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Old 01-28-2010, 07:31 PM   #1
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Question Low GFR - Should I be concerned?

Hello; I hope someone can answer my questions. I recently had a lot of bloodwork done as part of an annual screening. All of the hematology portion was normal, but I'm concerned about some of the tests that relate to kidney function:

BUN 17 (Normal range 5-25)
Creatinine 1.0 (Normal 0.6-1.4)
Bun/Creat. Ratio 17 (Normal 6-20)
GFR 58 --- LOW --- (Normal >60)
Potassium 5.2 (Normal 3.5 - 5.3)
Total Protein 7.7 (Normal 6.3 - 8.2)
Albumin 4.4 (Normal 3.5 - 5.0)
Globulin 3.3 (Normal 2.0 - 3.5)
A/G Ratio 1.3 --- LOW --- (Normal 1.4 - 2.6)
Glucose 102 --- HIGH --- (Normal 65-99)

My cholesterol and triglycerides were borderline high also. My fasting glucose has been between 101 and 112 for at least the past 12 years, so that is in the pre-diabetic range. I didn't list all of my results not knowing which are really the most important indicators of kidney disease, but after doing some reading on the internet, I'm concerned about my GFR. Also, doesn't my potassium seem a little on the high end? My doctor said we would do another set of blood work and a complete physical in 3 months, so until then I'm very anxious. I read that frothy urine indicates the presence of protein, and I hadn't paid any attention until now, but my first urine of the morning is frothy. I haven't had any tests on my urine.

Three months ago I started taking Levbid for IBS, and Prilosec for GERD; no other prescription meds. I've had a metallic taste for 12 months. The Levbid gives me a dry mouth and the drug information says it reduces secretions in the internal organs, eyes, nose, mouth, and also perspiration. Is it possible that some dehydration could cause these abnormalities? I'm 51 years old. My father died at age 83 with end-stage renal disease, about a month after starting dialysis.

Thanks for any comments!

 
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Old 01-29-2010, 10:58 AM   #2
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Re: Low GFR - Should I be concerned?

do you know for certain just what the actual cause was of your fathers kidney disease onset? what type of kidney disease or problems was he Dxed with? this just could really matter with what you are dealing with now. some kidney disease just are very much hereditary unfortunetly. i have one too, but mine is very much a heavy 'cystic' type of kidney disease called PKD?

your labs really do show something is most defintiely going on with your kidneys, the real key here is finding just what that something is. did your doc also do a UA on you just to see if you did have protien in your urine? it just is one of the earlier indicators of an underlying kidney disease. that truely IS the best type of test to show protien. our urines frothyness, at least as far as i feel anyways can be that way from many different things, includingthe overall velocity of the urine stream too? that UA should just be done to get a baseline if nothing else? this can also show the possibility of other things in your urine that should not be there like ketones?

i really do think asking your doc to refer you for an actual ultrasound would help alot right now in possibly seeing just how the actual kidneys themselves just 'look'? the thing about any labs being done on us when it comes to organ function is that function impairment just has to be at a certain threshhold level before ANY lab numbers actually will change or go out of the norm range? as an example, my kidneys LOOK like severely damaged and distorted just from huge massive amounts of hevy cystic growth in them(kidneys are almost getting to four times their normal size at this point), and also in my liver? but despite what looks so horrid upon my ultrasounds i have to have every year, my actual kidney labs and my liver labs are still in some insane way all within the norms. my actual GFR is astoundingly over 80? still? despite what is seen. it just blows my mind really. so getting that good 'look' at your kidneys right now really would give you and your doc the best overall picture here. and you do need that UA done too.

