CKD stage 4

I am new to this group. I have had UTI'S for years. Now they are looking for a cyst, tumor or any blockage in the ureter. Anyone has this? IS IT PAINFUL AND WHERE ARE YOU IN PAIN.

@kkellner
My Dr transitioned me to Lamotrigine. It has worked well, no side effects. I wish I was transitioned years ago. Take it once a day.

I have been on Lithium for about 50 years. In the beginning (first 25 years or so), the dosage prescribed was in the 450 mg to 600 mg range - and is likely the cause of my CKD - but there is no real way to be sure.

In the past 20 years or so (I'm 80), the blood level recommendation for the therapeutic range has declined to about 0.3 mM and my dosage has gone down slowly to 150 mg/day.

I have worked with various physicians to find an alternative medication, however I feel better with the low level Lithium and believe the current dosage is of little risk to my remaining renal function.

I tried Welbutrin and Effexor (sic?) but both caused unacceptable side effects.

"In 2019, the Older Adults Task Force within the International Society for Bipolar Disorder (ISBD) published recommendations for age-stratified lithium therapeutic ranges for therapy." Since this was published, other studies have suggested a still lower dosage is effective - as it seems to be to me.

Microdosage Lithium is also being studied for unrelated disorders. You may have to do some work with your physician and/or Nephrologist to find your correct dosage. Good luck!!

Thanks to both of you for your replies on alternatives to lithium. Appreciate your insight.

@gingerw
I was stage 3b for the last three years, then I got a very bad kidney infection late February while travelling in Asia. I am living in Italy, do not speak the language, so depend on family to interpret for me. I have an eGFR of 25...quite a drop in a matter of two weeks, as I was a steady 36 or better, before that. Is it still possible that my numbers could improve, as my last blood test was 20 days after finishing up antibiotics for the infection? I am not sure what I should be doing now, other than watching my BP, sugar levels, sodium and being careful of proteins, potassium and phosphorus. What are the pros/cons of getting a kidney transplant and during what "window" of time should I be ready for that? I appreciate any suggestions and understand I need to run things past a doctor, but I sure appreciate others' experiences and ideas!

@cras
I had 2 Covid infections and a few UTIs and my eGFR dropped to 16. The kidneys can recover, depends on your disease. My eGFR is 19 now, sometimes it takes a few months to recover.
I’m on the inactive list at Northwestern Memorial Hospital in Chicago. It’s closer to me home or I would be at Mayo. There many blood tests, heart…and you have to be current on all your yearly cancer checks, mammograms etc. Then if you are approved can go forward. I’m almost done with my tests and I have a live donor. But your eGFR has to be 20 or below to be tested. I hope your kidneys recover, just remember the transplant is always an option.
We go to Italy often as we have family there. I’m not sure of their protocols.
Best wishes

@cras Welcome to Mayo Clinic Connect, in case I forgot to do that earlier!

As @mrainne said, our kidneys are pretty resilient, and can indeed recover from drops in function. There are several factors at play. What happened to warrant the sudden drop? Having an infection and taking medications can be the culprit.

Watching the things you are, is great. Mindful eating, looking at the bigger picture. Living in Italy, your transplant center might have different requirements/parameters than we have in the US. It certainly bears looking in to. Of course, there are pluses and minuses to getting a transplant. Your age, and your overall health are major considerations. Remember, a transplant is a treatment for kidney disease, not a cure-all.
Ginger

@cras Your nephrologist will be the one to start you on the journey of finding a kidney. It can take a long time just to qualify but I'm told it is worth it. Can I suggest that Facebook has some kidney sites. I'm on ,Kidney disease is not a death sentence, also I hate dialysis. We hate it but it keeps us alive. There may be others, they all have people that are dealing with this daily. Good luck on your journey.