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.

Interested in more discussions like this? Go to the Kidney & Bladder Support Group.

@wkidney WOW. You have researched this a lot. It sounds like you are doing all the right things (at least it can’t hurt). At age 50 have you considered that your numbers are just part of aging? Not trying to be mean. I am 65 and I wish I had your numbers. You are in GREAT shape for the shape you’re in. Keep up the good work.

REPLY

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.

REPLY

@wkidney Welcome to Mayo Clinic Connect! As @cehunt57 mentioned, I think you are in great shape, also! I know, I know, this may not make you feel alot better right now with the questions you have, right?!

It is normal for a person's eGFR to decline a slight bit with age. Other factors that may show fluctuations in blood test results include your hydration levels at the time of the labwork, diet, and activity. A big factor I found is the simple fact that once we have our lab sample taken, the actual place it is processed may be different than another time, so different machines. For example, samples processed through my cancer center consistently show a higher eGFR than samples processed through the commercial lab I also use.

You lead a very active lifestyle! Has anyone ever clued you in to the combination of long distance running and kidney issues? Here is a link I found that may be enlightening for you, from Yale Medicine
https://medicine.yale.edu/news-article/marathon-running-and-kidney-damage-what-runners-should-know/
This is not to discourage you, believe me! A gal I know had Stage 3 kidney disease per her eGFR, and was a marathoner. When she decreased her miles per week, and took to running as a pleasure not a competition, she was able to reverse her decline in eGFR with lifestyle and diet, going back in to Stage 2.

Please let me know how all of this resonates with you, and if you have additional questions?
Ginger

REPLY

Your story is like mine. No family history, no known cause, except UTIs, and physicians ruled out that anti-biotic as a probable cause. I have researched constantly and I still feel as if I am wandering in the wilderness. as far as the medical profession and my condition.
No family history,
I had to fight to get care for what was originally diagnosed as CKD 3 (a or b). Now it seems I am really at Stage 2, Creatine 9, GFR 64. But six months ago, when this was first casually mentioned, my hospital records showed me as having a GFR of 50. (!) And, the advice was that I did not have to "do" anything. I have become knowledgeable about numbers, diet, and endless details about all aspects of this disease, as well as medical research, and diet. Especially diet.

I have researched and purchased several books and regularly visit a couple of websites. One book I bought is by Shelley Manning, altho I keep confusing her with Mary Shelley, who wrote Dracula.

Immediately on learning, by accident, that I was Stage 3 (remember I actually sort of at Stage 2) I began to read up and learn all I could.

Physicians tell you that at Stage 3, you do not need to change a thing. A crusade needs to form around telling people to ignore their doctors' advice and begin to make changes immediately. That is if you actually HAVE a kidney specialist; I had to fight my way to that as well, and after a brief 15-minute chat, I changed to another kidney specialist who actually sat down and explained it to me. Still, she told me not to worry about doing anything at this stage. Again, I think it is my age...

I receive vague assurances, no one has given me advice about diet, I changed kidney doctors because of lack of interest, and forced myself onto the hospital nutritionist. Meanwhile, I have researched everything I could find and followed all the tendrils that lead to and from CKD. God help the person who is not assertive and diligent about a CKD diagnosis.

Looking back, the most stunning part is the continued response from medical professionals that I do not have to "do" anything. Partly, I believe, this is because I am older, so since CKD is slow-moving, and I am supposed to die before I will approach the dialysis stage. Well, that was never going to be an option for me!

Get acquainted with all the kidney advice and dietary knowledge you can find. Change your diet, exercise, work toward lowering your GFR and other numbers. Haunt the web. Read comments and advice on sites like this one. Knowledge is power.

And, by the way, people with Kidney Disease do not die from Kidney Disease. They die from heart attacks. Aim for moderate exercise every day if possible, for 30 minutes. I am thin anyway, and I hate exercising, but I am trying to become diligent.

My take-away? Begin on day one to change your diet and fight.

REPLY

Ginger, thank you for your response. I actually did read a review of those studies, but the one you sent had more complete information. I have considered from that article, I may have some kidney damage from a marathon I trained for in 2012. There was an episode where my ankles were swollen, although after it went away pretty quickly, I wrote it off. I no longer run distances like that. I told myself about two years ago I’m going to keep it to no more than a 10K. So my running is about 3-5 miles each time, 3-5 days a week for enjoyment and good health. I also added yoga once a week. I don’t like strength training very much:( Right now with winter it’s about 3 days a week, as weather permits, I’ll increase it to 4-5 days a week. So I agree that could be a cause. Maybe I’ve had this mild kidney damage since 2012 and it’s very stable now. Given I have no other risk factors. My neph, basically says that it’s mild and stable. The number of miles I run right now does not seem to correlate to the lab results. I also tried a different lab one time, from the advice of a Urologist friend, who didn’t tell me what you did, but clearly he understands different labs sometimes produce different results. All my numbers were slightly better from that lab, but still high creatinine.

