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macarl
@macarl

Posts: 11
Joined: Aug 21, 2016

Diminished kidney function

Posted by @macarl, Oct 28, 2016

My doctor just informed me I have diminished kidney function. This was a complete surprise to me because I’m not aware of any symptoms. I had an ultrasound and the results were normal but my doctor still wants me to see a specialist. This is all making me feel very anxious. Has anyone else gone through similar circumstances? What can I expect at my appointment with the specialist? I’m 61 years old and have had a very, very stressful, anxiety-filled year. I am seeing a psychiatrist and a counselor at this time to deal with rhe issues.

REPLY

Welcome @macarl. I can imagine that this news would make you anxious. Thank goodness that your doctor discovered the issues even though you were not having symptoms. I’m going to ask @predictable @rosemarya and @jmbjar to join this discussion as they are more familiar with kidney function than I am. They will be able to tell you about their experiences and help you find the right questions to ask at the appointment with the specialist.

Carl, did your doctor say why he thought you may have diminished kidney function?

Hey, @macarl, I hope you can ease up on your apprehensions about “diminished kidney function.” I have several reasons for encouraging you to be less worried and more determined to deal with your doctor’s suggestion. Personally, my diminished kidney function has not been difficult to live with, nor has my wife’s. Key responses for us are patient education focused on diet and carefully selected medication at minimally effective dosages. Does your doctor recommend that the specialist be a nephrologist? If so, that could be really encouraging, because nephrology has such a broad range of therapies it uses before resorting to invasive therapies. Ask the nephrologist for a thorough, detailed report on the condition of your kidneys. In addition, ask him/her whether an endocrinologist might further illuminate your problem, because hormones are pivotal in certain kidney functions. If high blood pressure is among your symptoms, ask your nephrologist how your kidney might be involved in that. (In my case, I have a genetic syndrome that fails to reclaim potassium that the kidneys remove from my blood; the treatment for me avoids the most popular “water pills” and uses the strongest potassium-sparing diuretic instead.) Another positive aspect of my treatment is that we pay close attention every day for signs of kidney disease; this benefit of watchful waiting is often overlooked, but it is the main incentive for managing my own health care, developing confidence in the effectiveness of my treatment plan, and embracing trust in my medical team. Let us know how we can focus more precisely on your concerns and the path ahead for you.

@macarl, I can understand your concern. Your doctor has referred you to a specialist. This sounds frightening, but it is really a good thing for you. The specialist is able to diagnose and treat things that our PCPs are not trained to treat. I am happy for you that your PCP is checking into this right away so that if anything is going on, it can be dealt with. And @predictable has given you some wonderful information and encouragement.
Rosemary

Hi @macarl, as others have mentioned, seeing a specialist is the best way to get an accurate diagnosis, rule out problems, and discuss treatment options. It can be stressful, but take comfort in the fact that you are being proactive about your health. That’s a great thing!

That said, here are some tips that may help with the upcoming appointment along with some sample questions to ask. They all may not apply to your situation but I wanted to pass them along perhaps as a starting point.

– Be aware of any pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance, such as limiting your sodium or fluid intake.
– Write down any symptoms you’re experiencing. Include all symptoms whether you think they may be related or not
– Write down key personal information, including any major stresses, recent life changes and family history.
– Make a list of current medications, vitamins or supplements that you are taking
– Consider taking a family member or friend to your appointment. They can provide support and help you remember all the information discussed during the appointment.
– Gather any medical records required by your new doctor
– Write down questions to ask your doctor so you are prepared and can make the most of your time together.

Examples of questions to ask from Mayo Clinic

Is my kidney function worsening?
Do I need more tests?
What’s causing my condition?
Can the damage to my kidneys be reversed?
What are my treatment options?
What are the potential side effects of each treatment?
I have these other health conditions. How can I best manage them together?
Do I need to eat a special diet?
Can you refer me to a dietitian who can help me plan my meals?
Is there a generic alternative to the medicine you’re prescribing?
Are there any brochures or other printed material that I can have? What websites do you recommend?
How often do I need to have my kidney function tested?

Best of luck!!

Hi, @macarl, Have you been able to see the specialist, yet? I know how stressful it is to wait and be unknowing about what is happening inside. I do hope that you are getting some answers. I am living with one transplanted kidney because I suffered acute renal failure related to liver failure. So while I might not be familiar with your symptoms, I share your fear and concern.
Sending strength,
Rosemary

I have an appointment with a specialist on Jan. 9. Just had another blood test last week but still haven’t heard the results. Thanks for your kindness and support.

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

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I just heard from my dr. office with my second blood test results. My results are “stable” but still shows diminished function. They (again) recommended I see a specialist. I have that appointment scheduled in early January. I appreciate your offer to help me prepare for this appointment. I really don’t know where to start. This whole diagnosis is such a shock to me. I broke my leg and ankle about a year ago and have spent the last year recovering and rehabbing from that. And now I’m hit with this. I could really use your help and expertise. Where do I
start?

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

Macarl: Did you see the list of questions that @caretothepeople provided above in this discussion? I think preparing questions for your appointment that is a good place to start.

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

Update: I saw the Nephrologist and after reviewing my blood test results and my list of medications, he noted that a couple of the drugs I am taking has an impact on my blood pressure. One in particular, Propranolol, has a more significant effect than others. I took this medication because I have a bit of a tremor in my hands. The doctor asked me to stop taking the Propranolol and we’ll redo the blood test in a month to see how my numbers look. Apparently, low blood pressure can affect how well your kidneys work. So with the combination of my other meds that also effect on my blood pressure, he believes that caused my decline in kidney function. My doctor does not think any permanent damage has occurred.

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

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So glad to get this update from you, @macarl. It sounds like you are on the road to confidence and stability. In my lengthy contest with hypertension, my doctors and I had always avoided beta blocker medication (which Propranolol is) for its effect on heart rhythms. But that didn’t become the rule in my treatment until my HMO made me switch from cardio-directed medical care to that based on nephrology. That put me on a stable plain of my own. I’m now on Carvedilol, another beta blocker, but it’s for atrial fibrillation, which developed a year and a half ago, and my nephrologist prescribed it because it has good effects on kidney function as well as my blood pressure. Let’s keep in touch so we can share the best outcomes of our treatments.
Martin

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

@macarl, Thank you for this wonderful update. You have got to feel relief by knowing that your kidney is looking good! I hope that your labs next month are looking good.
Rosemary

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

Thank you for your message. I agree we should keep in touch.

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

Thanks, Rosemary. I did feel much better after meting with the specialist. Of course now that I’ve topped taking the Propranolol , my hands are shaking like before. If it’s not one thing, it’s another.

@colleenyoung

So good to hear from you again @macarl. Please keep us apprised of your developments. What questions do you have for the specialist on Jan 9? Can we help you prepare?

Jump to this post

@macarl, I hear what you are saying. Sometimes I think that we are experiencing a ‘domino effect’ kind of thing! One med does this, but it also causes that, etc. I sometimes have trembling hands, but mine happens sometimes if my immunosuppressant drug level is too high in my body. My labs will let my transplant team know if I need a dosage adjustment. So for me it’s a pretty simple thing to fix. But it is really annoying when it happens. Is there anything else that can control your shaking beside the Propranolol ? or is it just something to live with. I guess right now, you have to be sure that the kidney continues to be stable.
Rosemary

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