while your GFR is considered "low' since it simply falls below that 'norm' level,your creatinine is still within what is considered to be the 'norm", so thats a good thing. and yes it does appear that your potassium is crawling upwards too. the real key here for you right now is to actually just find out what exactly IS impacting your kidneys and bringing down that GFR. doing whats called the 24 hour urine collection test really would be ideal for you right now too. this just kind of better individualizes you and your own numbers as to where they should be kind of thing? the national standards are what are actually used as the guidelines for ratios of testing with labs, which in some people can be way off too depending upon how YOUR individual physiology just is? the 24 hour test just kind of gears the overall ratios more to YOU. but DO make another appt with your doc to discuss the labs, get that UA and the possible 24 hour test,and espescially to obtain that referral to just have the US done. getting that good look at your kidneys, like i said, just gives you a much better overall picture than only labs can alone? i forgot to ask here before? was your dad a diabetic?

if you have concerns about diabetes and your kidneys here, there IS an amazingly knowledgable woman here whos name is coravh? i am sure she will be popping in here too to try and help you out. hopefully whatever is impacting your kidneys can be easily and quickly found out. please DO keep me posted lynne. marcia
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Old 01-29-2010, 11:40 AM   #3
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Re: Low GFR - Should I be concerned?

Well Marcia beat me to it. What she said is correct. While technically, almost all of your numbers are fine, the GFR is a bit low. While this could be due to some dehydration (and keep in mind that usually it is an eGFR - estimated) it is a good idea to keep an eye on this and maybe do some follow up labs such as a urinalysis and some more blood work in the not too far distant future. I would actually be more concerned with the potassium. While it is still technically normal, my lab considers 5.1 as the cut off for the high end of normal. So your's is definitely getting to the limit.

In the meantime, I would try to keep hydrated, lower your intake of animal protein (don't cut it out, but stay away from very large portions) and cut sodium out of your diet. This will help take pressure off of your kidneys. Make sure that some arrangements are made for follow up labs so that you have a comparison.

Best of luck.
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Old 01-29-2010, 06:54 PM   #4
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Re: Low GFR - Should I be concerned?

Thanks Marcia and Cora for your comments. I don't know what the cause or type of my dad's kidney disease was. He was in and out of the hospital many times during the last 2 years of his life. Prior to that, he was the picture of health. I don't remember him or his doctors saying anything about the type or cause of his disease, and I really didn't know that there are different types until now. He didn't have diabetes, but his mother did.

The labwork I had done was an annual screening through my place of employment, and I had a copy of the results sent to my doctor and tried to discuss with her during my appt. for follow-up on my GERD and IBS that was recently diagnosed. When I started to ask about my GFR and asked her if it was anything to be concerned about, she said I would need to schedule a physical when she would have more time to discuss in detail. She did not mention a UA, but I suspect that will be done as part of my physical exam in 3 months. She said there would need to be a separation of 3 months between the labs and if the GFR is still below 60 in 3 months it could indicate something, but that's about all she said. I didn't get a chance to ask about my potassium, cholesterol, or triglycerides after she said we would discuss everything at my physical. So, I'm hoping my numbers are some sort of fluke, but it's making me very anxious and worried. I did get a referral to a gastroenterologist for my GERD and IBS.

I will try to drink more fluids and cut down on foods high in potassium in the meantime. I guess that's about all I can do for now. Thanks for listening...

Lynne

 
Old 02-07-2010, 04:17 PM   #5
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Re: Low GFR - Should I be concerned?

Just an update to my initial post. Since then, I've had a urinalysis and urine culture. There was only a trace of protein, and small amount of blood. The culture showed no infection, so I'm going to see a urologist this week. While researching all of this on the internet, I found that reflux meds --- proton pump inhibitors (PPIs) --- have caused interstitial nephritis in people, which results in higher creatinine levels and lower GFR numbers. There is also research that indicates that PPIs can raise serum potassium levels. The studies indicate that this condition can be reversible in many cases, but in some cases it results in chronic kidney disease. I started taking a PPI 4 months ago, so I'm wondering if this has caused my problems. If so, I hope it can be reversed.

