Hope all goes well with your appointment.

In the course of your questions to your doctor, ask simply “what should I not be doing.” It is not only important to know what you should be doing, but it can be of greater importance to know what you should not be doing. Hopefully, this is not confusing, however it is important to know your parameters in trying to reach a correct balance. Not too much water, not to little water. No too much protein, not too little protein. Not too much exercise, not too little exercise. With all our various problems and concerns we at best are trying to find our correct balance and to find that balance can be extremely difficult, yet necessary. Blessings.

Thank you so much!
Blessings to you as well.

Thank you!!

Thank you!

@sultanvr Our doctor has our individual health records there. And you bring to them whatever is most concerning to you. There might be a link between some conditions that aren't apparent to you. By asking the questions it proves you are invested and wanted to know the best way to handle your own situation. It would be nice if your medical team is all in the same records management system, but if not, then you would need to step up and be that communication link!
Ginger

I was dxd a month ago, so still learning and asking. Ask the Doc exactly how many ounces he wants your husband to drink.

My Nephrologist would like me to drink one gallon of water per day. I fill two 64 oz jugs with water to keep track of what I'm drinking.

Hi Ginger,

Unfortunately the Nephrologist was behind in her appointments and did not have time to discuss or answer our questions. I had all my charts and a list of questions. It was very disappointing. This was the second visit that was not unlike the first and I am feeling like we aren't getting the care that we need. I've been reading all the replies here and it sounds like others doctors are more helpful. Trust me, it isn't for lack of the questions and concerns that we bring to her.

Had a visit with the regular doctor 2 days later and they were not helpful. They telling us to ask the Nephrologist.

We can't see an Endocrinologist until July 21st.

I really felt like the message was "You got yourself to this place, now go home and wait to die". I know that sounds extreme. But it was very disappointing.

My husbands EFGR in October was 35. In January it was 29 (which we were surprised at as his numbers/glucose/blood pressure readings had improved). A week later when retested it was 32. I felt some encouragement. As all his numbers within that weeks time improved. Not just the one test.

As shared, the doctor did not have time for us and did not seem to share the enthusiasm we had at the improvement in numbers.

Needless to say, I am considering another doctor. Problem with that, I have been calling around and the soonest appointments are available is late May.

Feel like we are on our own.

Thank you for the ear/eyes.