GFR dropped 5 more points and I don't know why.

I have had these lower GFR numbers, without changes in creatnine. The nephrologist did an ultrasound of my kidneys to make sure they were still the right size. I had to go off of pain pills entirely. The large issue I have to correct is making sure I drink more water during the day. I try for 8 more cups and bought one of those bottles with markers on it. You can make cucumber water (put slices in overnight) or add a splash of juice to the water to make it more palatable.

My GRF was 68.9 in March it is now 48. Started a renal diet and Farxiga 5mg daily 2 weeks ago. Nephrologist told me in August when it was 58 it was probably from dehydration and to stay well hydrated, Renal ultrasound showed small cyst in right kidney otherwise no significant findings. What can be done to increase it or to prevent dropping further? Should I have a Renal biopsy? Read that Prednisone is helpful in some cases is this a option? Desperate for help.

@kathyyvette I am in a similar situation with drop from 53 to 36. But my Cystatin C is not so bad (50-54). My nephrologist goes by that because the creatinine eGFR is affected by things like losing muscle mass. My nephrologist wants me to hydrate and eat both salty things and protein to get my blood pressure up. She had me do an echo of my heart with the idea that weak heart function and low bp could be lowering the filtration rate. All okay. Then the idea that slight weight loss could be releasing muscle enzymes but test was negative. Still a mystery! I have stopped all pain meds except for Tylenol which is difficult! I have to have infused Reclast which can be damaging to kidneys. They are doing a 20% dose with IV hydration. Nervous!

Hi, I’m trying to look for a link that was sent thru this kidney/bladder discussions and a link was sent regarding a study on the kidney cells. That the kidneys cells are genetically defective because it lacked the chemicals it needed to function properly.im not sure if it was posted by Ginger or another mentor. If anyone can remember in which discussion it was posted or can repost it , pls do so. Thank you very much.

@kathyyvette Welcome to Mayo Clinic Connect. As you read through the posts and different conversations here, you will see a comment we refer to often. That is, it is better to look at trends in blood test results, not single values. There are many factors that can affect results, including but not limited to: hydration level, recent exercise, medication changes, illness/infection, different labs processing the samples, fasting or non-fasting, other disease processes.

Maintaining a moderate exercise program, following a sound renal diet [low sodium/calcium/phosphorous, good protein], minimizing stress wherever you can, can go a long way to helping you keep your eGFR from slipping too rapidly.

Any further questions for me?
Ginger

@gingerw I think the best diet varies with the cause of the lower eGFR. I have been told to increase salt and "push protein"! Curious how stress can contribute....

@windyshores. Every case is unique, but we do have similar concerns and approaches to managing chronic kidney disease.

Increasing salt intake may increase blood pressure. High blood pressure caused by high sodium, or stress, can put undue stress on our kidneys. It constricts the blood flow to our kidneys, making it difficult to remove waste products and fluids in the body, dropping the function value [eGFR].

The general rule of thumb regarding protein is to limit protein until we are on dialysis, then ramp it up, as dialysis depletes our body of protein. Here is a great article from the National Kidney Foundation about nutrition: https://www.kidney.org/atoz/content/nutrikidfail_stage1-4
Ginger

@gingerw as I wrote, my nephrologist wants me to INCREASE salt and protein. I have low blood pressure which can affect the filtration rate (as can a low cardiac ejection fraction, which was checked and I do not have). I was told to eat salt to raise my blood pressure and also that more protein ramps up filtration. My friend with very low eGFR is astounded. In addition, losing weight and muscle mass can lower the creatinine eGFR when the Cystatin C is stable. So it is more complicated and more individual than the standard advice would suggest.

@windyshores Your situation underlines exactly what we are saying in these forums, where we may deal with similar health concerns, but each of us is unique. I do question the idea of protein ramping up filtration. From Mayo Clinic: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/high-protein-diets/faq-20058207

And from DaVita Kidney Care about protein: https://www.davita.com/diet-nutrition/articles/basics/dietary-protein-and-chronic-kidney-disease
Ginger

That said, my heart is fine and a lot of the time my blood pressure is too. Tests on muscle enzymes show no loss of muscle mass. I tested with a high positive antibody for scleroderma so was concerned about eGFR dropping to 36 from 55. Cystatin C is reassuring, About to try 20% dose of Reclast after finishing Tymlos for bones and nephrologist is very nervous. But I am not sure I actually am having kidney issues!