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  • Does Stage 3, GFR 54, Warrant a Referral?

    Brand new to this forum and am trying to learn as much a possible about my Stage 3 CKD. A year ago, my GFR of 58 was flagged as low on my annual work up but my Dr. said nothing to worry about. I had no idea even what it was about so didn't give it any more thought. This year, GFR was 54. Still no concern from the Dr. Asked me if I take Ibuprofen - I don't.

    For some reason this year I went home and looked up GFR. When I began to realize the significance of declining kidney function, I went back and asked what I could do to slow or stop the decline. Was told it's not low enough to worry about. I asked if he normally sees otherwise healthy people with low GFR. He said no, it's usually seen in patients with diabetes or high blood pressure. I asked about a urine test to check for kidney damage. He agreed and was told it came back normal (although I never saw the results). I asked what else we could do.

    He said we could try a very low dose of ACE inhibitor as my blood pressure is occasionally slightly elevated. I agreed to try this. I have since asked for a referral to a specialist and was told my GFR "isn't really that low."

    I've read that diet may help slow down kidney decline and spoke to an acquaintance, who is a dietitian, about it. He thought I should see a kidney specialist to determine if there is a specific problem and is reluctant to give me advice about diet without knowing more about what is causing the decline.

    I'm feeling frustrated right now and don't know if I'm over reacting or if I should make an appointment myself with a specialist. Would probably have to pay out of pocket without a referral from my family doctor.

    Any advice?

  • #2
    Re: Does Stage 3, GFR 54, Warrant a Referral?

    Welcome LWB!!!!!!

    here's some info on that:

    http://www.baakp.org/Newsletters/Kid...ons_May_09.pdf

    There are things you can do to try and delay the progression
    of kidney disease. Keeping your blood pressure under control
    is key; especially by using an ACE-inhibitor type of blood pressure
    medicine with “pril” as the suffix. Know your lab test results
    and try to keep your hemoglobin A1C under 7.0% ( for diabetics), your
    blood pressure under 130/80, your bad cholesterol less than
    100, and eat no more than 0.08 gms/kg body weight of any
    type of protein per day. A proper diet is another way to slow
    the progression of diabetes and kidney disease.
    The website
    www.nal.usda.gov/fnic/foodcomp/search can help you find out
    what the foods you are eating have in them.

    Vivek Bhalla, M.D.,
    Stanford University Medical Center
    Division of Nephrology
    I received the GIFT OF LIFE on Nov 9, 2010 thanks to my wonderful donor Laura and her family!

    Comment


    • #3
      Re: Does Stage 3, GFR 54, Warrant a Referral?

      Hi LWB and Welcome, I'll share a little of what my experience was when diagnosed. I was referred to a Nephrologist who first did a complete history ( about 10 pgs. ) and Alot of blood tests,-- very thorough. Then I had 2 ultrasound done to determine if there was permanent kidney damage and they checked the arteries around the kidneys. My Neph. told me there was damage but I was at stage 3 and could possibly stay there for many years. He turned me over to my GP for future care and I was told to return if my GFR dropped significantly. Now my kidney function tests are done every 3 months. Every one is different and has a treatment plan according to their personal situation. For me I was to watch my bp as I take meds. and NO Ibufrophan ever. Things were left at that until recently when I read on this site how beneficial diet was to slow the progression. I asked for the referral a couple weeks ago and saw the dietician. I learned so much in the 1 1/2 hr. meeting--wished I had asked sooner. Now, I am on a much healthier diet that is customized according to my needs.

      Your not over reacting at all. It's great that you want to be proactive with your health. Talk to your Dr. and make it clear that you want to do everything you can to keep your kidney function stable. There is a wealth of information and support here on the forum so stay in touch. We understand what your going through.

      Toni
      May you always have Love to share, Health to spare, and Friends that care


      Acute Kidney Function Loss 12/07 - GFR 39
      Current GFR 46 - Stage 3 - Controlled HBP

      Comment


      • #4
        Re: Does Stage 3, GFR 54, Warrant a Referral?

        Marina, thanks for the warm welcome! The info you posted regarding diet coincides with what I've picked up on from my dietitian friend - so that is good to know.

        I've read lately that diet soda has been implicated in a faster than normal decline in kidney function. I've used diet soda for many years in an effort to keep my weight in a normal range. Any thoughts on that?

        Comment


        • #5
          Re: Does Stage 3, GFR 54, Warrant a Referral?

