Stage 3 chronic kidney disease (CKD): What specialists do I see?

Bill was considering a urolift after watching TV ads. Doctor suggested he go to a urologist but he backed out at last minute. About the only time he leaves the house is to go to a doctor's appointment. We just moved in with our daughter. He has taken some falls lately, which did convince him to utilize his walker. He is now 89 and has stage 3b ckd and conative problems. His legs and arms are covered with purpura - when one heals another appears. A few scrapes and bruises from his last fall. And he wore his hearing aids into the shower yesterday. Bad idea. I'm trying to dry them at the moment to see if that will help. Move was this past Monday. Trying to get him settled in, which is stressful.

As soon as I was diagnosed with stage three CKD, my rheumatologist sent me to a nephrologist. I also have labile
blood pressure, ME/CFS, and Graves disease. I see both a cardiologist and a nephrologist. Both do blood work
every three or four months. I think seeing both a cardiologist and a nephrologist is the safest way to handle the
situation. The tests are similar but there are some special tests that each doctor does. Each is trained in their own set of diseases. The heart and the kidneys do influence each others function however so I say the more information collected about your conditions, the safer you are. Good luck.
Petunia's Mother
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Petunia's Mother

Hi @rozalia. I can't speak for everyone, but I went back and checked my test results to see when I started seeing a nephrologist. I was stage 3b with an eGFR of 39. Everyone's situation is different and I think it depends on the cause of your CKD (mine is PKD), the rate of decline, your age, whether you're controlling your blood pressure and blood sugar, etc. Don't feel bad if you want to get a second opinion - it's your health and your life. Your doctor should respect that. Best wishes and take care of YOU!

My husband, Bill, is 89and in Stage 3b - he recently read about farxiga and is eager to try it. But he loves taking medications and wants to buy every one he sees advertised on TV and on his computer! Side effects mentioned are frequent urination (he has a major problem with that even taking Flomax and Avodart) - it also can cause dizziness and lately he has fallen twice and almost fallen five or six times in the past couple of months. Finally consented to use his walker - thank heavens - as he weighs a 100 more than me and I can't get him up.

I told him I would check with people suffering from CKD and also his doctor during his next visit (July). He also has memory problems that seem to get worse almost daily.

I am taking Farxiga daily. There are 2 doses as I understand, 5mg or 10mg. I was told by my endocrinologist that the 5mg dose was the diabetic dose and the 10 MG is the kidney dosage. Both my diabetic and kidney docs strongly believe in Farxiga as a way to prevent further worsening of the kidneys. I am also at 3B and was told for some there can be side effects, which is true of any drug. The best way to control this is also his diet, No red meat or dairy but plenty of fruits, vegetables, and a plant based diet will also help.

A few months ago, I posed a question on Farxiga . There were few responses but one gentleman made a great point about its side effects on some people. Science sometimes can be a double edge sword. Search "Farxiga" in this forum.

Lastly, if you are affiliated with Mayo, have your husband see a neurologist for testing. Follow up with asking your doc about the HABIT program that is offered at Mayo for MCI or mild cognitive impairment.

At the moment he is only being treated by our family doctor as he has been fairly stable for past two and a half years (not so much with his other problems). His memory problems seem to get worse daily. He hasn't wanted meat most of the time. I can get him to eat a lot of fruit. He is also into sweets big time - which I know aren't good for him but at 89 figure he should enjoy. Doctor said the same thing as he doesn't seem adversely effected by them. At the moment he is taking a handful of pills daily. Falling now has become a major problem.

Thank you for your comments - very much appreciated.

If falling is a major problem, a neurologist would help with both memory and balancing issues. Since we both live in the Phoenix area, you can find a neurologist in north Phoenix off the 101 or Scottsdale. I would suggest talking with your family doctor and have your husband get a thorough exam from Mayo. I wish you both the best.

I was just diagnosed a few hours ago… My doctor was always complaining that I was just dehydrated!
Where can I find a beginners book on what is healthy for me to eat for my kidney disease? I’m devastated, but I know knowledge is power.

Hello @lyndaannpidgeon. This discussion originated 9 years ago about Stage 3 chronic kidney disease (CKD). Is that what you’ve been diagnosed with?

First of all the doctor who specializes in this is a nephrologist. Do you have one? If not; get one. A nephrologist can also help you determine the cause of your CKD. The two most common things are diabetes and hypertension (high blood pressure). But there are other reasons too.

Second of all, what was your diagnosis based on? There are a lot of labs / equations that lead to a CKD diagnosis: eGFR, creatinine, BUN, cystatin (sp?) ….. Learn what these labs mean and what was used for your diagnosis.

Third, there are other labs that measure things that your kidneys have a role in processing. This includes calcium, potassium, protein, phosphorus, oxalates….. These labs will show what to focus on for your eating. Generally speaking red meat is harder on kidneys. I limit this for myself. Some kidney patients go vegan and avoid all animal protein and fat. Potassium and phosphorus are common ones to limit. My nephrologist tells me to “eat for the labs”. That is why I said to learn what labs are drawn on you to get an idea what you need to focus on. An awareness of carbohydrates is important due to the connection to diabetes. Limiting salt is common due to preventing high blood pressure.

Fourth, once you know the things you need to be careful of you can ask for a referral to a renal nutritionist who can provide lists of things you need to watch out for and can help you develop an eating plan that suits your needs. If you find one affiliated with the same practice as your nephrologist they will have easy access to your lab results.

Lastly if you have stage 3 CKD it is possible to stabilize your kidney function for a very long time. I have had stage 3 CKD since 2005. I dropped to stage 4 around 2016 but started learning about renal nutrition requirements and by the grace of God got back to stage 3. “Knowledge is power” and so is faith, hard work, a positive attitude and a bunch of other good things.

I was diagnosed with Stage 3 CKD. I freaked out! What happened to Stage 1 and 2? Then it went from 3a to 3b. I will see my nephrologist at Mayo in August. Mayo doctors are the best!