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Early CKD Support
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Ckd stage 3b

hi all im 24 years old and have been diagnosed with ckd stage3 today, i had only found out last year when i was pregnant with my son that i had ckd, well today my doctor told me my gfr is 40, my blood pressure and evrything else is perfect but serum eura level is high, does anyone know what that means and what causes it as my doctor didnt tell me. Im so worried as i have a 1year old and dont want it to get worse

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Hello and welcome Hennah05. This is a very informative and supportive community and I am sure that there will be lots of responses for you with support, advice and info.

I would however return to your GP and ask the questions that are concerning you. Write them down if you are afraid you will forget to ask some of the important ones that are bothering you. It doesn't say where you are from so I have included two very good sources of websites information.

Please keep posting on this site and keeping us up to date on your progress.

Good luck with your family.

Very best wishes,

MAS Nurse and Moderator.

nhs.uk/conditions/kidneydis...

kidneyresearchuk.org

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Thanks for the reply, as i will be sent to see a specialist soon i shall ask them as my doctor says he cant answer my questions as he doesnt know so best to ask the specialist everything

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what is "eura" level please?

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sorry i meant urea levels

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I believe you mean Urea, not eura. This is most commonly referred to as your BUN level. Many things can cause a high BUN level. Heart problems, dehydration, kidney problems, low blood pressure, a diet too high in protein, etc. Do you know what your level was? Personally speaking I can go for a serum test one day and have a BUN level of 30. Then 2 days later it could be 21. It is sensitive. However your doctors have diagnosed you as having 3b (me too). So there must be other kidney issues. A high BUN level by itself is not reason to be called 3B. I would assume your creatinine level is high?

I am surprised that the doctor just told you this and sent you home. I would either go back and have a prepared list of questions for him, or if possible seek another doctor and get another opinion. He should have at least advised you to drink plenty of water (60 to 70 ounces per day), keep your protein level consumption within daily recommended amounts (little beef, avoid too much coffee and tea, no soda, lots of water, try to remain active). He should have tested your urine to see if you have any protein beyond the normal amounts. A scan of the kidneys to see if anything is wrong (a growth, a blockage, damage). But perhaps you have had this done previously.

Also of interest is if this was a fasting serum test. When you fast for 12 hours you obviously increase your BUN (urea) level. So to expect a higher number. If I have a fasting blood work, and the BUN is high, my doctor always sends to me the lab for another test of kidney function (not cholesterol, etc.) with NO fasting. Each time, my urea level then appears normal. That is how sensitive it is to dehydration.

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hi sorry i meant urea levels, & i had a scan on my kidneys and they said both of my kidneys are small, i seen a specialist a few times when i was pregnant and one time after but was never told what to do and just to get a blood test after 1 year, so i went for a blood test and got my results the other day and the only thing my doctor told me was my kidney function is 40 and i have ckd stage 3. i wanted to know more but he said to wait to see a specialist and ask all my questions as they know more about it than him. He didnt mention anything about my urea levels i showed a friend my results and was told everything seems normal but that was the only thing high, also a year ago when they tested my urine they said there was alot of protein but since then they havnt checked

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Stage is determined by GFR only. GFR only uses creatinine and age. So basically Drs stage people for CKD using only serum creatinine.

I definitely agree with your statement that urine protein needs to be checked. Urine protein is the best way to check for “real” CKD. Serum creatinine is just a quick way to screen people.

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Thanks for the reply, hopefully the specialist will want to do a urine test to check for protein as my doctor says i dont need to as i have had a blood test

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The responsible thing to do would be for your regular doctor repeat the blood tests and add urine tests while you’re at it. Most common lab tests are automated and mistakes DO happen!

Instead your Dr apparently wants to stress you out and wait for a specialist when even a medical student would have you do what I described above.

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Yep. That is the problem with the entire staging approach. It only takes into account one thing from your blood. No consideration of urine, other diseases, your build, medications, medical conditions, etc., etc. In instills panic in people who really may be totally healthy when you take these other factors into account.

