Just diagnosed Stage 3 CKD: Should I be referred to a nephrologist?

@ljashton Welcome to Mayo Clinic Connect! You've come to the right place to ask questions, and learn from others about their experiences. We are all unique, but share similar stories, and what works for one may not be the same for another, or may be close with a little "tweaking". It underscores we are all in this together!

As so many have talked about, diet plays a major role in CKD [chronic kidney disease]. Paying attention to lab results, we can see improvements when we limit red meat, sodium, calcium, potassium, and phosphorous. Exercise also plays a major factor in our health, in general and with kidney issues. As a Stage 5 patient, I have watched my eGFR numbers slowly decline since 2007. One thing to remember, is that results are best viewed as trends, not a single set of results. A difference in labs, or hydration levels at the time of the blood draw, can change what we might be expecting to see. If the cause of our CKD is known, that issue may play a major factor in how our disease progresses.

As for eGFR numbers, here is a link to the National Kidney Fund article to help you understand what's behind that number. They are a great source of information, and also check out their diet section! https://www.kidney.org/atoz/content/gfr

Others have expressed the frustration of not having their medical professional take a Stage 3 diagnosis as serious enough for intervention. I put myself on a strict renal diet before 2010, and I believe it helped me slow my disease, even though doctors kept telling me "You don't have to do that." Being proactive and responsible in any way I could was beneficial to me. It is my belief doctors do us patients a disservice by downplaying the way we can guide ourselves to a better outcome.

Any other questions for me?
Ginger

@kamama94 I am so pleased to read you are doing well.I get labwork done tomorrow; my last eGFR was 18%, and hoping that was a fluke. Like you, I cannot have a transplant.

Kidney disease can sneak up on a person, and it shows just how resilient and accommodating our bodies are, as we acclimate to a reduced function and our survival mode goes in to gear. Usually, it is a slow decline, and then one day we feel "off", or our routine bloodwork shows abnormal results. This is why some members here find themselves in Stage 3 without any idea how they got there!
Ginger

@gingerw, another update. As you already know (but others may not know,) am now in Stage 3b CKD. Am keeping fingers crossed, complying with neph and primary suggestions to try to have kidney remain stable and to better manage diabetes plus following a renal vegetarian (almost but not quite vegan because I do eat eggs for the protein) diet modified to help with the diabetes and with gastroparesis. It's a balancing act and I'm much more tired these days than I used to be. I actually weigh my food portions in grams and usually am able to maintain CKD recommendations for phosphorus, potassium, sodium, and protein, etc., plus watch fiber content for GP and try not to exceed carb limits to continue to need less insulin. It's practically a full time job to plan menus within the parameters but it can be done. I say, don't be afraid to read labels, look up nutritional values of various foods on the USDA website and other reliable websites and actually calculate daily totals before consuming meals for that day. It's a lot of trouble but this past Monday I made another trip around the sun and at 78 I'm still here! Hugs to all.

@kamama94

Without a doubt, my type 2 diabetes caused my kidney maladies. So several months ago, I took the action that I needed to make my diabetes a non factor as it got to the point where my endocrinologist put me on insulin. Insulin was not for me, and my former PA nephrologist began working with a functional doctor, and I joined her. Instead of taking 1 mg of Ozempic, I now take 2 mg weekly. My diabetes is now under full control, allowing me to concentrate on stage 3A to Stage 3B kidney disease. My endocrinologist was elated yesterday that my A1C was in the low sixes. All my labs from 3 docs were good except kidney function. This will allow me to concentrate on my kidneys as I no longer take any insulin or medication for diabetes control other than weekly Ozempic.

Lastly, I cannot write strongly enough about the importance of the eGFR Cystatin C lab test vs eGFR Creatinine lab test, both measured in the same manner. According to my nephrologist, a bodybuilder or one who exercises a lot can lose muscle mass. That does not put him/her in late stage kidney disease which the creatinine eGFR test may show. The object is to have both eGFR tests at the same good value. You can be at 45 or greater on the creatine test but be in Stage 4 of the Cystatin C test. The latter is the true test of overall kidney function health. In my opinion, there is a false sense of security by believing that your stage of kidney disease is determined solely by the eGFR Creatinine test.

Enjoy many more trips around the sun!

Hello. My 31 year old granddaughter was admitted to the hospital last Wednesday night with what was close to kidney failure (numbers were above 3). She has since been released and her numbers came down with 2 nights of IV fluids and oral fluids. She is quite overweight but does not have high blood pressure nor is she diabetic. She has been struggling with possible autoimmune issues (skin rashes/inflammation, rosacea, etc.) with no real diagnosis. She is quite weak and on a bland diet and LOTS of oral fluids. The theory is that she she had a bad stomach bug for about a week that caused severe dehydration. She had some diarrhea and vomiting but always drinks water. I am super worried about her health going forward. Any ideas or information you may have are most welcome! Thank you!

Hello. My 31 year old granddaughter was admitted to the hospital last Wednesday night with what was close to kidney failure (numbers were above 3). She has since been released and her numbers came down with 2 nights of IV fluids and oral fluids. She is quite overweight but does not have high blood pressure nor is she diabetic. She has been struggling with possible autoimmune issues (skin rashes/inflammation, rosacea, etc.) with no real diagnosis. She is quite weak and on a bland diet and LOTS of oral fluids. The theory is that she she had a bad stomach bug for about a week that caused severe dehydration. She had some diarrhea and vomiting but always drinks water. I am super worried about her health going forward. Any ideas or information you may have are most welcome! Thank you!

@billjudis This must have been very confusing and concerning for everyone, right!? I can certainly understand your worry.

Sudden infections and illness can indeed cause major organs to have issues, and the kidneys do a lot for us! If I am reading this right, she is under the care of a primary doctor, and a nephrologist now [kidney specialist] now? What are they saying will be the game plan going forward?
Ginger