Worried and feeling depress kidney funct... - Early CKD Support

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Worried and feeling depress kidney function when down from 54 to 44 need advice plzzz

jennifer24
jennifer24

Hi everyone I'm just driving myself crazy feeling depress and sad I am really tryin to forget about it and focus on other things but I cant help thinking about my kidney fuction going down from 54 to 44 in 3 months. I recently started taking this blood preassure med called candersatan I didnt had any allergic reaction like the other one so I have confident that my kidney function would be good when to the dr with a positive attitude next thing u know the dr says my creatiane is 1.4 and my gfr when down to 44 I instantly wanted to cry im really concern this dr I been seeing him for almost a year now he said that this med do cause gfr to go down so theres hope . But honestly I'm freaking out plus he looked concern too every since i been seeing him he had change 3 blood preassure medications and all caused my gfr to go down I'm really I'm hoping this is the case now too. Can anyone give me advice on how to take this news and remain calm and positive I know this causes more harm to my kidney.. I'm just praying to God to give me strength....

25 Replies
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Hi there, First of all, you should realise that the method of testing they do to determine our Kidney function is only an estimate. That is why they call it the eGFR where the e stands for estimate. Second thing to note is that our kidney level can be affected by how much exercise we have done before the blood was taken, what we have had to eat and how hydrated we are. So you may be worrying about nothing and your kidneys have not dropped at all. Also, as you have noted yourself some blood pressure tablets can temporarily affect your kidney performance. The ones I was given did this but when the doctor took me off them the level of kidney function increased. If you are not happy that your doctor is doing enough then are you able to try someone else. This forum is a really good source of advice.

Rabbit01 said it all. There are so many factors that come to play when checking kidney function. If I am dehydrated it makes my creatinine rise and eGFR fall. So your lab numbers could be the result of that. The most important thing is for you to relax and don't let CKD control your life. Make sure that your blood pressure is under good control. High blood pressure can lead to kidney damage.

jennifer24
jennifer24
in reply to WYOAnne

Yea I understand that but my blood preassure is stable I'm just hoping is the med that is doing this called candersatan I was told it effects gfr I'm just praying the when I go back is up again

Are you also controlling your diet and drinking enough? I have been able to lower my creatinine level and increase my GFR. Are you seeing a nephrologist, and if so, are your nephrologist and personal physician in communication?

Yea I have a kidney transplant for 17 years now I'm recently switch dr to this new one I been stable for a long time until I seem this dr and my gfr has gone up and down he has been switching my BP meds like 3 times because they all affect my gfr he recently prescribe me this new one called candersatan which I think caused the gfr to go down plus i dont eat red meat, drink 6 bottles of water a day no Soda no fast food just once a month eat veggies vitamins that I been prescribe also only eat chicken ,Turkey and fish

Hi, Jennifer. Candesartan is in the class of blood pressure drugs called ARBs (angiotensin receptor blockers). ARBs and ACEs are often used for patients with kidney disease because they not only reduce blood pressure, but they protect the kidneys in various ways. For example, they help reduce proteinuria (protein in the urine), which is one of the things which can make your kidney disease worse over time. Do you happen to know if you have proteinuria, and what the values for protein in the urine were before starting candersartan and now? Hopefully, you'll see a decrease! Many people incorrectly presume GFR is the one and only yardstick of kidney disease. But GFR AND amount of proteinuria are the two key measures of kidney disease progression; and of the two, amount of proteinuria is the more important, because it can cause the GFR to lower too over time.

Even as they are helping slow kidney disease, ARBs and ACEs frequently reduce GFR a bit too. That may seem paradoxical. But here's why it happens. GFR (glomerular filtration rate) is a flow rate. An ARB not only reduces the blood pressure in the entire body; it can also reduce the intra-glomerular pressure (the blood pressure in the kidneys), by dilating the vasculature in the kidneys. It's a little technical, but here's a great article on this:

onlinelibrary.wiley.com/doi...

("What Should the Physician Do When Creatinine Increases After Starting an Angiotensin-Converting Enzyme Inhibitor or an Angiotensin Receptor Blocker?").

So the GFR goes down but that's okay and even expected -- if the drop is within a certain range, and it doesn't keep dropping. Here's from the article: "So what is an acceptable increase in creatinine level? An increase in creatinine concentration of about 25%–30% above baseline is acceptable (eg, creatinine level of 1.2 mg⁄dL increasing to 1.5 mg⁄dL)." Or equivalently: a 25% - 30% drop in eGFR is "acceptable". In your case, that would mean a drop from 54 to down to 38 (30% drop) would be acceptable. Just keep checking the creatinine levels and eGFR, and if the eGFR continues to drop you probably want to get off the ARB.

Hope this helps reassure you! :-)

P.S. Here's an excellent paper on slowing/stabilizing kidney disease by reducing proteinuria (using ARBs or ACE inhibitors):

ncbi.nlm.nih.gov/pmc/articl...

