Why is CKD Stage 3A downplayed? Am I over reacting to be concerned?

@gatiger12 Welcome to Mayo Clinic Connect! Gosh, that sure was not a very helpful comment from your doctor, was it? Can you get another nephrologist?

What have been the trends in your eGFR numbers? There are several [temporary] factors that could cause a wonky number. Dehydration, illness, medication change. Do any of these factors fit in here?
Ginger

@gingerw Hi, he made that comment when I saw him in Feb. I went for lab work last week and got the results back yesterday. Creatinine at 1.75. I'm seeing him later this week. I'm taking a med for kidney stones and try to drink quite a bit. Have hypertension and a bit overweight. Diagnosed last summer with EGFR around 36, so it bounces around. I wish I could get diet recommendations etc. He just says you need to take off some weight. I don't know, it just seems a little too dismissive. I have chronic lower back pain, but have been told by a urologist that a ureteroscopy procedure won't alleviate that.

I am at stage 3A, even though my eGFR ranges from 33 to 40 (only my creatinine is high, partly from weights and exercise....best to wait a couple of days before blood draws). I stay hydrated and follow a mostly renal diet. With celiac and collitis I have to juggle meal plans a bit. Doctors are used to treating diseases after symptoms slap us upside head (or kidney in this case); best to be preactive and stay hydrated and follow a renal diet (with the occasional comfort food nibbles). On June 22nd I had blood drawn for my nephrologist and oncologist; one eGFR was 33 and the other 38. Same lab, same draw.

@kayabbott I’m at 3b now and yes, it’s seems I’ve been the only one concerned. My last Nephrology appointment my doc told me that I am shedding Phosphorus and my calcium is on the low end. She ran a FGF test (Fibroblast Growth Factors) which was extremely high at 280. This means my parathyroid gland is working overtime pulling calcium from my bones to keep a normal level. She said she was baffled by the results. Now she is doing something she said she has never done because it’s so rare. She is ordering a full body PET scan to look for a BENIGN “Brown tumor”. A tumor that can attach to bone anywhere in the body and suck out the calcium. The tumor itself is benign, but can become life threatening due to bone loss and calcium deficiency. She has never seen it before but is a last ditch effort to figure out what’s happening.
But now I wait. It will take months to get the scan booked, after my referral rises to the top of the pile… IF my insurance company approves it.
Sigh, our healthcare system is so broken. Wait times for procedures rivals that of Europe, but their healthcare is free, we pay billions to wait.
Terri

@rocksology A PET scan would be good, particularly if decalcification is due to bone lesions or other nasty things that ramp up calcium in bloodwork. An orthopedic doctor could also help with reasons for the high calcium, especially if associated with osteopenia or osteoporosis (reversable now with meds and exercise). My Ca, K, Na, and phosphorous levels are all normal, but I avoid foods high in these elements. The renal diet is a bit of a pain, but important. Check with your doc to see if a SGLT2 inhibitor such as Jardiance would be useful; they don't seem to improve eGFR numbers when they are less than 45, but mine did drop my systolic BP a lot (it was OK before, but relaxed blood vessels and kidney tubules are supposed to slow CKD progression).

@rocksology I agree completely. I am 83 year old male at stage 3b. My eGFR holding steady at 39. I had a PET scan 4 months ago at Oncologists recomendation. These are not all that uncommon. Is basically a full body scan with radioisotope to expose tumors, both benign and malignant. Mine took 3 months to schedule and was covered by my insurance (Medicare+BC/BS). Yes, getting any medical appointment, even with PCP, take a long time. Medical care in US is as bad or worse than Europe/Canada and far more expensive.

@nycmusic
Thanks for your comment. It's very helpful. I'm having some trust issues with my primary care physician and new nephrologist right now. What I wonder about tests is this: "When you write, "needing attention," do you mean outside the range on MyChart?" And, if something is low, are you asking a nephrologist about it or do you know how to fix it? In terms of "ratios," if it's not too much trouble, what ratios are you referring to? And, finally, do you or did you see a renal dietician or do you just know which dietary items you can change? I have diabetes and CKD 3a, and I don't have a diet that is working for me My brand new nephrologist recommended a renal dietician, whom I'm calling next week, but I am seeking a simple diet because I hate cooking, and am a picky eater. At 76, I am willing to change, but I don't want to make this so complex that I can't or won't follow it. For awhile, I was working with a diabetic peer counselor, but I didn't like spending my entire day, counting numbers on a glycemic index. She, her husband and two kids all had diabetes. I'm just cooking and doing menu planning for myself.

Is farxiga effective for stage3 without diabetes? My nephrologist prescribed it and I am reluctant to take it

@hatetocook because I had CRC not long ago, I get blood tests every 3 months, including basic chemistry/ kidney function….some numbers were ‘’out of range’’ so I looked into that, did some research and spoke to my primary about them….she said they are not far out of range, especially for my age, etc. and that I can make a few dietary adjustments to make sure my #s stabilize, or even get better…she warned against an extreme kidney diet, as I am finally getting healthy past cancer and need a very well balanced diet to maintain overall health. She looks at the big picture with all of my numbers—over treating or over-compensating for one condition can affect others….like overdoing the osteoporosis diet is not good for kidney health, etc. she said I don’t need an army of specialists, as early stage age-related conditions can be helped by diet, hydration and exercise thoughtfully done. Docs have very little to offer early stage conditions—common sense is a viable path.

@lb0530
I also do not have diabetes. However, my nephrologist prescribed Farxiga (I am Stage 3 b - close to Stage 4). She is certain that Farxiga is protective of the kidneys. My cardiologist also wants me to take it. Like you, I was extremely reluctant to take it, but did agree. However, I have been on it for about 6 months without any side effects. My kidney function seems steady, and my BP is generally low. My nephrologist is pleased, and she told me that she had expected me to be on dialysis by now. Hopefully, Farxiga will keep me off dialysis. Good luck!