          Tonia, thanks so much for your reassuring reply. I’m wondering how exercise plays into the equation. Did your dietician or doctor mention that? It’s good that you’re tested more frequently – I don’t go back for six months.

          I’m wondering too whether drinking diet soda is prohibited – I’ve heard it may cause accelerated decline in kidney function.

          I appreciate your taking time to reply to my post!

          Comment


          • #6
            Re: Does Stage 3, GFR 54, Warrant a Referral?

            It's a good question about diet drinks. My dietician did discuss exercise as it's essential to stay strong and it's good for your overall health. I have always been active when not feeling sick, but never on a regular exercise program. So I made a commitment to get back on the treadmill, which I enjoy or at least tolerate! And I'm hopeful I will lose that last 15 pounds thats been hard to take off. It really helps mentally too and if I start to feel slugish, I'll get on the treadmill and it perks me up.
            May you always have Love to share, Health to spare, and Friends that care


            Acute Kidney Function Loss 12/07 - GFR 39
            Current GFR 46 - Stage 3 - Controlled HBP

            Comment


            • #7
              Re: Does Stage 3, GFR 54, Warrant a Referral?

              Originally posted by LWB View Post
              I’m wondering too whether drinking diet soda is prohibited – I’ve heard it may cause accelerated decline in kidney function.

              I appreciate your taking time to reply to my post!
              Hi LWB,
              here's a post on that from KidneySpace


              http://www.kidneyspace.com/index.php...16050#msg16050
              HELP YOUR KIDNEYS PASS ON SALT AND DIET SODAS

              Individuals who consume a diet high in sodium or artificially sweetened drinks are more likely to experience a decline in kidney function, according to two papers being presented at the American Society of Nephrology’s annual meeting in San Diego, California.

              Julie Lin MD, MPH, FASN and Gary Curhan, MD, ScD, FASN of Brigham and Women's Hospital studied more than 3,000 women participating in the Nurses' Health Study to identify the impact of sodium and sweetened drinks on kidney function.

              “There are currently limited data on the role of diet in kidney disease,” said Dr. Lin. “While more study is needed, our research suggests that higher sodium and artificially sweetened soda intake are associated with
              greater rate of decline in kidney function.”

              The first study, “Associations of Diet with Kidney Function Decline,” examined the influence of individual dietary nutrients on kidney function decline over 11 years in more than 3,000 women participants of the Nurses’ Health Study. The authors found that “in women with well-preserved kidney function, higher
              dietary sodium intake was associated with greater kidney function decline, which is consistent with experimental animal data that high sodium intake promotes progressive kidney decline.”

              http://asn-online.org/press/Renal%20...%20release.pdf
              I received the GIFT OF LIFE on Nov 9, 2010 thanks to my wonderful donor Laura and her family!

              Comment


              • #8
                Re: Does Stage 3, GFR 54, Warrant a Referral?

                Just an update. Thanks for the article about diet soda and reduced kidney function. I’ve stopped using artificial sweeteners altogether and have warned friends and family as well. Interestingly, when I mentioned it to two friends who are nurses, they each said, “I NEVER use artificial sweeteners.”

                I can’t help wondering if diabetics do additional damage to their kidneys by using diet pop, artificial sweeteners, etc. and also higher protein consumption?

                Speaking of diabetes, I have a lot of type 2 diabetes in my family, including my brother, but have never been tested. So I went to a local hospital that has low-cost screening tests for 55+ members and had an A1c test. Thankfully, it came back normal at 5.5% so that’s one less thing to worry about and also I feel better about changing my diet (less protein, more carbs) to be more kidney friendly.

                I started to chart my daily food intake and that was an eye opener! I’ve been eating way more protein than I realized. Also, I’ve always avoided salty foods because of water retention but keeping a diary made me realize how much sodium is in “normal” food that doesn’t taste “salty!” One trick I found is that when I eat out, I plan on taking ½ of my sandwich or entrée home for the next day. That way I automatically reduce protein and sodium by half.

                Thanks again for the help!

                Comment


                • #9
                  Re: Does Stage 3, GFR 54, Warrant a Referral?

                  I am the same way, I went down to 38, then bounced up to 69. That is when the nephrologist dismissed me, saying I was normal. Then I went down to 63. So I asked, and he said I was still in the normal range and not to worry about it.