Thankz for that article very helpful and yes u have protein but in blood is called albumin I think but not protein in the urine . I understand wat u mean but I been stable for so long that as soon as he changed my meds I started having issues with my gfr here are a list of the BP meds I been takin so far wit this dr

Varsatan

Ramipril

Candersatan

All effect my gfr drastically!!!!

You sure about not having protein in the urine? Was just looking at your message from a year ago. . .

healthunlocked.com/early-ck...

No last year when that happen I when to the emergency room and checked and there was no protein in the urine

2 months ago was 1.4 and my old dr said it was ook

Brilliantly written and really helpful, Chris.

Thanks Chris! You write so clearly and helpfully.

And one more article. . . This very claridying quote is from the president of the National Kidney Foundation. She writes about ACE inhibitors, but the same points apply to an ARB like candesartan:

medscape.com/viewarticle/76...

"That is the finger on the garden-hose analogy that I always use: Angiotensin II is like your finger on the end of a garden hose; it causes the water to spurt out and increases pressure within the garden hose. If you take angiotensin II off, the water plunks out and the pressure within the hose is much less. It is good for a kidney to have that pressure within the glomerular network reduced, but it decreases filtration fraction because the pressure is less. It lowers everyone's calculated GFR (glomerular filtration rate) but does not hurt kidney function. Nonetheless, this always makes us nervous. We think that we have lost kidney function because of the ACE inhibitor, but we really have not."

If you new drug caused your eGFR to decline it should stabilize rather quickly. So you should retest in a few months. If your eGFR is still about the same then it will likely be your new baseline. And with no further decline it would then be reasonable to conclude that the new med was indeed the cause of your creatinine spike. And then all is well! No protein in your urine is another clue that points to the possibility that your new drug caused your eGFR to fall. It would be extremely unusual to have a “true” gfr that low and not have any protein in your urine. One would expect at least trace amounts.

hi..try not to panic iv been through the same..i can give you advice on my own experiences..avoid painkillers.cut out salt added to food..lower intake of red meat..avoid high fat food cheese etc..lower weight to bmi levels.and most of all dont worry and smile a lot😊..chris

please dont stress...keep well hydrated..add no salt to food..avoid pain killers..avoid excess red meat..eat fish and veg diet..keep weight at bmi levels...and the most important thing is ...😊😊😊😊😊😊😊

Thankz I'm trying I'm really I'm but it's hard I feel like im in a dark place right now im honestly not looking forward for any bad news

i was working 5 days on 12 egfr..now have new kidney...dont worry😊😊😊😊

Good for u but I do worry I have my kidney transplant for 17 years I really dont want to go back to dialysis those r horrible memories so I'm tryin my best to preserve my kidney pluz for others kidney transplant may come to then months and weeks and other years especially with my blood type

Hidden
Hidden
in reply to toeragthecat21

So glad to hear you have new kidney!

You are such an encourager 😊

jennifer24
jennifer24
in reply to Hidden

Thankz thankz to God next year is gonna be 18 years with my kidney keeping strength and faith but most of all smiling

Hi jennifer, how's your condition today?

From what you wrote here, you really worried about your condition right now.. And I think that is normal.

But, even people trying to give you their support.. You still scared..but it was 9 days ago. How about now? (Sorry if my english not pretty good)..

How is your kidney condition and how is your feeling now?

I came here, when I try to find some information for my dad. He has a problem with his kidney a long with his heart and diabetes hehehe... But that's my story.

How about you? Kidney problem is really new for me. So I can't give you some explanation about your kidney test. But I know a lot about anxiety. I know this mental state can make your healthy getting worse.

Don't make your condition stopping for doing something you like...

Pampering your self to make you feel relax and joy again.

Contact and be with people who really love and care about you... Not only from this forum.. But real people around you..

More hugs and kiss..

When I read all the comments, all people here really kind and I think is your turn to be more kind to your self.

When my father know about his condition, he feels really worried.. it's really understandable.. And it make him little bit withdrawl and lost his motivation to live..

But after there is a little improvement.. He get more lighter.. Well of course he will feeling that way..

But I mean, it help him much better...

I hope today, your condition is more better than when your posting your concern here

Hey well I had a kidney transplant when I was 13 years old I was on dialysis for 6 months so I was lucky to only be on it for a short period the drs never really figure out what caused it all they know that it probably was some bacteria or something because in six months my kidneys were done. But anyhow, I'm here, 17 years since my kidney transplant going to 18 years thanks to father may he rest in peace the reason now I get really worried and nervous is because I been stable in stage 2 ckd for such a long time and now being at stage 3 frightened me and I panic but thankfully I'm doing better my gfr when up. I'm still on stage 3 but I'm having faith that I could stay on that stage for a while as long as I take care of myself so I'm tryin my best. The dr says I'm doing pretty well so that relaxes me and I'm content right now with my new results just have to deal with it and try my best . Thankz for being interested in my condition I appreciated it and good luck to your dad .🙏👍

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