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Old 08-08-2012, 02:56 PM   #1
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eGFR of 48... Reasonable plan/steps?

Hi! New here! Been lurking for awhile. Thought I'd weigh in! I participated in a health screening in July. eGFR result was 48. Was finally able to get into the Doc today. She said my screening eGFR (48) indicates slightly decreased kidney function and very likely my high blood pressure has caused damage. I didn't have any protein in my urine, so that's good news. Makes me wonder if that's because I've already been monitoring/limiting Na, K, Phos, and Prot? She ordered blood work to either confirm the 48 or indicate that the screening number was just a normal fluctuation for me. I'm to limit protein and sodium, no dark colas, no NSaids, etc., etc. She's mostly concerned about my fluctuating BP. It roller coasters from highs like 180/106 (at the doc's today! And that's on meds!) clear down to 90/55. She's keeping me on my same BP meds (generics for Atacand HCT and Atenolol) and has added Amlodipine which I'm only to take when systolic goes above 150 and/or diastolic goes above 90. She'll call me on Friday with blood work results and may want a kidney ultrasound. From all of my reading, I was pretty much doing all that she's wanting me to do already. And, even if it doesn't come back as "officially" CKD, Stage 3... I will continue doing these things, as I suspect it's just a matter of time with my BP as it is (and has been). In two years, I've gone from eGFR of 70 to 64 last year to 48 this year (assuming that's confirmed). So.... does this sound like a reasonable plan/first steps for me?? Thanks!!

 
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Old 08-08-2012, 03:33 PM   #2
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Re: eGFR of 48... Reasonable plan/steps?

It sounds like your plan is pretty good to me. I wouldn't cut back on potassium and phosphorus until I was told to by a dietitian basing it on my blood work. These are difficult foods to cut back on (they're in all sorts of good and healthy foods) so why limit until necessary?
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Old 08-08-2012, 05:02 PM   #3
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Re: eGFR of 48... Reasonable plan/steps?

I personally would see a nephrologist if the 48 is confirmed. It could be the high blood pressure, but could be something else that is treatable as well. The ultrasound is good idea in meantime.

 
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Old 08-08-2012, 05:45 PM   #4
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Re: eGFR of 48... Reasonable plan/steps?

Thanks, Cora! I'm kinda just paying attention to Phos and Potassium.... I have a max level that I'm paying attention to, but it's more for awareness at this point. I go over and don't freak about it. My doc said to limit my protein to 4 servings.... I'm trying to grasp what that means, as she didn't give me a set number of grams. Sodium, because my BP is so wacky... I'm shooting for 1500 mg or less per day, but don't freak if I go up to 2000. I appreciate your input! I realize you're not a doc, but I also see how knowledgable you are... so I hope you don't mind if I pick your brain on occasion!!! Thanks, again!

 
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Old 08-08-2012, 05:51 PM   #5
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Re: eGFR of 48... Reasonable plan/steps?

I agree, Ladybug. I feel a little lucky, however as my general practitioner is an internal medicine doc who did two fellowships in nephrology. So, though she's not a nephrologist per se... I think she's more knowledgable then many GPs. I've been with her care all these years. I'll get a copy of my labs and see what she says. For sure, if I'm not comfortable with what we're doing, I'll ask for a referral. I know she'll be open to that. One thing that DOES baffle me a little is no protein in my urine. Wouldn't you expect that with an egfr of 48 and wacky high blood pressure??

 
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Old 08-08-2012, 06:05 PM   #6
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Re: eGFR of 48... Reasonable plan/steps?

The amount of protein in urine varies from person to person. As kidneys are damaged, different parts of it don't work as well at different times. Even when my kidneys were very bad I never leaked much protein. Go figure. Your creatinine level is a decent way to keep track of trends. It will go up and down over time but you will see a trend.
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Old 08-08-2012, 08:19 PM   #7
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Re: eGFR of 48... Reasonable plan/steps?

Not necessarily, as some conditions cause protein leaking into the urine and others do not. That is a good thing! Sounds like you are in good hands with your Dr.

 
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Old 08-10-2012, 11:02 PM   #8
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Re: eGFR of 48... Reasonable plan/steps?

Need some opinions. I went to the doc on Wednesday (8/8). Got a call from the doc's office today They said I'm "back to baseline," and they said no problem! I asked what my creatinine level was. It was 1.05. Based on the eGFR calculators you use, that puts it at either 59 or 55. That IS up from the 48 I had as a result in July, but is still below 60 (even if slightly). And.... that means that my trend was 70 in the fall 2 years ago. Last year it was 63... July it was 48 and this week either 59 or 55.... Should I accept that I have "no problem" and wait to see what kind of result I get at my annual physical in October/November? In the meantime, should 'I' choose to keep following the renal diet, work to get my BP, and personally see the trend and make the changes that I need to anyway? Should I push to see a Neph now or give it some time? I seem to be right on the fence.... not sure what I should think/do. Thanks!

 
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Old 08-10-2012, 11:20 PM   #9
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Re: eGFR of 48... Reasonable plan/steps?

Your precipitous drop in GFR in such a short period of time should be grounds for concern. I had a GFR reading of 90 in July of 2010 (as part of a pre-surgery blood work up), and by November of the same year, after issues with polyuria, and going to the ER, my GFR had dropped to about 79, where it has stayed fairly stable since. I, too, have shown no protein spillage or blood in urine for over a year. My kidney issues might be from a pituitary lesion spotted on an MRI. Only time will tell.
A good diet, including modest amounts of protein, low salt and reasonable potassium will be good for anyone, not just renal patients. You might be good to go for many years. All the best!

Last edited by Deanne1962; 08-10-2012 at 11:25 PM.

 
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