                  Well that's fine, but I don't want to have my GFR rate to still continue to fall, so I came to Davita here, to look to what ranges of sodium phos and potassium should I limit myself to each day to stay healthy. I have an appointment in a few months to meet with a proper dietition and plan on keeping that appointment. I want to stay healthy, so I will be pro active and do all I can to stay healthy.

                  Wish you all the best, and fight for your right to be as healthy as you can!!!

                  Comment


                  • #10
                    Re: Does Stage 3, GFR 54, Warrant a Referral?

                    Flaxgirl3,
                    Thanks for the words of encouragement. I've just been a little frustrated because my Dr. seems to be saying, "When it gets worse, we'll take a closer look."

                    My GFR decline has accelerated over the last three years: 63, 61, 58, 54. I don't like the trend and to wait for it to get worse before doing anything about it seems illogical. I wonder if it has anything to do with the fact I'm on Medicare. Does anybody know?

                    Comment


                    • #11
                      Re: Does Stage 3, GFR 54, Warrant a Referral?

                      Hi, LWB I am new on here and just saw your post I will tell you I just found out I am at the same stage you are right now and I saw a nepherologist back in 00 and 06 and then I was only stage 2 never did they tell me about sodium and diet or what smoking does to your kidney and alcohol I was told doesnt have anything to do with your kidney so I went on my marry little way now I went to dr. yesterday and now at 3 I am going to see a dietician next week and wanting to do everything to prolong my life I quit smoking a month ago and cut down 80% on the drinking Ive gotta work alittle harder on getting alcohol out of my life for good but just wanted to tell you I personally agree with you and think its a bunch of crap I would look for another nepherologist and alot of times it can be because of medicare I have went to 3 diff.kidney drs. I like this one but it does seem to be a trend that they dont tell you anything till it gets bad im frustrated because if they woulda told me this 10yrs ago I coulda educated myself and not let it even get this far it really makes me wonder alot of people dont get diagnosed till stage 3 if the drs. see it at 1 or 2 and dont say anything until 3 is it about the $$$$$$$ ?????
                      ckd,stage3,due to birth defect/refulx,controlled b/p

                      Comment


                      • #12
                        Re: Does Stage 3, GFR 54, Warrant a Referral?

                        Just my two cents. A GFR in the 50's is not normal. If your GFR is dipping, someone needs to find out why and see what may be done to attempt to remedy that. Where you ever told why your GFR is low? Really, why wait for it to dip further to find out what is causing that.
                        I hope that you get some answers.

                        CKD Stage 3, No high blood pressure, No diabetes

                        Comment


                        • #13
                          Re: Does Stage 3, GFR 54, Warrant a Referral?

                          Thanks everyone for your insights! Here is an update and also a question:

                          I noticed the early signs of a UTI a couple of days ago. Began drinking lots of water and also cranberry juice. The symptoms eased within a few hours but in view of my lower kidney function, I didn't want to take a chance and wait it out. So called the Dr.'s office and they squeezed me in. Urine showed only minimal sign of infection but he prescribed an antibiotic and said they would send the urine sample to the lab for further testing.

                          Now, I read that antibiotics can be hard on kidneys. Seems like I'm damned if I do and damned if I don't. Anyone know the low-down on antibiotics? My RX is for nitrofurantoin-macro. 100mg twice a day.

                          Comment


                          • #14
                            Re: Does Stage 3, GFR 54, Warrant a Referral?

                            Long term antibiotic use can be damaging but you must treat an UTI or it can lead to more kidney problems now, not to mention the suffering you will go through if untreated. Don't delay on taking your prescription because these infections can flair into more serious ones quickly.
                            Feel better soon! Toni
                            May you always have Love to share, Health to spare, and Friends that care


                            Acute Kidney Function Loss 12/07 - GFR 39
                            Current GFR 46 - Stage 3 - Controlled HBP

                            Comment


                            • #15
                              Re: Does Stage 3, GFR 54, Warrant a Referral?

                              I just found out that I have stage 3 kidney disease. I am devastated. My kidneys have shrunken, they are scarred. I dont have to do dialysis yet. But to tell the truth I am very afraid. My nephrologist is still running tests. But thats what the ultrasound revealed, and now its just I guess seeing what the next step is. This is been a very tough thing for and my family. A shock really. My son is 5 too young to understand. But thats what keeps me going besides my fiancee. How do you deal with this kind of diagnosis?

                              Comment

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