Stage 3 to 2: how I brought down creatinine levels and question about results

I am a 55 year old guy, in good shape, no high blood pressure, no diabetes, no hypertension. Don't smoke, drink and workout 3x a week since my 20s.

Since 2007 my GFR has always really been between a 69 and a 78. I am pretty muscular.

This past June 3rd, I got results back that were a creatinine of 121 umol and GFR of 58. So, like most people being told I am in "stage 3 renal disease", I panicked.

Up to that test, I had been eating a lot of meat, sometimes twice a day for at least 6 months, including some 18 hrs before the test and also didn't drink for 12 hrs before the test. I'd been dealing with some sort of stomach bug, so I took that into account.

I cut out meat, increased water intake from 1-1.5 liters a day to 3.5-4 liters, and increased fiber with a lot of whole grains (bulgur, oats, quiona etc) and psyllium fiber supplements and lots of vegetables/fruits. The only animal protein was a piece of salmon a day (but no red meat/poultry/pork etc). And didn't exercise 5 days before the next test this week on July 22 (so, 6 weeks later)

Also drank one cup of nettle tea a day. Added fish oil and CO Q10, both of which are good for cardiac function and anti-inflammatory (anything that helps with circulation will be good for kidneys as heart and kidney function are intimately connected)

Now my creatinine is down to 104 and GFR up to 70 in 6 weeks.

One question I have though is my PCP also sent me home with a 24-hr urine collection. I wonder about these results which show my urine creatinine as being roughly in the middle of normal but the 24 hr urine creatinine as being at the high end of normal range:

Creatinine 9.6 (range: 3.5-24.5 mmol/L)

Creatinine (24 hr urine) 19.2 (range: 7.8-20 mmol/Day)

is the high 24 hr urine clearance bad?

My thinking is that having the opposite, high serum (blood) creatinine and low urine clearance would be bad. This would likely tell us that the kidneys, not working properly are not excreting creatinine, so it results in low in urine clearance and building up of levels in the blood.

So, would it be that is it good to have low serum/blood levels of creatinine and higher urine clearance levels - or is having higher 24 urine clearance levels of creatinine a concern?

[MAS_Nurse]

Hi Specimen65 and welcome to this caring forum where you will receive support from other members. You will find the following website helpful in answer to your query--

Proteinuria-edren.org

edren.org/ren/edren-innfo/proteinuria

Please can members of the forum pop by and say hello to Specimen65, please?

Thank you and best wishes.

[Hidden in reply to MAS_Nurse]

Thanks! It is really something to read how widespread this issue is with so many people.

[Bassetmommer]

HI Specimen,

Good for you and your test results. Humans consume way to much protein in general so It was a good thing you did by cutting down the meat. A long time ago, my college professor told me that the way someone or something's teeth were in their head dictated what they should eat. Hence we have very limited incisors, for tearing meat, but many molars for grinding fruits, veggies and grains. It make sense to me.

[Hidden in reply to Bassetmommer]

This makes a lot of sense. I don't really miss meat at all, especially given meat prices. My lipoproteins are much better too.

I bet this is why most CKD patients do much better on a plant-based or DASH diet or similar.

I read one study that patients with CKD prevented progression of the disease with a diet high in fiber and lower in protein. (apart from keeping blood pressure, blood sugar and LDL levels in check)

[HA_Q8]

How did you know you have CKD? Do you have protein in your urine?

[Hidden in reply to HA_Q8]

It all started after I had the test results from my June 3 lab test. The doctor called me and told me "your GFR is 58, which tells us you already have stage 3 kidney disease. You have the kidneys of a 65 yr old already"

So I read a lot about this for weeks on end. This whole "not telling patients till they are in stage 3" seems like malpractice - if stage 1 and 2 are actually a real disease. Would be better if they told people when they are in those stages to make lifestyle changes rather than springing this on them years down the road when things have progressed for the worse.

I did two urine tests this week, both came back with below the lab range. Something like 'Unable to calculate 24-hr excretion as the concentration is less than the lower limit of the analytical range of the method."

So, it looks like no protein in the urine or not enough to calculate anything from.

The only thing I had was a 24 creatinine urinary excretion at the very high end of normal. But normal serum creatinine. (am thinking that someone with advanced CKD would show high serum creatinine and low urinary creatinine clearance).

[HA_Q8]

I think the eGFR should be <60 for 3 months? to be CKD?

Also, If the is no protein how they consider you as CKD patient?

Some doctors on Twitter told me to do Kidneys Biopsy, what you think? did your doctor told you this?

You said your eGFR is in thr 70s since you are in your 20s ???

If your creatinine went down, does that mean you have no CKD? what you think?

I have been studying and doing searching on many research papers about these stuff, the muscle mass play a big role also.

[Marvin8]

My suggestion is to insist that your cystatin-c be checked next time you go in for your bloods. Verify it against the serum creatinine and you'll put your mind to rest.

[RickHow]

Very interesting post and lots of info. My initial reaction (of course I'm no doctor). First the water intake. Of course drinking lots of water will lower your creatinine level. You are "flushing" more through your kidneys. The higher the hydration the lower the level. BUT while this is really important, and healthy (to get toxins out of the body) you have to consider what is your REAL kidney function. It is looking better than it actually is due to high water intake. If you were to take in normal amounts of water, a better reflection of true kidney function, the results would be higher. That said though, again, drinking the water is great.

You talked about urine test results over a 24 hour period. This is a great test, much better than a spot test. Because again it shows the true performance of the body. Because for those 8 or more hours you are asleep, you are not hydrating. And generally speaking for 2 or 3 hours before bed, most do not drink high volumes either. So the results of this test are the ones you need to focus on.