 
Old 02-10-2010, 10:09 AM   #6
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Re: Low GFR - Should I be concerned?

while what you mentioned about your meds IS indeed a possible here,the mere fact that the UA actually DID show even trace protien(this was what MY initial UA showed too, only 'trace') is still there and kind of that 'underlying' indicator of possible kidney disease. that is why we wanted you to actually ahve the UA at all lynne. it really is just pretty accurate as far as showing what could be a kidney disease of some kind. can i ask just why you are being sent to a uro instead of a good nephrologist? while they do just do some of the very same types of things(within the same type of overall system), usually a good neph is who would be better to actually monitor someone with actual kidney disease?

but you still do need some further in depth testing espescially with that protien even showing now? perhaps the uro may be better able to at least DO that part of things for you. you still do need that 24 hour urine collection test done too hon. i am sure he will have you do this at the first visit. they just send you home with a big red jug that you fill up with exactly 24 hours worth of your urine,then return this to their lab. like i mentioned before, this really just does a much better job of actually setting your 'own' real ratios when it comes to your labs too? and it 'could' actually make a real difference for YOU too? good luck hon and do please keep us posted, Marcia
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Old 02-17-2010, 08:17 PM   #7
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Re: Low GFR - Should I be concerned?

OK; finally a diagnosis! The urologist did a cystoscopy and the bladder is fine, but the CT scan revealed a 2.5 cm. angiomyolipoma, a benign tumor, on my left kidney. I have to go back for another CT scan in 6 months to see if it has grown larger. The doctor said if/when it gets to be 4 cm., it needs to come out due to the risk of spontaneous hemorrhage, but they are usually slow-growing. He also said microscopic hematuria is normal for some people and he sees a lot of patients with this and the majority of the time, no problems are found. He also said foamy urine is nothing to be concerned about. I asked him whether the tumor can have any affect on kidney function and he said not unless the tumor ruptures. Hopefully, it will stay small and not cause any problems!

 
Old 07-31-2010, 02:21 AM   #8
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Re: Low GFR - Should I be concerned?

Lynn. You're is almost but not quite 60 which is ok. Yet, I tested this week with 54 and my doc wasn't happy at all. and ordered a kidney function test.(Urine) Someone on this thread mentioned Proton Pump Inhibitors.I took 1 20 mg. of aciphex for 3 years and was good.I wanted to try 2 pills a day and have low GFR now. I started 2 pills a day 1 year agowhen my GFR was 68. So I will get off PPI's if I can. that is a possible cause. Another cause is taking Lithium for 29 years.Switching now would be a nightmare,scarry'Third,is diet matters.Low on proteins(meat).no salt and less potassium.I have severe acid reflux and have had colonscopy,endoscopy,ENT input.The cause is too much acid.Follow your diet.stop eating at 6, and, the sphincter,gets soft from caffeine and acid foods and lets the bile in. so no oranges,spicy foods,pop, or food made with tomatoes. You don't need an colonosopy or endoscopy.Costs a fortune. Used to be an operation to tighten sphincter.No longer offered.So it is diet and timing.Good luck.

 
Old 08-03-2010, 06:47 AM   #9
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Re: Low GFR - Should I be concerned?

I hope someone can help, my gfr has been steady at 35 to 38 for the last 4 years
in february following a blood test my gfr had dropped to 21!!!!!
Following another blood test 3 months later (May) my gfr had gone up to 35 again,
I am confused, is it possible for gfr readings to fluctuate like this, please let me know
Mike

 
Old 08-03-2010, 11:15 AM   #10
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Re: Low GFR - Should I be concerned?

