27 years old male, CKD stage 2 at 82. How long it can be predicted to preserve my kidney status at stage 2?

[spiritvan]

I am 27 years old, got CKD stage 2 with GFR at 82 two days ago. My Creatinine level is 1.08 but ratio Albumin/Creatinine is 12.22 mg/mmol and Proteinuria is at 1.0 g/L. As I know my Creatinine level is normal, but Albumin/Creatinine is so high. What should I do to decrease Albumin/Creatinine level and also is it possible to decrease my Proteinuria? With the appropriate lifestyle and diet from now, is my current status dangerous and how long I can predict to preserve my kidney in stage 2?

[Bassetmommer]

HI Spiritvan, No one can predict how long someone can stay at any stage. With proper diet and a healthy life, you can be there forever. But something can come along and change all that like an illness or medicine. The best defense is to become educated on CKD. There is a ton of material here on this site and out there on the internet. Take the time now to learn.

kidney.org/

[spiritvan in reply to Bassetmommer]

Thank you very much Bassetmommer for you advise. It's a long way ahead for me to start living with CKD and preserve the current stage.

[Marvin8]

First off, it's possible your creatinine level is normal for you and your age and that you don't technically have kidney disease. The only concern I'd have is what's causing the leaking of protein in your urine. Fyi, my creatine stayed in the 1.1 range for 20 years and is now in the 1.3-1.4 range. Back then, I was within the reference range. Today I'm not. I'm at Stage 3A, but then again, I'm also 61. Btw, I would ask for a cycstatin-C test to better ascertain your prognosis if you truly have kidney disease. If your doc doesn't know what a cystatin-C test is or what it's used for, read up on it, then educate him/her. Did you ever get an ultrasound? GP's aren't quite as knowledgeable about diagnosing ckd as nephrologists and many nephrologists feel that creatinine is not the best way to diagnose ckd. And never forget that most nephrologists also own pieces of dialysis centers. I'll leave it at that.

[spiritvan in reply to Marvin8]

No, I didn't have the ultrasound and my GP concluded right away with my eGFR and the proteinuria. Thanks for your advise, I will do the cycstatin-C.

[spiritvan in reply to Marvin8]

Btw, how did you do that with 20 years stable before stage 3A? I am so depressed now. I am too young and even don't have a girlfriend

[Marvin8 in reply to spiritvan]

I understand how you feel, but try not to let yourself down because stress doesn't help kidneys. The major difference between then and now is that they changed the reference range. My creatinine was 1.1 back then and the upper limit of the reference range was 1.5. My creatinine is now about 1.35 and I'm 20 years older. I was never hydrating properly all these years and I'd taken some drugs for ulcerative colitis. Those two factors combined with a couple of kidney stones probably caused my disease. If I could give somebody advice to heed, it would be to make sure you're always properly hydrated.

[spiritvan in reply to Marvin8]

Really appreciate your advise Marvin8 . My creatinine is now raised to 1.19 after taking Telmisartan for some days. I really concern if it's a bad effect of that meds besides that good point of lowering my BP or not. Btw, I am glad to know that you've been keeping your status for very long time.

[Marvin8 in reply to spiritvan]

Generally speaking, a rise in creatinine of up to 30% is permissible once starting an ACE, ARB, or other blood pressure medication. I'm no doctor, but your 45% increase seems a bit concerning and is something you should ask your nephrologist about. At the very minimum, you should be having blood work every week or two when starting such a medication in order to make sure your creatinine levels don't stay elevated at that higher level. Hyperkalemia (high potassium) is the other condition that can occur when started one of these BP meds. Please talk to your doctor and see what he/she says and get back to us. Good luck.

[spiritvan in reply to Marvin8]

Thanks for your advise. As my calculation, it is now around 11% (increment from 1.08 to 1.19). Btw, I will talk to my doctor next week to see if she has any alternative meds or keeps it.

[Marvin8 in reply to spiritvan]

Sorry, my mistake. I was thinking your creatinine was around .85.

The 11% increase in creatinine is perfectly fine with a BP med and it "may" even lower over time.

[spiritvan in reply to Marvin8]

Hi Marvin8 ,I just did the Cystatin-C test and the result is 0.98mg/L. It's slightly out normal range (0.56 - 0.95mg/L). Can it be considerable level combined with my eGFR 82? Thank you.

[Marvin8 in reply to spiritvan]

It would appear that you are at a very mild stage of kidney disease. If you treat yourself properly with diet and hydration and keep your blood pressure normal, it probably won't progress.

[RickHow]

The feelings and questions and worry you have are normal considering your GP seems to have just told you this information but apparently not done much about it. He should have instructed you on some guideline things to do for your kidneys. Such as diet, exercise, etc., etc. Also, excess of protein in the urine is most often a sign of a weakening kidney. But it is not the only cause. You may have something going on that your body is simply producing excess proteins. Or you are perhaps consuming excess protein (foods high in protein, protein drinks, etc.). Or there is something else biologically happening. Did your blood test show any abnormalities?

