Early CKD Support
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GFR 63 From 70 in February

Hi guys,

I am a 46 year old mother of 3.

I was recently diagnosed with gallstones and I have had an underactive Thyroid for 24 years and am on Thyroxine. I went for a well woman check in June to be told my kidney function was on the low side. Had another blood test last week ....to be told my gfr had gone from 70 in Feb to 63 now!!

I am in total shock as I have had no symptoms the Dr doesn't seem unduly worried but I am beside myself. I am going back tmrw for another blood test to check my thyroid levels...Any advice?

19 Replies
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Go one step at a time and have questions prepared. GFR can fluctuate, but question it.

Let me know what your thyroid tests. I have it, too.

We are wondering if the two are somehow connected..mine is autoimmune.

Know I am standing beside you!

Get back to me!

B...

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Yes the Dr is questioning my Thyroxine levels apparently an underactive Thyroid can cause kidney function to reduce. Im just so shocked because ive had no symptoms!

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Hi there, please don't worry. Your kidney function is still fairly high in terms of kidney disease. In fact, most doctors consider anything above 60 as normal. In fact, it's amazing that you were even told about this as most people on this forum weren't told till their GFR went below 60 (and for some people it was much lower). Anyway, I want to reassure you that, depending on the cause of your low kidney function, most people, with good diet and exercise and sensible living can maintain their kidney function. I have been at CKD stage 3 for over 10 years (I'm 52 now)and my GFR has fluctuated from 60 down to 49 and back up to 60 again (with readings in between). GFR does fluctuate naturally and it's possible that with a few more readings, yours might go back up.

I'd wait till you talk to your doctor again and find out a bit more. Please don't panic though! If it is confirmed that your kidney function is staying a bit low, it shouldn't be something that is terrifying, it can be managed and it's unlikely you will have any symptoms. Come back once you know more and ask for further advice.

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Thank you for youre kind words.It was the gastroenterologist who is seeing me for my gallstones who mentioned Id had a slight dip in kidney function. My own Gone a not mentioned it. How have you managed to increase your GFR?

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Yes, I've increased my GFR with diet. I eat whole natural foods, plenty of fruit and veg. For me I have food intolerances (dairy, gluten, soya and alcohol) and find that avoiding the foods that I'm intolerant too, particularly diary, increases my GFR. Everyone is different but the general rules are avoid processed foods, salt and fizzy drinks. Try and cut down on red meat, dairy and alcohol. Also cut out smoking if you do, and exercise and relax :-)

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Certainly no need to panic. Without other supporting evidence of kidney damage such as protein/blood in urine, or damage seen on imaging you are in the "normal" range. And even if you do have kidney damage it would be mild at best. You'd be classified as stage 2. Many doctors don't even mention stage 2 disease to their patients cause they don't even consider it "real" disease. Your chance of progression would be extremely low. Watch your diet a bit, cut down on meat a tad bit, stay away from cola, limit you sodium and chances are you wont ever advance to the next stage.

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Thank you for you're comforting comments. I'm back in hospital today to get my Thyroxine checked and also idea in blood but the Dr didn't order any urine tests which I found odd. It's almost as if they are brushing it off!

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Sorry urea in blood

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One thing I did not see anyone mention is to drink more water. Dehydration can also result in lowering kidney function.

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Hi Lowraind,

A quick question...…..Any ideas on this one..... are small bubbles in urine normal?

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Found this on healthline.com

Why Is My Urine Foamy?

Symptoms

Causes

Risk factors

Diagnosis

Treatments

Outlook

Overview

Urine is normally pale yellow to dark amber in color and is also flat. A variety of factors, from diet to drugs to disease, can cause changes in the color and foaminess of your urine.

If your urine looks foamy, it could be because your bladder is full and the urine is hitting the toilet fast enough to stir up the water. But conditions that could also cause foamy urine are causes to see your doctor about.

Find out what makes your urine foam up and what you should do about it if it happens.

What other symptoms can occur with foamy urine?

Urine can foam up briefly every once in a while. This is usually due to the speed of urine flow.

Foamy urine is more likely to be a sign of disease if it happens often or it gets worse over time.

If your urine is foamy, look for other symptoms as well. These symptoms could be clues that a medical condition is causing the problem:

swelling in your hands, feet, face, and abdomen, which could be a sign of fluid buildup from damaged kidneys

fatigue

a loss of appetite

nausea

vomiting

trouble sleeping

changes in the amount of urine you produce

cloudy urine

darker colored urine

if you’re a male, dry orgasms or releasing little to no semen during orgasm

if you’re a male, infertility or having difficulty getting a female partner pregnant

What are the causes of foamy urine?

