CKD Stage 2, No known cause

Posted by wkidney @wkidney, Mar 8, 2022

I have been recently diagnosed with CKD Stage 2. My last serum creatinine test was 1.12 which is aGFR 60, and 5 days before that a creatinine clearance test was 67.7. My serum creatine has fluctuated from 1.12 a few days ago to the highest of 1.3 (eGFR 43), with monthly testing since Oct 15, when it was first discovered. The nephrologist stated my stage of CKD is 2 based on those tests. My urine is totally normal. Protein within range, no albuminuria, no abnormal findings in urine. Through blood tests, all the following conditions are ruled out, no high blood pressure, no diabetes, healthy thyroid, no autoimmune disease. There is no family history of kidney issues. I have had only 1 UTI in my life- which was the incident that sent me to the Dr and the high creatinine was discovered. I steer clear of NSAIDS, I have not been on any regular medication. Moreover, I’m a distance runner, exercising 3-5 days a week and eat a gluten free and mostly dairy free diet. Unfortunately I don’t not have past CMP results to compare to, as I had not been to an MD in the 10 years prior.
I have so many questions…
1. How often are people diagnosed with kidney disease and no known cause.
2. Is it possible my level of creatinine is just normal for me. (I’m a 50 yr old woman). Is it possible I don’t have kidney disease at all?
3. Isn’t Creatinine clearance test an antiquated test, as it’s always higher due to distal tubule secretion of creatinine that is in addition to the filtration the kidneys do? So is that test result even relevant?
4. Does the cystatin C test really provide better, more sensitive results? My neph said they don’t do that test.
5. Over a 5 day period my creatinine went from 1.3 to 1.12 after drinking 1 gallon of water daily, plus ensuring my protein intake was 75 grams or less a day. Is all that water really helping my kidney function, or is the water just diluting my urine? Seems like the research for water intake is conflicting.
5. Do I even need to pay attention to my protein intake if my BUN has never gone above 21? It was at the high end of the clinical range since October, however after the 5 day period of 1 gallon of water and lower protein it went to 13. So what’s the recommendation for protein? My neph says they don’t recommend lower protein intake anymore. But, why would I eat more protein than my kidneys can filter? Should I continue decreasing it a little to lower it from the high end of the range?

I appreciate any feedback. Thanks.

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@susanna82

Won't let me edit my mistake: Immediately on learning, by accident, that I was Stage 3 (remember I am actually, sort of, maybe at Stage 2). If you write for a living, you can not rest with an uncorrected writing error.

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@susanna82 I completely understand! 🙂

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@susanna82

Hi Ginger, You seem awesome. Keep up the diet fight. I went wholeheartedly into the kidney diet and raised my GFRs. significantly. Problem is, since there were mistakes and a lack of coordinated response, I cannot tell what was a mistake and what is a result of radically changing my diet. Did I actually raise my GFRs or was there a series of errors? I had not eaten meat in 20 years, so the changes were not so radical, except for giving up chocolate.

You have raised your GFRs. You are inspiring.

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susanna82 I am also interested in vegetarian diet. I'm not totally sold on it, but I am a diligent researcher. I still have much to study about that.

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@wkidney

susanna82 I am also interested in vegetarian diet. I'm not totally sold on it, but I am a diligent researcher. I still have much to study about that.

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wkidney: I have been a vegetarian for 20 years. I did not stop for health reasons or for dislike of meat. I am an animal activist and over time it developed that I just could not eat meat anymore. Oh, and yes. Kidney advisors seem to recommend less protein since it is harder on your kidneys. For instance, it is recommended that I eat no more than 45 grams of protein a day. I have cut it to a bit less than 40 grams. The worry is anemia.

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@susanna82

wkidney: I have been a vegetarian for 20 years. I did not stop for health reasons or for dislike of meat. I am an animal activist and over time it developed that I just could not eat meat anymore. Oh, and yes. Kidney advisors seem to recommend less protein since it is harder on your kidneys. For instance, it is recommended that I eat no more than 45 grams of protein a day. I have cut it to a bit less than 40 grams. The worry is anemia.

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Thanks for that. I have read less protein is better. It’s just hard to know how much less when I’m stage 2. Most advice seems to be for Stage 3-5. But less should be better. Maybe I just need to keep an eye on BUN and make sure that stays within optimal range.

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@wkidney

Yes, I’ve considered that. Doesn’t hurt my feelings at all:). But apparently my creatinine should be lower for age, given the diagnosis, I guess. I’m going to try acupuncture and see if that helps.

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I began acupuncture a couple of months ago for stage 3. This is a long term process, but I can truthfully say at this point, I am stable. It will get interesting when I do herb therapy. Most nephrologists and dietitians will tell you be to be cautious with herbal treatments as there is typically phosphorous and other ingredients that may reverse permanently any gains you make. I have a Chinese medical doc for acupuncture with a Ph.D. from a prestigious U.S. college and I trust her. At this point, I rely on my renal dietitian and PCP for best advice and recurring lab work as nephrologists are tough to see regularly at Mayo.

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@collegeprof I have found a very good acupuncturist. She is very confident that it could help my kidneys. I'm going to try it on a schedule she recommends and get once a month CMPs and see how it affects my eGFR. I'm glad to hear you have had success. Did it improve your eGFR, or did you experience other improvements?

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For me, I went twice a week for the first 5 weeks, and for the last 3 weeks, I have been going once a week. The thing about kidney disease is that there are 2 types, acute and chronic. I have chronic so if I remain stable, I am happy. The acute is like trauma or an infection of the kidneys where reversal can be achieved. In fact, my acupuncturist has been able to do that several times with some of her kidney patients where the GFR was low, and some were able to get back into the 70s and 90s. Those, I suspect, had acute kidney disease.

On Tuesday , we looked at my labs over the course of two months, and compared it to prior months, and there was definitively an improvement over the last 2 months. But I also see a dietitian, and that helps as well. For me, I will wait 6 months to see if more progress has been made. Working with an acupuncturist is working with the entire body. With the exception of glucose and creatinine/GFR, my labs are very normal. Perhaps the acupuncturist had something to do with this.

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That’s all very encouraging! Happy to hear you are stable. I hope I get good results too. Thanks for your comments.

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Good research !
How are you doing now..

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