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  1. #1
    LWB
    Guest

    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. #2
    Senior Member
    Join Date
    Feb 2006
    Posts
    1,511

    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!

  3. #3
    Senior Member
    Join Date
    Jul 2008
    Posts
    890

    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

  4. #4
    LWB
    Guest

    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?

  5. #5
    LWB
    Guest

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

    Tonia, thanks so much for your reassuring reply. Iím wondering how exercise plays into the equation. Did your dietician or doctor mention that? Itís good that youíre tested more frequently Ė I donít go back for six months.

    Iím wondering too whether drinking diet soda is prohibited Ė Iíve heard it may cause accelerated decline in kidney function.

    I appreciate your taking time to reply to my post!

  6. #6
    Senior Member
    Join Date
    Jul 2008
    Posts
    890

    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

  7. #7
    Senior Member
    Join Date
    Feb 2006
    Posts
    1,511

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

    Quote 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!

  8. #8
    LWB
    Guest

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

    Just an update. Thanks for the article about diet soda and reduced kidney function. Iíve 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, ďI NEVER use artificial sweeteners.Ē

    I canít 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 thatís 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! Iíve been eating way more protein than I realized. Also, Iíve always avoided salty foods because of water retention but keeping a diary made me realize how much sodium is in ďnormalĒ food that doesnít taste ďsalty!Ē One trick I found is that when I eat out, I plan on taking Ĺ of my sandwich or entrťe home for the next day. That way I automatically reduce protein and sodium by half.

    Thanks again for the help!

  9. #9
    Junior Member
    Join Date
    Aug 2010
    Posts
    1

    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!!!

  10. #10
    LWB
    Guest

    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?

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