Is my CKD stage 2 has been delayed or false positive?

[spiritvan]

Over two weeks ago, I has been diagnosed with CKD stage 2, with eGFR of 82 and existence of both proteinuria 1g/day and albuminuria with ACR around 108mg/g. Today, I retested the lab and consulted another GP and the lab showed that protein in my urine is negative, albumin in urine is 10mg/L, ACR is less than 30mg/g( my creatinine in urine dramatically high as 1g/L), eGFR is still 81.5. The lab took randomly my second morning urine sample. I am taking Telmisartan (an ARB meds) everyday. The newest ultrasound show both my kidneys normal, only only one small 4mm kidney stone in the left one. That new GP told me that I don't have CKD and my kidneys are working normally with eGFR > 60, even she knew I was taking ARB meds and told me that at least albuminuria lasts longer than 3 months that CKD could be confirmed, otherwise it is just the consequence of my high blood pressure, which is now controlled by ARB meds.

Could anyone please give me an opinion is it due to my ARB meds that makes proteinuria and ACR down to normal in only 2 weeks and CKD can't be confirmed or it's just my CKD stage 2 now delayed and under control?

Thank you very much.

[MAS_Nurse]

Hi Spiritvan,

Glad to hear your results are looking better. I would suggest that your GP has said this because your results have changed in such a short space of time since commencing Telimesartan. The short term benefits of the drug are on the blood pressure. Did you see the change in your blood pressure recording between each visit? The long-term beneficial effects of telimesartan in order to delay CKD would not be seen so quickly.

I hope this helps clarify a little.

All the best,

MAS Nurse and Moderator.

[spiritvan in reply to MAS_Nurse]

Hi MAS_Nurse

Thanks for your reply. My BP is well controlled right after 2 first days taking meds till now and always below 130/80. It even reach 100/60 many times I monitor at home.

After researching from many sources paper and statistics of albuminuria, it's highly like the mark outcomes of kidney damage that is irreversible. My opinion now is that my risk to ESRD is pretty much reduced by keeping this albuminuria negative or low microalbuminuria and there still exists the damage of my kidney, that's why my eGFR is still lower than 90 and got no improvement. There is no paper says albuminuria is just temporary mark just due to hypertension, but there must be permanent damage to kidney as my understanding.

I will do the lab every one month to see if it's controlled as my BP or not.

[Ddd4 in reply to spiritvan]

BP medications not only helps with lowering high BP, they do have the effect on reducing proteinuria/albuminuria. And you'd be quite surprised how effective this drug can be in a short period of time, in decreasing proteinuria! I'd definitely say your kidney condition is stablized for now. However, proteinuria is a definite marker for substantial kidney damage and it needs to be controlled carefully. It's perhaps time to incorporate mindful moderate-low protein CKD diet (0.8g/kg protein intake), which would benefit your kidneys in the long run. Since kidney disease is a chronic life time disease, it really is all about prevention & retarding its progression as best as you can.

Perhaps it might also be good to ask your GP to refer to see a nephrologist. Since your eGFR are still in the high range, but with the presentation of proteinuria, you might have an autoimmune disease (e.g. glomerulonephritis, minimal change disease, multiple sclerosis etc.) that's causing it. I think it's also good to self-educate, and read as much information as you can so you understand why you're having certain symptoms, or what your lab results indicate.

Best of luck to you!

[spiritvan in reply to Ddd4]

Thank you Ddd4 for your kind sharing

[citronc3]

Look at the NHS site for more help with clarification. Also be determined to follow an officially advised diet for CKD it is really useful in regulating your future blood tests and greatly helps prevent deterioration of the condition.