Understanding GFR and kidney disease: What's normal?

@bugsowen, as you likely know, Glomerular Filtration Rate (GFR) tells how much kidney function you have. It may be estimated from your blood level of creatinine. Living with kidney disease means patients become professional GFR readers. I'd like to bring @kamama94 @gingerw @trishanna and @fiesty76 and @jolinda into this discussion to talk about GFR and interpreting lab results with you.

Bugs, How are you doing with adapting your diet?

Hi @bugsowen

First off let me say how sorry I am to hear of your diagnosis. Most of us in this group can relate to the many emotions that come along with receiving the news you just heard. In the whirlwind that is a CKD diagnosis it is awesome to know you've already found your bearings and are taking steps toward becoming proactive (this will serve you well).

Something I have learned about GFR tests over the years is that hydration plays a big role in this test results. If you go into the test dehydrated your results will read worse than they actually are AND likewise if you take the test in an overly-hydrated state your results will look better than they should. In the end it does none of us any good to pay for a test that isn't giving us accurate data. Those of us who take this test on a regular basis tend to have it done at the same exact time of day each time and we ensure we are not changing our habits to influence the results either way.

There are a few other tests that can produce very accurate results in kidney function: Iothalimate Clearance and/or a 24hr Urine/Kidney Function Test. Only your doctor can say if these are needed in your case. Seems like you are pretty proactive so could be something for you to read about.

I think your self described "cobbled" together kidney diet is perfect as, animal protein tends to be hard on the kidneys! I met with a dietitian shortly after my kidney numbers started to decline and based on their advice I cut out most meat, keeping some because I was anemic.

Just curious, how had your blood pressure been? It is common for CKD patients have elevated blood pressure and high BP can damage kidneys quickly and quietly.

Welcome to the group, I look forward to learning more about you and your journey.

@jolinda

Ver difficult to go from rare ribeye steak gal to basically vegan overnight. But I guess by current GFR I did something right

@bugsowen
Sounds like you're doing a lot of things right.

I have been on linsinopril on and off for about four years. Fist 5mg then 10mg then off completely due to pressure way too low. Went back to 10mg then went to ,20mg in June. I still have spikes (160/85) I had one this week at 95/53! Go figure.

@bugsowen Just like @jolinda mentioned, test results can vary over time if we have extenuating circumstances. Hydration levels [too little or too much], what we had for meals the last couple of days before the test, if we are not feeling well [for example cold/flu] can all be factors. A good doctor looks for the trends, not a single set of blood results. Good dietary habits created when you have kidney disease, go a long way in preserving kidney function. Low potassium, low sodium foods, reduction of red meats all help. Healthy levels of activity. Reduce stress where you can. You can change a trend of GFR around, as several will attest to.

The MCH refers to the amount of hemoglobin in cells. The monocytes refer to leucocytes that functions with ingestion of bacteria and foreign particles [whatever that may be!]

Do you know the basis for decrease in kidney function? Is there an underlying medical issue, or medication? Perhaps a life-style choice, or a hereditary factor? Also, keep in mind as we age there is a natural slow decline in kidney function.
Ginger

Hi, @bugsowen, I take Amlodipine Besylate for high b.p. but was recently diagnosed with orthostatic-hypotension which is a sudden drop in b.p. Your readings of 160/85 and then drop to 95/53 makes me wonder if you also experienced dizzyness or faintness with the drop in yours? Have you talked with your doc about the drop? My cardiologist diagnosed my hypotension by doing the sitting,standing, lying down blood pressure test. This link might give you more info: http://www.healthline.com/health/orthostatic-hypotension. Also Mayo Connect has a blood pressure forum as well and the Mayo Clinic site is always my first "go-to" for medical questions about new diagnoses or treatments.

As for the chronic kidney disease diagnosis (ckd), I range from stage 3 to 2 and give a lot of credit for improved lab scores to my kidney diet, exercise and learning how to read and understand my kidney lab reports. The site http://www.kidneyschool.org was a great resource for me in learning how to read and understand my labs. Davita.com offers some good kidney meal prep guidance. Each person is different and each needs to follow doc. instructions however, getting to a good dietitian really helped me with my meal planning. Giving up red meat was very hard for me at first but now kidney friendly veggies fill much more of my plate and I rely heavily on plant protein, along with skinnned chicken breasts and some fish and seafood. It is quite a jolt first receiving a kidney problem diagnosis but becoming a self-advocate in learning and sharing through reputable sites like this and others and can make this new journey much more manageable. Looking forward to getting better acquainted and hope you feel free to post more about your journey.

My next dr appointment is next Friday. Hopefully I will find some additional info and a referral for renal dietician. Also, are you seeing a nephrologist? Some say definitely should...

@bugsowen

Having a good nephrologist has worked out great for me. I like having a specialist who stays up-to-date is this one specific area. I have a blended team of physicians from various institutions and they all exchange records electronically.

Maybe ask around in your community or research specialists on your own before your appointment, always good to go into an appointment informed.

@bugsowen Like @jolinda, and others here, I have a nephrologist. You might ask your primary care dr if he feels you should be followed by a specialist. My nephrologist works hand-in-hand with my oncologist and primary care drs, and they exchange information. If you know someone else with kidney disease you might want to ask them, or if you are near a teaching hospital or a Mayo Clinic campus, think about getting referred to a nephrologist there.
Ginger