Can somebody tell me why CKD stage 3a or 3b is no big deal?

Posted by thenazareneshul @thenazareneshul, Aug 31, 2024

The knee-jerk prescription of every healthcare provider I see is for me to "take some Ibuprofen" even though I've been doing that consistently since 1990.

Then, surprise, I get told to not take any NSAIDs at all by my PCP. I look up his reasons, and it tells me I have stage 3b chronic kidney disease. To the best of my knowledge, the stage after 3b is stage 4, and that appears to be a big deal as far as the subject of kidney disease goes.

Not according to the Nephrologist I asked to see. She thinks it's all no big deal. She thinks I need to stop having trouble forgiving 30 years of PCP's knee-jerk just telling me to take Tylenol and/or Ibuprofen for what I now know is a whole raft of things wrong with my C and L spine, and "move forward" in my life. "Move forward into what?" Was my reply. She never answered that one. She even reminded me I am 70 years old, and just how long do I plan to live from now on? I told her I have religious issues with options such as donor kidney's and blood transfusions. It's like that wasn't a real problem that I need to consider among my options for this future I am supposed to just forgive past healthcare providers who knew my kidney's were gonna get shot, but hey, it avoids me taking opioids.

I'm seriously wondering if I've got a bad kidney specialist or what? Your thoughts on this situation would be most appreciated? Thank you.

Interested in more discussions like this? Go to the Chronic Kidney Disease (CKD) Support Group.

I have Stage 3 CKD and physician does. not seem concerned ....No prescriptions...Will I eventually go to Stage 4 CKD and how long can one live with CKD?

REPLY
Profile picture for mucho @mucho

I have Stage 3 CKD and physician does. not seem concerned ....No prescriptions...Will I eventually go to Stage 4 CKD and how long can one live with CKD?

Jump to this post

@mucho Welcome to Mayo Clinic Connect. In 2003 my father-in- law had a kidney transplant. I started researching kidney disease. I learned that diabetes and hypertension are the leading causes of kidney disease. I paid attention to this because I have both. In 2005 I was told that I had mild to moderate kidney function. It was not called CKD and did not have a stage or alphabet # associated with it. There were no symptoms and my primary doctor did not seem particularly concerned. I wasn’t satisfied with that and started going to a nephrologist in 2008 (the one who treated my father-in-law.) That was a really good decision. My endocrinologist and nephrologist can collaborate to give me the best treatment possible for my diabetes and my kidneys. In 2016 my nephrologist told me that I have Stage 4 CKD. I have started researching dialysis and kidney transplantation. I like to be proactive. I can tell you that you can live well and for a long time with Stage 4 CKD. Besides your physician do you have any other supports for your health?

REPLY

I was diagnosed 3aCKD. My doctor would not give me a referral. I looked at the Kidney Assoc website and they recommended a kudney diatician. There is only one with kidney certification in Maine, so I contacted her. My insurance pays unlimited visits with a dietician.She has been helpful.

REPLY
Profile picture for seapen @seapen

I was diagnosed 3aCKD. My doctor would not give me a referral. I looked at the Kidney Assoc website and they recommended a kudney diatician. There is only one with kidney certification in Maine, so I contacted her. My insurance pays unlimited visits with a dietician.She has been helpful.

Jump to this post

I have never worried about an eGFR in the 50's , which continued for maybe 20 years, and it never came up with my doctors. I have an autoimmune disease so when it dipped to 36 I did worry, but it is back in the mid-40's.

I just want to say that the dietary advice I get is very different from the usual. I am encouraged to have more salt and "push protein." I did see a nephrhologist and see her every year. and she feels that my low blood pressure could be a factor, hence the salt. Also muscle loss can affect the eGFR, hence the protein. I had an echocardiogram in case heart function might be slowing filtration rate, and my heart was fine.

Time will tell if this advice is wise. I do not have diabetes or high blood pressure. My autoimmune labs are highly positive but there is no evidence that that is the cause of my drop in eGFR. I am often dehydrated, I am sure.

I don't want to repeat myself too much on kidney threads but again, the Cystatin C give a different eGFR that is not as affected by the factors that affect the creatinine based one, and my Cystatin C is still in the low 50's which is reassuring.