The most obvious cause of foamy urine is the speed of urination. Just as water foams up when it comes out of the tap quickly, urine foams if it hits the toilet quickly. This kind of foam should also clear up quickly.

Sometimes, urine can also foam up when it’s concentrated. Your urine is more concentrated if you haven’t had much water to drink and you’re dehydrated.

Foamy urine can also indicate that you have too much of a protein, such as albumin, in your urine. The protein in your urine reacts with the air to create foam.

Normally, your kidneys filter extra water and waste products out of your blood into your urine. Protein and other important substances that your body needs are too big to fit through the kidneys’ filters, so they stay in your bloodstream.

But when your kidneys are damaged, they don’t filter as well as they should. Damaged kidneys can allow too much protein to leak into your urine. This is called proteinuria. It’s a sign of chronic kidney disease or the late stage of kidney damage, called end-stage renal disease.

A less common cause of foamy urine is retrograde ejaculation, which is a condition that happens in men when semen backs up into the bladder instead of being released from the penis.

Taking the medicine phenazopyridine (Pyridium, AZO Standard, Uristat, AZO) is another less common cause of foamy urine. People take this medication to treat the pain from urinary tract infections.

And sometimes, the problem is actually just your toilet. Some toilet cleaning chemicals can make your urine look foamy. If this is the cause, the foam should stop as soon as you flush the cleaner out of the toilet.

What are the risk factors?

You might be more likely to have foamy urine if you have a full bladder, which can make your urine stream more forceful and faster.

The urine can also get foamy if it’s more concentrated, which can occur due to dehydration or pregnancy.

Protein in the urine can also cause foaminess and is usually due to kidney disease. You’re more likely to get kidney disease if you have:

diabetes

a family history of kidney disease

high blood pressure

The causes of retrograde ejaculation include:

diabetes

drugs used to treat high blood pressure, enlarged prostate, or mood

nerve damage from a spinal cord injury, diabetes, or multiple sclerosis

surgery on the prostate or urethra

Contact your doctor if you suspect you have kidney disease or retrograde ejaculation, or if your urine continues to look foamy.

How is the cause of foamy urine diagnosed?

Your doctor will likely take a urine sample to test protein levels in your urine. One urine test, taken over a 24-hour period, compares albumin levels to levels of creatinine, which is a substance produced when muscles break down.

This is called the urine albumin-to-creatinine ratio (UACR). It shows how well your kidneys are filtering your blood. If your UACR is higher than 30 milligrams per gram (mg/g), you might have kidney disease. Your doctor will do other tests to check how well your kidneys are working.

If retrograde ejaculation is a suspected cause for your foamy urine, your doctor will check for sperm in your urine.

How are the causes of foamy urine treated?

Treatment for foamy urine depends on its cause. If your urine is concentrated, drinking more water and other fluids will relieve dehydration and stop the foaming.

Treatment for diabetes and high blood pressure

When foamy urine is caused by kidney damage, you’ll need to treat the cause. Often, diabetes and high blood pressure cause kidney disease. You can slow down the progression of kidney damage by managing these conditions well.

Your doctor will recommend that you eat a balanced diet and get plenty of exercise to help treat diabetes. You’ll have to test your blood sugar often to make sure it’s staying within a healthy range.

High blood sugar can damage your kidneys. You might also need to take medicine that lowers your blood sugar.

For high blood pressure, you’ll also want to watch your diet and stay active. Limiting the salt and protein in your diet can both bring down blood pressure and prevent your kidneys from having to work so hard.

Your doctor can prescribe calcium channel blockers, diuretics, or other drugs that lower blood pressure. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are two drugs that lower blood pressure and protect the kidneys from additional damage.

Treatment for retrograde ejaculation

Retrograde ejaculation doesn’t need to be treated unless you want to father a child or the dry orgasms bother you. Your doctor can treat this condition with drugs that are approved for use for other conditions but that also close the bladder neck so that semen can’t get inside your bladder.

Off-label use of the following drugs can help treat this condition:

brompheniramine

chlorpheniramine (Chlor-Trimeton Allergy 12 Hour, Chlorphen SR)

ephedrine

imipramine (Tofranil)

phenylephrine (4-Way Nasal, Neo-Synephrine, Neo-Synephrine Mild, Neo-Synephrine Extra Strength)

pseudoephedrine (Sudafed Congestion, Nexafed, Zephrex-D)

“Off-label drug use” means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that hasn’t been approved. However, a doctor can still use the drug for that purpose.

This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think it is best for your care.

What’s the outlook?

Foamy urine may not be a problem if it happens every once in a while. If it continues, it could be a sign that you have kidney damage. Usually, this symptom appears late in kidney disease, so immediate treatment is important.