I appreciate your comments a lot. And thanks for the better article. Maybe the running is the cause. 16-20 mile training runs, over and over again is brutal. Not sure I will ever know for sure. Wish I had past lab results to compare, but I haven’t been to an MD since just before 2012 and I recently found out all those decade old records are purged. That’s unfortunate.

REPLY
@susanna82

Your story is like mine. No family history, no known cause, except UTIs, and physicians ruled out that anti-biotic as a probable cause. I have researched constantly and I still feel as if I am wandering in the wilderness. as far as the medical profession and my condition.
No family history,
I had to fight to get care for what was originally diagnosed as CKD 3 (a or b). Now it seems I am really at Stage 2, Creatine 9, GFR 64. But six months ago, when this was first casually mentioned, my hospital records showed me as having a GFR of 50. (!) And, the advice was that I did not have to "do" anything. I have become knowledgeable about numbers, diet, and endless details about all aspects of this disease, as well as medical research, and diet. Especially diet.

I have researched and purchased several books and regularly visit a couple of websites. One book I bought is by Shelley Manning, altho I keep confusing her with Mary Shelley, who wrote Dracula.

Immediately on learning, by accident, that I was Stage 3 (remember I actually sort of at Stage 2) I began to read up and learn all I could.

Physicians tell you that at Stage 3, you do not need to change a thing. A crusade needs to form around telling people to ignore their doctors' advice and begin to make changes immediately. That is if you actually HAVE a kidney specialist; I had to fight my way to that as well, and after a brief 15-minute chat, I changed to another kidney specialist who actually sat down and explained it to me. Still, she told me not to worry about doing anything at this stage. Again, I think it is my age...

I receive vague assurances, no one has given me advice about diet, I changed kidney doctors because of lack of interest, and forced myself onto the hospital nutritionist. Meanwhile, I have researched everything I could find and followed all the tendrils that lead to and from CKD. God help the person who is not assertive and diligent about a CKD diagnosis.

Looking back, the most stunning part is the continued response from medical professionals that I do not have to "do" anything. Partly, I believe, this is because I am older, so since CKD is slow-moving, and I am supposed to die before I will approach the dialysis stage. Well, that was never going to be an option for me!

Get acquainted with all the kidney advice and dietary knowledge you can find. Change your diet, exercise, work toward lowering your GFR and other numbers. Haunt the web. Read comments and advice on sites like this one. Knowledge is power.

And, by the way, people with Kidney Disease do not die from Kidney Disease. They die from heart attacks. Aim for moderate exercise every day if possible, for 30 minutes. I am thin anyway, and I hate exercising, but I am trying to become diligent.

My take-away? Begin on day one to change your diet and fight.

Jump to this post

Thank you Susanna82. I feel similarly and am frustrated by the lack of advice and information. I have researched daily since Oct 15. I also feel like I do not want to sit around and wait for dialysis. I’ll look for that book/author you mention. I read Lee Hull’s book. Very informative read, although long and repetitive- but I understand the motivation to repeat the data. Thanks much.

REPLY
@wkidney

Ginger, thank you for your response. I actually did read a review of those studies, but the one you sent had more complete information. I have considered from that article, I may have some kidney damage from a marathon I trained for in 2012. There was an episode where my ankles were swollen, although after it went away pretty quickly, I wrote it off. I no longer run distances like that. I told myself about two years ago I’m going to keep it to no more than a 10K. So my running is about 3-5 miles each time, 3-5 days a week for enjoyment and good health. I also added yoga once a week. I don’t like strength training very much:( Right now with winter it’s about 3 days a week, as weather permits, I’ll increase it to 4-5 days a week. So I agree that could be a cause. Maybe I’ve had this mild kidney damage since 2012 and it’s very stable now. Given I have no other risk factors. My neph, basically says that it’s mild and stable. The number of miles I run right now does not seem to correlate to the lab results. I also tried a different lab one time, from the advice of a Urologist friend, who didn’t tell me what you did, but clearly he understands different labs sometimes produce different results. All my numbers were slightly better from that lab, but still high creatinine.

I appreciate your comments a lot. And thanks for the better article. Maybe the running is the cause. 16-20 mile training runs, over and over again is brutal. Not sure I will ever know for sure. Wish I had past lab results to compare, but I haven’t been to an MD since just before 2012 and I recently found out all those decade old records are purged. That’s unfortunate.

Jump to this post

@wkidney You'll read from others here, and I echo them, that each person's journey is different, even when they are similar. It is generally understood that kidney disorders are slow-moving, and our bodies learn to adapt to the small changes as we go along. Think of if as balancing a globe or sphere, where everything works together. As you move it slightly, there are accommodations made elsewhere, so you simply do not notice it. Kidneys are alot like that! The medical community will often tell you there is no need to address lifestyle changes in Stage 3.

