rapid decline in gfr

[5911jovet]

I am a 67 yr old white male. My gfr fell from 51 on 10/19

to 34 in 5/20 with readings of 36 on 7/17, 31 on 7/31 and 21 on August 17. Creatinine was last read at 2.86 and had very high levels of protein but it is still high but trending down. I workout with machines and weights 6 times a week. I walk 1.25 miles a day. I eat what i thought was a kidney friendly diet though I do drink white wine on a daily basis . Protein and albunin in blood are normal

BP is normal, no longer diabetic as A1C was 5.0m

I am 5 10 and 178 lbs with a BMI of 25.4.

Dr is puzzled by rapidity of decline. Going for biopsy on Wed. 8/26.

Any opines appreciated.

Tom

[Sheshechu]

I’m sorry I can’t answer you but am very interested in your outcome. I am close in age and have trending up creatinine despite diet changes. All they say is drink more water.

[Sammi_n_Munk]

Hello 5911jovet!

Often times, dehydration may be one of the causes of a dropping GFR. GFR levels can fluctuate, but can be helped by drinking plenty of water everyday. It’s good for those of us with CKD to do our best to flush our system by consuming a good amount of water on a daily basis.

Also, you may want to speak to your doctor regarding the amount of exercise you engage in on a daily / weekly basis as well. Sometimes, overly strenuous exertion can contribute to a rising creatinine level. Avoiding excessive amounts of protein in your diet can also be helpful with that.

Not sure if you use any anti-inflammatory meds such as, Advil, Motrin, Aleve or Aspirin, or if you are currently on any similar such prescribed medication, but if you are for any reason, you may want to speak to your physician about that. Anti-inflammatory drugs are famous for destroying the kidneys.

I hope you will find these suggestions helpful somehow. Please keep us posted as to how things come along. We are always here of offer our support, and hopefully, some sound and helpful advice. Do take good care of yourself. I look forward to reading more of your posts! Bye for now! 😊👍✌️🙏

[RickHow in reply to Sammi_n_Munk]

My kidney doctor tells me the exact opposite. That drinking larger amounts of water does NOT NOT NOT flush the kidney. It just makes it process more water. Here is a link from American kidney society that drinking more water can actually DECREASE GFR.

jasn.asnjournals.org/conten...

Here is another one year study that found kidney decline was the same in those drinking lots of water and those who just drank normally.

eurekalert.org/pub_releases...

[Sammi_n_Munk in reply to RickHow]

Hello there RickHow!

It may depend on the stage of CKD that one is in as to how much fluid they should be consuming, but I’ve always been advised, and have read similar such advice right here in the forum, that not drinking enough can have very detrimental effects on the kidneys. Dehydration, is apparently one of the worst things one can allow to happen in our situation. I haven’t read the articles you have provided just yet, but I’m definitely about to. You have made me curious! Lol! Will post again as soon as I’m done reading! Thanks for the links! 😊👍

[Guitargirl2 in reply to Sammi_n_Munk]

I was told by my Doctor to drink at least 4 to 5 bottles of 16.9 oz. bottles of water.

which would be about 8 to 10 regular glasses of water a day not counting any other liquid you might drink. My kidney function GRF goes between 39 up to 45 for the past 5 years I was told to get plenty of exercise mostly walking and to eat sensibly staying away from processed foods. Dehydration can cause GRF to go down

[Sammi_n_Munk in reply to RickHow]

Hi again, Mr. How!

Well, from what I read, it seems there is really no definite answer as to whether drinking more water is a benefit, but, I do know from my own experience back in 2017, when I had suffered from extreme blood loss and was told by the in-hospital specialist herself, that due to the fact that the loss of so much blood caused me to dehydrate, my kidney function had been negatively impacted. And, as I say, my doctor(s) have always suggested to me not to allow myself to get dehydrated as that would cause even further damage.

I think the articles, although may have suggested that drinking more water would not “reverse” kidney damage (as nothing really can once it’s begun), it also didn’t truly suggest that it is bad for the kidneys either. Dehydration is not just an enemy to CKD sufferers, it’s an enemy of healthy individuals as well. I would never suggest to anyone to consume an overwhelming amount of water either. I believe it is always best to consult with a medical professional such as a family physician, and / or a nephrologist on the amount of water to be consumed on a daily basis, as this is definitely something that can differ with everyone depending on their stage of CKD, and perhaps even other medical issues they are contending with.