REPLY
Profile picture for thenazareneshul @thenazareneshul

The healthcare network is not into painkillers, so that's kinda out. I've had sepsis too, in 2017, not since. And right now, I'm recovering from yet another bout of Covid (with just finishing a course of Paxlovid). She didn't tell me a thing about what to eat or not eat, though I had learned not to load up on potassium, but only because it was way high with the bad results that got this front and center. I'm not sure what you mean by "on the list" except that sounds like a transplant list. I told her already I doubt I'd do such a thing. I already turned Orthopedic guys down back in 2014 about putting cadaver bone in my hips to make them recover. So, now I have avascular necrosis in the right hip. I had it in the left hip already way back then. There's so much wrong with my body, honestly, I think they're just waiting more for me to kick the bucket than helping me fix/correct what can be done.

Jump to this post

Exactly. I have RA dx last October to now find out I have stage 3a CKD. My doctor tells me, you don't need a Nephrologist yet, it's not uncommon for someone your age to have it. (61) like it don't matter to her. She was...my new GP. Not any longer!

REPLY
Profile picture for thenazareneshul @thenazareneshul

Now, see, this is why she, the nephrologist, isn't making sense. It turned out to be because of past labs also that it's fluctuating between CKD 3a and 3b. I'd already been taken off of all NSAIDs and then she's told me I can take the prescription for Meloxicam again. That was when my worst results came in! It's not like I don't want to take it, that was the best my pain has been for years. But I had stopped, because as I told her, "I'm not gonna just kill off my kidneys. I don't knowingly do things like that." So now, my daughter and I had allowed me 1 or 2 tabs a week (instead of 3 per day) as rescue meds. But I'm now to give Cymbalta a try, so if that helps the pain instead, that too is not an opioid. If it's safe for my kidneys. I do have high blood pressure. I have sinus tacycardia, and high cholesterol, and I'm obese from high Prednisone back in 2014-2015 for Polymyalgia Rheumatica. I've lost 30 obs of that but still have about 60 to go. And I take assorted other meds. I guess I'll just ask for a different nephrologist appt. Because I have to be able to ask about food restrictions, all she told me was not to eat large amounts of beef at any one sitting. I'd heard to cut the salt. That's really about it. Yet, it's good to find out my impression that I did not get good advice from her was right. I can move on with that, and her, behind me. I haven't had contrast in any imaging lately, so it's not that. Again, good to know. Thank you very much for the straight talk.

Jump to this post

Re- check Cymbalta. I've been on it for years to read recently it can cause kidney disease. Oh, and Omprazole for stomach also.

REPLY
Profile picture for lalaw @lalaw

Re- check Cymbalta. I've been on it for years to read recently it can cause kidney disease. Oh, and Omprazole for stomach also.

Jump to this post

Also, Cymbalta just helps nerve pain.

REPLY

I saw my nephrologist this week, during the discussion, I was told, that about 2 yrs ago when hospitalized they saw me very near or at stage 5. They believed I would need dialysis, but they held off. As it turned out, my body began to recover, moving back to stage 3b eGFR levels. Then some bouts with a flu and UTI took me back to stage 4 a few months later. Here I am almost 2 yrs later, firmly in the 3b category. Does that mean I've relaxed in my diet, exercise and follow-ups? No, I'm staying vigilant. My healthcare team isn't taking it lightly and neither am I. I think it is a big deal. And, since it is your life and body, isn't that the important point? You are the customer in this and you should be taken seriously. Your questions should be answered. You should be given guidance on how to improve or remain at 3a or 3b levels. My nephrologist gave me good news this week, saying I was at a low risk for kidney failure. As best as they can, they believe I would be at a 'moderate' risk looking 5 years out. Keeping it at low risk in the next 5 years is totally up to me and my efforts. I feel like they've given me the tools (advice), now I have to carry out the orders. All I know is, I feel quite healthy at this point.

REPLY
Profile picture for lalaw @lalaw

Re- check Cymbalta. I've been on it for years to read recently it can cause kidney disease. Oh, and Omprazole for stomach also.

Jump to this post

I'm almost certain my CKD was caused by 30 years of Omeprazole.

REPLY

I think the following is why many PCP’s and nephrologists don’t show too much concern for stage 3 CKD.

REPLY
Please sign in or register to post a reply.