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missdebbie 01-09-2013 12:27 PM

New Here, kidney failure ?
Hi, My husband who is 69 is in stage 3 kidney failure, has uncontrolled diabetes, COPD, had a heart attack 20 yrs ago, has
A fibs, is having PVC's all the time and a low heart rate of 40 at this time. We seen his kidney doctor yesterday. I am concerned about his health. He went from his eGFR 3 months ago being 55 to 42 now. His creatanine number is 1.79. His sugar numbers are all over the place. He does not take very good care of himself. Not sure what this all means, just very worried and scared right now!

Cora1003 01-09-2013 01:52 PM

Re: New Here, kidney failure ?
By looking after his diabetes and his kidneys, it may be a very long time before he required dialysis. His creatinine, in the big scheme of things, is not really that high. Mine was at over 10 before I took the plunge.

In the meantime, he needs to get better control of his diabetes. This is very important for the kidneys and also his heart disease. Has he seen a cde (certified diabetes educator)? This can be of great help. Also a renal dietitian will help keep things stable for the kidney. Sometimes the 2 diets conflict, and it is very important to follow the renal plan and adjust with insulin for the diabetic stuff.

Hope this helps a bit. Feel free to ask lots of questions.

missdebbie 01-09-2013 02:13 PM

Re: New Here, kidney failure ?
He has seen a cde for his diabetes, not one for renal. He says he taking care of himself (according to him) he's always having things he knows he should not have.I have been doing my best to try and help, but I'm about ready to give up. Why would his eGFR number go from 55 3 months ago down to 42 now? Should I be worried about this?

ladybud 01-09-2013 02:13 PM

Re: New Here, kidney failure ?
Have the Drs determined why his heart rate is only 40? That may be temporarily causing trouble for his kidneys by lack of adequate blood flow to them. I would ask more about that, and make sure they have checked his thyroid. If it is a conduction problem in the heart, has there been any mention of a pacemaker? I can't imagine he feels very well with a pulse of 40 and the other problems he has. The advice by Cora is good, and I would try your best to get him to do what he can to get his blood sugars controlled, and press for some answers about his heart rate. Maybe he is on medicine that is lowering his rate too much and just needs a dose adjustment? It could be something simple.

missdebbie 01-09-2013 02:20 PM

Re: New Here, kidney failure ?
They took him off one of his meds, thinking that it my of been causing the low heart rate. But it's still low. Yes they have mentioned a pacemaker, but nothing has been done. I am scared about the drop in his eGFR number. We seen a different doctor yesterday and he was no help at all for me, he did not even want to talk to me.

Cora1003 01-09-2013 02:30 PM

Re: New Here, kidney failure ?
Don't worry quite so much about the eGFR. The "e" stands for estimated. It is based on an assumed body size. It can vary a great deal depending on how hydrated/dehydrated he is when he has his labwork done. Yes, his function probably slipped, but it may pop up somewhat again. That is the nature of the best - the levels go up and down. Watch for trends over longer periods of time. Don't get too excited if it looks like things are improving, and don't get too upset if they drop. It is typically a long, slow process.

writeleft 01-09-2013 02:34 PM

Re: New Here, kidney failure ?

About the big jumps in his eGFR, I have had experience with the same things, both going way down, and then going back up as well.

For me, keeping my BP, weight and fitness seems to have an effect on my GFR. I have dipped as low as 16, and have crawled my way back up to the high 20's My initial drop came after having strokes, 10 years ago now. My creatinine is in the 2.5 range.

Although I have been through the counseling for dialysis, it is not in my immediate future.

I agree with the others, that managing his diabetes and other medical issues is the first step in protecting his kidneys.

ladybud 01-09-2013 02:35 PM

Re: New Here, kidney failure ?
I would not be too worried about the drop in his eGFR, as that may be temporary and may be better next time it is checked. It fluctuates like most things in the body over time. I would talk to his cardiologist about the pulse problem. A low thyroid hormone can cause a slow rate like that or a conduction defect in the heart. It is also possible he is having so many PVCs that it is falsely lowering his pulse rate. If his heart rate improves, his blood flow to kidneys should improve and the eGFR would come up. The creatinine, and its trend, is more useful for evaluating overall kidney function.

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