Way back in 2015, when I was diagnosed with my ultra-rare kidney issue, that's what they told me, too. But I decided to upgrade my lifestyle, my diet, my approach to life and make it all the best I could. My last lab work showed my eGFR at 19%, up from a low of 14%. I am monitored each month. While they are certain I will be on dialysis before too long, I will campaign to hold off as long as possible! At age 69, dialysis will be part of the rest of my life once it is started, as I cannot be transplanted. But I intend to stick around for a long time, off dialysis as long as possible ;))

Put your running shoes on, run a mile for me! And, please, let me know if I can help in any way to relieve your concern.
Ginger

REPLY
@susanna82

Your story is like mine. No family history, no known cause, except UTIs, and physicians ruled out that anti-biotic as a probable cause. I have researched constantly and I still feel as if I am wandering in the wilderness. as far as the medical profession and my condition.
No family history,
I had to fight to get care for what was originally diagnosed as CKD 3 (a or b). Now it seems I am really at Stage 2, Creatine 9, GFR 64. But six months ago, when this was first casually mentioned, my hospital records showed me as having a GFR of 50. (!) And, the advice was that I did not have to "do" anything. I have become knowledgeable about numbers, diet, and endless details about all aspects of this disease, as well as medical research, and diet. Especially diet.

I have researched and purchased several books and regularly visit a couple of websites. One book I bought is by Shelley Manning, altho I keep confusing her with Mary Shelley, who wrote Dracula.

Immediately on learning, by accident, that I was Stage 3 (remember I actually sort of at Stage 2) I began to read up and learn all I could.

Physicians tell you that at Stage 3, you do not need to change a thing. A crusade needs to form around telling people to ignore their doctors' advice and begin to make changes immediately. That is if you actually HAVE a kidney specialist; I had to fight my way to that as well, and after a brief 15-minute chat, I changed to another kidney specialist who actually sat down and explained it to me. Still, she told me not to worry about doing anything at this stage. Again, I think it is my age...

I receive vague assurances, no one has given me advice about diet, I changed kidney doctors because of lack of interest, and forced myself onto the hospital nutritionist. Meanwhile, I have researched everything I could find and followed all the tendrils that lead to and from CKD. God help the person who is not assertive and diligent about a CKD diagnosis.

Looking back, the most stunning part is the continued response from medical professionals that I do not have to "do" anything. Partly, I believe, this is because I am older, so since CKD is slow-moving, and I am supposed to die before I will approach the dialysis stage. Well, that was never going to be an option for me!

Get acquainted with all the kidney advice and dietary knowledge you can find. Change your diet, exercise, work toward lowering your GFR and other numbers. Haunt the web. Read comments and advice on sites like this one. Knowledge is power.

And, by the way, people with Kidney Disease do not die from Kidney Disease. They die from heart attacks. Aim for moderate exercise every day if possible, for 30 minutes. I am thin anyway, and I hate exercising, but I am trying to become diligent.

My take-away? Begin on day one to change your diet and fight.

Jump to this post

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.

REPLY
@gingerw

@wkidney You'll read from others here, and I echo them, that each person's journey is different, even when they are similar. It is generally understood that kidney disorders are slow-moving, and our bodies learn to adapt to the small changes as we go along. Think of if as balancing a globe or sphere, where everything works together. As you move it slightly, there are accommodations made elsewhere, so you simply do not notice it. Kidneys are alot like that! The medical community will often tell you there is no need to address lifestyle changes in Stage 3.

Way back in 2015, when I was diagnosed with my ultra-rare kidney issue, that's what they told me, too. But I decided to upgrade my lifestyle, my diet, my approach to life and make it all the best I could. My last lab work showed my eGFR at 19%, up from a low of 14%. I am monitored each month. While they are certain I will be on dialysis before too long, I will campaign to hold off as long as possible! At age 69, dialysis will be part of the rest of my life once it is started, as I cannot be transplanted. But I intend to stick around for a long time, off dialysis as long as possible ;))

Put your running shoes on, run a mile for me! And, please, let me know if I can help in any way to relieve your concern.
Ginger

Jump to this post

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.

REPLY
@gingerw

@wkidney You'll read from others here, and I echo them, that each person's journey is different, even when they are similar. It is generally understood that kidney disorders are slow-moving, and our bodies learn to adapt to the small changes as we go along. Think of if as balancing a globe or sphere, where everything works together. As you move it slightly, there are accommodations made elsewhere, so you simply do not notice it. Kidneys are alot like that! The medical community will often tell you there is no need to address lifestyle changes in Stage 3.

Way back in 2015, when I was diagnosed with my ultra-rare kidney issue, that's what they told me, too. But I decided to upgrade my lifestyle, my diet, my approach to life and make it all the best I could. My last lab work showed my eGFR at 19%, up from a low of 14%. I am monitored each month. While they are certain I will be on dialysis before too long, I will campaign to hold off as long as possible! At age 69, dialysis will be part of the rest of my life once it is started, as I cannot be transplanted. But I intend to stick around for a long time, off dialysis as long as possible ;))

Put your running shoes on, run a mile for me! And, please, let me know if I can help in any way to relieve your concern.
Ginger

Jump to this post

Thank you GInger. A positive attitude is so important and I very much appreciate yours. I will run a mile for you tomorrow morning. I hope you live fabulously dialysis-free for a very long time! Thanks so much for your input!

REPLY
Please sign in or register to post a reply.