I must say though, I still believe that not drinking enough water can be harmful to anyone, in a few different ways. It can harm other organs as well, along with disrupting digestion, and brain function too.

Once again, I thank you very much for those links. It was good reading! I look forward to reading more of your posts, Mr. How! All my best to you! Bye for now! 😊👍🙏✌️

[RickHow in reply to Sammi_n_Munk]

I think you are correct. And it basically is what my kidney doctor say. Once the kidney starts to have disease water won't stop it. She did not say let yourself get dehydrated. But to drink normal amount. So many people post that drinking large amounts, will reduce creatinine and slow the disease, etc. But the articles (and there are many studies) and my doctor say, just drink normally. MORE is not needed that what is needed to just stay hydrated. Extra is not needed.

[bobbyt4715]

Stop the weight training. It causes Creatine to increase.

[Hidden]

People that strength train produce more creatinine. It's a horrible biomarker for most people and people that exercise especially. I would be hesitant to have an invasive kidney biopsy without some other indicator that your kidneys are impaired.

[Gorsemoor]

It’s really quite simple ,quit weight training this produces huge amounts of creatinine which your kidneys cannot cope with.Walking is fine but cut out white wine or any other alcohol apart from a glass of red wine every other night.Has for water don’t over or under do it you can judge this by the colour of your urine,amber dehydrated ,pale almost clear over hydrated.

[Sammi_n_Munk in reply to Gorsemoor]

Wow! Thank you for that information about the colour of urine. Didn’t know that pale urine meant too much fluid. Good to know. Sometimes, I tend to overdo things! Lol! 🙄😊👍✌️

[Hidden]

Before you quit strength training, talk to your doctor. My Creatinine indicates I am in stage 3 CKD, but my Cycstatin-C indicates my Kidney function is fine. My Nephrologist said Creatinine is not a good measure of kidney function in people who exercise. Not exercising is likely worse for your health. It is important to remember creatinine is just one of hundreds of substances your kidneys remove and having elevated creatinine is only suggestive of kidney impairment... it does not prove kidney impairment.

[Sammi_n_Munk in reply to Hidden]

You’re absolutely right. Never quit the exercising, but it’s important to note that over exertion can be harmful to our kidneys (especially those of us whose kidneys are already in a weakened state). However, light cardio, like walking, is actually very good in keeping our heart rates and muscles functioning as normal as possible, as well as maintaining, and even improving our energy levels. Good stuff! 😊👍✌️

[Hidden in reply to Sammi_n_Munk]

Frailty syndrome/sarcopenia has been associated with a worsening of CKD. I intend to vigorously strength train as long as I can to prevent it. My body makes more creatinine because I have more muscle mass than most 50 year olds, that means my blood will have more creatinine at any level of kidney function. Creatinine is a horrible biomarker for kidney health and especially bad for people that exercise. A kidney biopsy is not a risk free procedure, I would not let any doctor do it to me based on Creatinine alone.

[Hidden in reply to Sammi_n_Munk]

Frail patients with CKD do worse than their nonfrail counterparts. In predialysis CKD, frailty is associated with faster disease progression,7 worse quality of life,8 and an increased risk of death.9 In the dialysis population, frail patients are three times as likely to fall,10 are up to twice as likely to be admitted to hospital, and experience a high rate of hospital readmission.11 As in the prerenal replacement population, dialysis patients have an increased risk of mortality, with some previous studies demonstrating a 1-year relative hazard (HR) of 2.24 (95% CI 1.6–3.15)12 and a 3-year HR of 2.7 (95% CI 1.02–7.07).13 This risk worsens as frailty becomes more severe.14

ncbi.nlm.nih.gov/pmc/articl...

[Sammi_n_Munk in reply to Hidden]

Hey Matt! Yeah. We do seem to be in a somewhat crappy situation with our health when kidneys begin to decline. As you say, it is necessary to keep up good muscle mass because that is the body’s strength, and it’s always a plus in fighting any disease, but then we have to deal with the high levels of creatinine. I haven’t yet read from the link you attached, but I am definitely going to. You know, I always think that I’m just beginning to understand our kidneys and their function, and how to handle slowing the progression of the illness, but then there is always another point that pops up and needs to be considered. Sometimes, I wonder if even those in the medical community know all there is to know about what the right path is for us.

I agree with you though, that it’s better to have your body in a position of greater strength when contending with any sickness. It can increase our chances of longevity. Keep up the awesome work! Many blessings. 😊👍🙏✌️