Less often, it could be a sign of retrograde ejaculation if you’re a male, or it could be an effect of a drug you’re taking. Treating the condition or stopping the drug that’s causing it should stop the foaming.

Most of the time, foamy urine is nothing to worry about. Often, you can relieve foamy urine simply by drinking more water.

But see your doctor if:

the foamy urine doesn’t go away within a few days

you also have symptoms like swelling, nausea, vomiting, appetite loss, and fatigue

your urine is also cloudy or bloody

if you’re a male, your orgasms produce little to no fluid or you’ve been trying to get your female partner pregnant for a year or longer without success

So, I guess, if it continues, you should let your dr. know.

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Thanks for a very comprehensive answer!

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You are welcome. Something I knew nothing about.

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Hi DIY,

Thinking of you! Honestly, your feelings are very normal as the words kidney function issue are a shock as it is your body. Unfortunately, in most cases there are no outward symptoms. We are both lucky that labs were run and we were made aware of an issue at the base stages.

As I mentioned, your GFR can fluctuate; even a cold can influence it. Anywhere between 96 and 60 is not dreadful.

What were your other labs? Creatinine level? Albumin level? I keep an eye on that as well as my sodium, potassium and phosphorus levels.

I have questioned that my Hashimotos hypo thyroid has i influenced my Membraneous Nephropathy kidneys as they are both autoimmune. See what the thyroid results show.

They both can be controlled; thyroid with medication and as Cruz, Julesbuz and lowraind have said, kidney through diet.

The 4 keys are low protein, low sodium watching potassium and phosphorus.

I avoid soy due to my thyroid.

Lots of fresh and fresh frozen vegetables, no red meat or processed foods such as cold cuts or canned soups. Keep an eye on the sodium levels.

Hummus is great vegetable protein and beans as well.

Easy on the dairy, I actually switched to Carnation Fat Free Original Creamer- liquid and don't miss the milk.

Potatoes are high in potassium so moderation. Check your labs.

Loweraind is right on about water and hydration, especially in this hot weather. I even add a splash of lemon to my water for variety.

I know that it is instinctive to panic when kidneys are mentioned. Just sit tight and see the doctor, adjust the diet and please reach out to any of us day or night, as one of us will always be here to listen and support.

Sending you warm thoughts..

Looking forward to hearing from you..

Bet

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Hi Bet

My Thyroid levels were 3.8 so within the range he has increased my dose to 150mg. My urine was clear and my cholesterol at 5 but he said my good cholesterol was at a good level.My blood pressure was 125/85. He also said he can't refer me to a Kidney specialist until it goes below 60! In the end he said he was a bit baffled!!!

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hi, don't panic but do your own searching. Doctors really don't have a lot of answered. I think it is coming from medicines used, poor eating habits etc. I read on the kidney foundation site that 38 million have kidney disease and most don't know it. Prescription meds for stomach, pain killers, steroids, supplements, etc. are hard for kidney to filter. I no longer take vitamins, went off cholesterol medicine because I exercise hard every day and watch what I eat and no proof meds help. So maybe look up kidney diet suggestions, lots and lots of water, little soda, alcohol, smoking. A sizeable kidney stone destroyed one of my kidneys...at least doctor thinks so.

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Sounds like a plan!

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Hi DIY,

Thanks for getting back to me..was thinking about you!

Good news is that your urine is clear of protein, very much in your favor.

I'm not surprised that your doctor increased your thyroid medication. I had mine increased in the spring.

Do you know what your TSH, T3, T4 and ferretin levels are?

I would ask.

As far as the GI and gall stones, a good place to consult. See what he says about his area and ask if this could be effecting your GFR. I have found my GI to be great and knowledgeable.

It amazes me that you were not referred to a nephrologist or urologist if you would like to see one.

Your kidney function is not bad at all, but you have the right to check.

I agree about making some diet changes and see if it helps.

Minimal dairy, low sodium, no red meat and alot of fresh or fresh frozen vegetables such as cauliflower, broccoli, cabbage, onion and peppers. Fresh fruit as apples, strawberries and blueberries.

I know that when my bro-in-law was awaiting the removal of his gall bladder, the surgeon had him on wheat toast, oatmeal, boiled or broiled chicken, steamed veggies and salad without mayo based dressing and salt.

He dropped weight and felt much better.

Give it a try and continue to drink water.

Let me know the outcome.

I am behind you all of the way!

Bet 👍

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Hey

My GFR dropped from 63 to 62.8 in five days I don't smoke/drink/do drugs.... I eat very healthily .

My weight is 69kg but height is only 5ft 2 so I know I need to lose another 10kg.Although in February it was 77kg.

So it is defo on a downward trend but Dr has no clue as to why!

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