Quote:
Originally Posted by hopalongxxx View Post
I hope someone can help, my gfr has been steady at 35 to 38 for the last 4 years
in february following a blood test my gfr had dropped to 21!!!!!
Following another blood test 3 months later (May) my gfr had gone up to 35 again,
I am confused, is it possible for gfr readings to fluctuate like this, please let me know
Mike
When there is kidney damage, there are all kinds of things that can happen. Things can remain stable, even for years, as you've seen. But then things can take a downward turn. Unfortunately, the decline in kidney function is not linear. It can go up and down, but the general trend tends to be downward. So don't get too obsessed if the number goes down, but don't get ecstatic if it goes up again. That doesn't mean you are "getting better", it just means that for that test, things were in alignment. What you want to watch is the gradual trend over time. Since the value did dip, don't be surprised to see it drop again at another lab test.

Sorry I can't be more positive, but that is how things typically go. You may have another long period of stability, but if you get sick, maybe not. Hope things continue to go well for you.
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Old 08-03-2010, 11:35 AM   #11
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Re: Low GFR - Should I be concerned?

I hope someone can help, my gfr has been steady at 35 to 38 for the last 4 years
in february following a blood test my gfr had dropped to 21!!!!!
Following another blood test 3 months later (May) my gfr had gone up to 35 again,
I am confused, is it possible for gfr readings to fluctuate like this, please let me know
Mike.....UK

 
Old 08-03-2010, 01:52 PM   #12
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Smile Re: Low GFR - Should I be concerned?

I am most grateful to you for addressing my concerns about
fluctuating gfr levels
Thank you so very very much
Mike

 
Old 08-03-2010, 03:34 PM   #13
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Re: Low GFR - Should I be concerned?

Quote:
Originally Posted by hopalongxxx View Post
I am most grateful to you for addressing my concerns about
fluctuating gfr levels
Thank you so very very much
Mike
No problems Mike. Ask all the questions you like. We are here to help.
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Old 08-03-2010, 11:25 PM   #14
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Re: Low GFR - Should I be concerned?

A short time ago I met someone who, like my husband, has CKD stage 3. He was also in the 34 or so eGFR range, and is a friend of ours. At one of his appts. with his neph his creatinine had risen to 2.5 and his neph insisted that he follow a V strict renal diet. (Before, he hadn't really been very strict about his diet as he should have been). Anyway after having been on the renal diet for a period of time, his eGFR rose to 89! (I posted this on an earlier post). His neph was amazed, and told him he no longer needed to see him!!! (This is what this man told me, and he is not a person to make things up, believe me)!

Unfortunately for this person, he was not able to enjoy his good luck re his kidney function as he has been diagnosed with unoperable lung cancer. The last time I saw him he said that his eGFR was running in the ''sixty something'' range (still pretty good). He is undergoing chemo and radiation, which probably has a negative effect on his overall kidney function, not to mention a negative effect on his whole body.

monte

 
Old 08-04-2010, 01:20 AM   #15
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Re: Low GFR - Should I be concerned?

Lynne,

I encourage you not to worry, particularly for three months until your physical.

Your eGFR is very close to 60, and there are slight variations in your eGFR's at different times. I have actually regained significant numbers with careful attention to diet, and close control over my blood pressure. In fact, how is your BP? Hypertension has a major impact on your kidney function, in fact is is the cause of my kidney failure 6 years ago. Since then, I have regained approx. 20-25 points in kidney function!

At this point I have stabilized my kidney function, and as I was so close to dialysis, and now I am safe from that for as long as I can keep my BP under control.

Your labs do not suggest that you are in serious trouble with your kidneys, in fact I wish I had your numbers! It is simply something to follow, but nothing to worry about. Stress is the worst thing you can put upon yourself over potential health issues. It is highly counterproductive, and is an unhealthy practice.

Instead, I encourage you to enjoy the next 3 months, eat wonderful healthy foods, get good exercise, and keep a positive attitude. These things will always be good for you, and will reflect in your overall health in a positive way.

My doctor recommends keeping around the edges of the grocery store, and avoid the middle aisles. The fresh foods are all around the edges, while the processed foods are in the middle. It is a good way to remember what is best to eat, fresh and clean.

 
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