But first calm yourself. Stage 2 is MILD kidney disease. So most doctors will attempt to find what is the cause of this disease. Is it in both kidneys or just one. And ultrasound could show any growths or abnormalities in the kidney. Do you have high blood pressure. Signs of diabetes. Medications. These could all cause "damage" to the kidney and by fixing them you could prevent further damage.

Here is a link all about excess protein. webmd.com/a-to-z-guides/pro...

Here is another link to a reputable site about stage 2 disease and things to do to stop, slow progression. kidneyfund.org/kidney-disea...

About your future? No one knows. But you already received a post of someone who was in that stage for 20 years or more. You have not been given a death sentence. Find a doctor who will do further testing to see what is causing the problem, or if it simply is the kidney itself. Follow the normal preventative measures (diet, exercise, no alcohol, no smoking, et.c).

Get another urine test! Be sure of the accuracy of the test that led to your current determination.

[Marvin8 in reply to RickHow]

I think they mostly just changed the reference range. I've never been one to hydrate properly and was on a harmful inflammatory med for a long time that required good hydration. Those two combined probably caused my problem.

[spiritvan in reply to RickHow]

Thank you RickHow for your very detailed sharing. For my blood test, I got high result of LDL, which is 4.42 mmol/L, and cholesterol 6.4mmol/L. My GP gave me meds to reduce cholesterol and blood pressure, that combines with Albumin. I am changing my lifestyle, reduce protein, avoid alcohol and sodas, cut off salt and do more exercise. The retest will be next 4 months. The root cause for Proteinuria was just blamed on my high blood pressure I guess, so she didn't do the ultrasound or any other test besides.

[RickHow in reply to spiritvan]

Sounds like you are proceeding "normally". Yes high blood pressure can definitely be the root cause of all your problems. The hardest part of any disease is waiting (for next testing after medications, etc.).

[spiritvan in reply to RickHow]

Thank for your comment. I am keeping the pace to control BP under 120/80 at home. Sometimes, it's only 100/70, especially after waking up. But during work, it may bump up to 140/90 due to some stress. I am also using Telmisartan to reduce both BP and Albumin for almost one week.

[RickHow in reply to spiritvan]

That's good bp. You are doing well. I get about the same, although for me when I get up in the morning is when my bp is the highest. My doctor has me take my pressure 3 times daily. He stresses that the most important thing is to try to take it the same time each day. I am using lisinopril (bp med) to control protein, and amlodipine for bp control.

[spiritvan in reply to RickHow]

Today I saw the side effect test result of using ARB medicine (Telmisartan) that it makes my Creatinine level raise from 1.08 to 1.19mg/dL and decrease my eGFR to 73 just for 3 days after using it. Is it really a big problem and bad effect of the medicine that used for lowering BP?

[RickHow in reply to spiritvan]

I too have heard that ARB's can increase your creatinine levels. However I have also read that an increase of up to 30% can be expected, but if it is providing proper bp control it is acceptable. To me, it would make me nervous. There are so many bp medications I personally do not see the need to use a drug which does increase creatinine. Now, it does not increase it for everyone. But seems to have done so to you. Speak to doctor about a change. One of my drugs is an ACE. It too can increase creatinine levels up to 20% (10% less than ARB). However that was not my experience. We all react to medications differently. With your doctor experiment differerent ones until you find one that provides bp control, without significant change in creatinine.

[johnmehta123]

are you or your doctor considering getting a biopsy done? it can help to identify root cause and develop better treatment plan

[spiritvan in reply to johnmehta123]

Hi johnmehta123 . Thanks for your advise. My GP didn't really care about the root cause so she didn't send me for biopsy. I read about biospy and they also recommend to have it when it's uncleat to judge root cause. I am just basically treating my BP and keep it around 120/80 and low down my cholesteral. I have no diabetes. My acid uric is also normal. I just took Cystatin-C today and let see how bad it is.

[spiritvan]

Hi all,

After 2 weeks taking meds and diet as well as exercising everyday, I retest my own with a private lab and got the result of decrease ACR and protein in urine, which is reduced from 108mg/g to 36mg/g and 100mg/dL to negative with spot test. My creatinine is still going around 1.03 - 1.2, and the latest one is 1.07. Cystatin-C reduces linearly from 0.98mg/L to 0.89 and now reached 0.73. With the calculation of eGFR CKD-EPI creatinine-cystatin equation (2012) it is now 108, with CKD-EPI creatinine equation (2009) it is 93. But one bad thing I observe is my Calcium is now a bit lower than normal range.

Just an brief update from me. I appreciate all your opinions, because I haven't consulted any GP yet with it, I did my own test at a private center.

Many thanks.