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Yeah. And if you look at the literature, the use of serum creatinine as a screening test (and to compute GFR) is hihly debated among physicians. The many physicians who dont debate this tend not to take these tests seriouly at all.

The end result is that there is a massive staging ststem determined by GFR, but many physicians tend to partially ignore the results because they think they are not reliable. What kind of screening method is that? Lots of REAL kidney patients likely get overlooked for years because many people do not trust the tests.

The dozens of methods of computing GFR over the last 20 years just make people wonder how real they are. I don’t doubt that there are many people with CKD, but you dont create a screening system, constantly change it and expect people to take it 100% seriously. To top that — Stage 3 is a WIDE range that you could drive a truck through. It gies from what is supposedly mild insufficiency to dangerously low function. Now stage 1 and 2 mean very little because there is no clinical correlation of their validity. You then jump into stage 3 and can be fine or dangerously insufficient with regard to kidney function. So how does this screen anything?

It’s not unlike the “new” blood pressure guidelines. They are very strict, but data to support them is few and far between. People dont trust guidelines that are constantly changing. Even cardiologists will quietly tell you that they are a bit excessive.

My point to all of this is that guidelines that do not work do not screen patients.

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Oh how I agree with all that. And blood pressure too. All you hear is 120/70. Well that is this weeks version, lol. But for years I took my father to a cardiologist (well respected) who said after 62-65 he wants 130's/80. I too see a cardiologist. Luckily so far only because of our family history. As a precaution. He tells me don't even blink an eye if I get 140/80, that it is fine for my age (69). He is part of a health system in our community which includes clinics, hospital, several doctors. They just sent out a flyer telling everyone that over 120/70 is now considered high blood pressure. I questioned him about the difference between his advice and their directive. He said "they don't know what they are talking about. Those that publish haven't been in the real word, or seen a real patient in their life". :).

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Try and get an appointment with a nephrologist they will be more informative that GP. Try not to stress over until you have better information. It can be scary I know. Good luck and let us know what's happening. This has been a great forum and very helpful and supportive.

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hi hopefully i should be seeing a specialist soon just waiting for an appointment so will definitely be asking alot of questions

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Anything on test results that are red or have a flag on them those are the most important to ask about. Those are the ones out of the normal range. Make them explain each one. They will probably do a blood panel and urine test.

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anyone know how i can add a picture of my results on here as i have no idea, maybe someone could help me understand it abit more as my doctor is useless

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No idea. Most just type a list of their results. I think (but don't know) that you are falling into one of the problems with the entire CKD system. We all talk of this many times on here. How many are classified as have disease, or told how bad things are, and are fearful. That the system does not take into account WHY a person may have lower than "normal" numbers. They just look up your Creatinine level on a chart, tell you have disease, what level it is, without ANY consideration that perhaps you are just perfectly fine for YOU. For your situation. For the way you were born. For example. I had a kidney removed because of cancer. Now my numbers of course are not "normal". I have one kidney doing the work of two. Impossible. So my numbers are high and they look at the chart and say I have CKD. When it is entirely possible that it is just because there is simply one kidney! Others have problems because they have some other medical condition. This makes their results not in the normal range. But in actuality the kidneys are NOT diseased. In your case your kidneys are small. The way you were born. Does this mean they are failing? Or are diseased? Or is it just that two small kidneys can not do the same work as two normal sized kidneys, and thus your numbers fall outside the "normal" range. But for YOU are perfectly normal and this is how YOU will be for the rest of your life. YOUR normal. In fact this may be exactly what your doctor is thinking. And he is just not communicative enough to tell you why he does not send you to other doctors, or take other actions. That as long as your "numbers" remain about the same from test to test (remember BUN can definitely change. A more important number is to look at your bun/creatinine ratio. It this is normal (I bet it is)), things are not bad.

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Thank you so much for ur reply, it means alot as i was just stressing out so much thinking all sorts

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i will post a picture of my results now

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hi im sure your doctor will refer you to kidney specialist to investigate reasons why you have this low function ..it could have come from young age..reflux is usual reason..infection goes up to kidneys from bladder due to under developed valves in wall of bladder..but im sure a specialist will find this out...regards chris...happy xmas😊

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