Understanding GFR and kidney disease: What's normal?
Just officially diagnosed ckd stage 3 June this year but doc has been monitoring. December 2018 GFR 56. June 2020 GFR 48. Was not given any thing other than water daily excersise and reduce alcohol. After research on ckd it looks very serious. Called doc back few days after appt for more info. Came with plant based low protein diet. Ordered some cookbooks and cobbled together what I called kidney diet. Follow up blood work now showed GFR 60!!! But monocytes and mch are high. Next appt is 10/2/20. Is this increase in GFR normal and will it last? BTW I am 66 will be 67 in c
December
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I hope our readers will take note of your post regarding medical staff, including doctors, who do not read patient's lab results or discuss them with the patient. It is a sad situation, but I believe we, the patients, need to be better advocates for ourselves. We may be seen as trouble-makers for demanding better communication between us and our doctors, but we will have the information we need to make good decisions. In my opinion, if I cannot establish a good line of communication with my doctor, I find a different doctor.
Sarah.
What you have done is remarkable, and apparently a short time. Two things, in my opinion are important to remember in addition to exercise and eating habits, and that is the overall trend of your eGFR and another test called Cystatin C. The trend is important because many CKD patients experience highs and lows as you have done. For me, I was at Stage 3A and gradually went to Stage 4 twice because of nephrologist recommended Torsemide and later Farxiga. This is individualized and not everybody may go through this. After 6 months or so, you develop a trend and that overall trend becomes important. Fortunately, my last two eGFR tests were 45 and 40. The second lab test you may wish to take is Cystatin C which I am told by my Mayo nephrologist is more accurate than a eGFR.
I am 84 and was told that I had CKD stage 3 after a total hysterectomie in 2020. And that it was not going to get better...But this was very encouraging to read THANKYOU!...I had a GFR of 33 and was told there wasn't really any need to change my diet and go on as usual. It seemed so stupid not to adjust you diet to accommodate lessen kidney function and being borderline prediabetic (A1C 6.4) My GP said that it all had to do with getting old. ..I was very angry and refused the offer of Metformin and said I wanted to try and control my numbers first with diet. She said she would be very surprised if I did. I put together a "crossover diet" by combining diabetic/kidney portion diet....and getting my blood tested every 3 mos. For A1C and GFR and my last numbers were A1C 6.0 and GFR 44! Which is better. Now my GP is saying she is only going to test A1C every six month and that I only need a check up every one to two years! This is very worrying to me because I need to know how I am doing if I am to keep on track. I know I am getting old but can't help wonder if this isn't a case of "your old and boring and going to die anyways so why bother" So does anyone out there know of how I might be able to do these tests myself or are there other simple tests that would help me keep track of how I am doing. I am getting ready for exhibitions and do my work and this situation is distracting and depressing...I cannot go silently into the night. Am so pissed off! Thank you for listening to my long rant.
@fromthehill you have done remarkably well at taking care of yourself. (I’m 66 and not in as good a shape as you.) It sounds like you have issues with your GP not recognizing your accomplishments &/or not taking your concerns seriously. It is important to be heard and understood by your GP. Can you tell her how you feel about recent interactions with her and your current situation (“distracted, depressed and pissed off”)? If she is unwilling to respond perhaps it is time to look for a new GP? Another thing to consider is that she maybe has lots of other patients in way worse shape and is minimizing your situation? Still you deserve to be treated as an individual, not one of the herd. Another thing that has worked for me in the past is to make it personal for your provider. I have asked “what would you recommend if I was your mother”or “if you were me”?
Thank you very much and yes I will try what you say...I do have a good relationship with her receptionist...and I also realize that GPs work hard and they are very tired...I would not change GP's without a lot of thought....they are very hard to come by.... and I am lucky to have her. One of our local GPs is retiring and he is only 53yrs.old...he is exhausted and loves his patients. I would not want to lose my GP.
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Fortunately I do have a great primary doc but also see a nephrologist. Maybe there's one in your area your primary could refer you to?
I have an appointment in Sept. and I shall ask her about seeing a Nephrologist re- diet etc...or a nutritionist? I think if I am referred by an Md. there is no charge...I really just need to know that I am doing the right things or how to go about it without interfering with my work and costing me an arm and a leg. Am trying to keep my stress levels down. Thank you for your time Peace be with you
Is Torsemide and Farxiga, good or bad in your treatment. My daughter has been diagnosed with WM and has been on 3 Chemo meds plus torsemide. She is taking a month off chemo now right now.
Thanks for your answer.
I changed GP after he dismissed my concerns of GFR dropping 10 points in 3 months, from 65 to 55. He had not apprised me; had not made note of it. Said all the readings were in normal range. I insisted on seeing nephrologist. He refused to make referral. I studied publications from NIH, Mayo Clinic, others. They say 55 is not normal, but Stage 3a. I posted findings in note to GP, who grew adamant in reply, that there is no reason for me to see nephrologist. Meanwhile, my GFR dropped to 46, 9 points in 2 weeks, discovered in ER when it was thought I had a DVT. The ER MD made referral to specialist, and I began search for another GP.
The lesson here is to be an informed patient. Study your test results. Demand test results and explanation with direct medical advice for sudden changes. Do not accept dismissive attitudes. Find a GP/PCP who listens and responds with empathy.
I chose a internal medicine specialist as my PCP. He studied my charts before the new patient visit. He asked the same question I had asked which the GP had ignored. WHY HAD MY GFR DECLINE 10 PTS IN 3 MONTHS, AND 19 POINTS IN 8 MONTHS.
He ordered urinalysis which showed blood in urine. CT scan showed cysts. MRI defined cysts as benign. But I will see urologist in Sept.
My mother died of renal failure at 86, having endured CKD all her life from adolescence. So genetics may play a part.
Good news from recent blood work, the GFR has rebounded to 54. But I will still see the urologist for assessment.
1. BE AN INFORMED PATIENT.
2. QB YOUR OWN CASE FOR KNOWLEDGE ABD UNDERSTANDING.
3. ASK QUESTIONS ABOUT WHAT YOU DO NOT UNDERSTAND, THE JARGON OF TESTS, THE DIAGNOSIS, TREATMENT PLAN AND PROGNOSIS.
4. EXPECT CLEAR REPLY IN TERMS YOU CAN UNDERSTAND. TAKE COPIOUS NOTES IN THE DOCTORS OFFICE, SND AT HOME WHEN QUESTIONS ARISE.
Best wishes in your journey.
Maurice in Mineola
Thank you....gives me encouragement in keeping on the straight and narrow. My GFR was 44 on my last blood work the end of Feb....which was better than 33. Take care and be well