With a gfr of between 50 and 60 along with hypertension, does this put my wife in the CKD category? She also has other problematic things that are documented in my name's history of you click on the name.
Should she be avoiding salt, and saline IV drips?? It's just when in hospital and on an IV drip her weight increases a lot as her belly and legs fill up with fluid. I hope someone has some experience in these matters. Thanks.
Hi. Your wife and I are similar. I too have only one kidney and also high blood pressure. Her egfr has been about 50, my last reading was 46. She has other health issues. My other health issues are cancer and colitis. Now that are similarities are out of the way let me offer my opinion and experience, but of course always refer to your doctors who know much more about her than I.ANYONE with high bp should monitor their salt intake. Depending on how high her bp is, if very high then of course a salt free diet is recommended. But if not excessively high she should limit her salt intake, but my doctors tell me not to eliminate it. My practice is to not add salt to anything I cook. Do not add salt on my food at mealtime. when I buy foods, if a sodium free version is available I buy that. Almost everything comes with a label of sodium content, how much of it meets the daily requirement. I monitor what I eat and try to keep my sodium total at the end of the day is as close to daily recommendations as possible, which for a female is 2300mg. I can tell you that it is almost impossible to NOT exceed that limit. Our foods are just loaded with salt. But I try to get as close to that figure as possible. NOW, do I cheat? Yes. Do I have that pizza occasionally, or a salted snack? Yes. But as my doctor tells me, going over here and there, even excessively is not going to have much negative affect.
Regarding saline. You must remember you are given saline because you are in the hospital for some medical condition. Does saline affect bp? Of course. It is a sodium mixture. But it is given because for whatever reason you are hospitalized, it is necessary to keep you hydrated, etc., etc. Again, it is not like you are taking it every day of your life. If your bp spikes here or there, as long as it is not long term, it is not going to damage the kidney. That is to day, if today my bp spikes to 150/80, but returns to normal the next day, my kidney is not damaged by that one day spike. Here is an excerpt from an article on saline and salt:
Our study suggests that it would have an adverse effect for blood pressure control if the saline infusion was >500 mL per day during continuous for 3 to 5 days.
Regarding weight gain and fluid buildups. You said your wife has other medical issues. If heart problems are one, and being pumped full of fluids (saline), sedentary (laying in bed), urinary retention, fluids will build up. Every time I have been hospitalized, not matter the reason, the first thing done to me is putting the "medical socks" on my legs, to prevent fluid buildup. For patients who have this problem (retention) diuretics (pills) are usually given.
Regarding is it CKD. Technically yes. But as my doctors tell me, depending on a persons age, and medical condition, having only one kidney can effect your egfr dramatically. That is to say many, likely most, who have one kidney have normal egfr levels. BUT many (again, age, other health conditions, etc.) never achieve normalcy. The remaining kidney in these cases does not pick up the workload. "normal" people with one kidney, that kidney actually expands in size, and internally grows more filters, and thus produces normal results. But with age, other medical conditions, medications, it is not always the case and generally speaking these people get a higher Creatinine level which means a lower egfr. My doctors do not even bother to be concerned about my egfr level. Instead they monitor my Creatinine level. To make sure it remains consistent. For example, my Creatinine is constantly in the 1.6, 1.7 range. It has been since 2017.
My mum's gfr is in the same range and she has just 1 kidney (tumourous one removed ~4y ago). Shes stage 3 but doing OK on a healthy diet although we are seeking to improve urine test results which are also used in ckd determination.
Exactly the same as me. The problem with the formula used to determine egfr is it does NOT take into account if a person has one kidney versus the norm of 2. It does not take into account what medications a person takes that can affect egfr. My doctors indicate to me, they consider a Creatinine level of 1.6 to 1.8 as quite typical for a solitary kidney.
I have one kidney and distal renal tubular acidosis (a rare deformation that causes stones and ckd as well.) I am in stage 2 with a 79 eGfr. So hers is lower than mine yet we have the same thing. Mines is believed to have "withered" in utero or as an infant, there even used to be a tubule but it's gone. Just a small remnant kidney...
My right kidney, the one that is left, is bigger. My Dr. says I am at 89% kidney function and that it is very, very good for having the DRTA untreated for so long.
I do not know about the saline -- I am on an incredibly low-salt diet and it's now a lifestyle. We spent the whole pandemic cooking literally everything but cereal in the morning from scratch.
The daily recommended salt in the US is too high according to my doctor, who says that I should be getting less than half of that. So we use low sodium everything from cooking stock to canned soup from Amy's, but not everyone has access to those things due to price or region. To complicate things, the treatment of DRTA involves sodium bicarbonate.
She may be eating products you don't realize have salt. It will hide in products that are even considered low sodium with words like "disodium phosphate" -- and don't eat that stuff. Not only is sodium bad but phosphates are dangerous. It takes a LOT of label reading if you want to eat any processed microwave or boxed food.
These are basically all the things I know thus far, but I am going to a webinar today on kidney disease at the National Kidney Foundation, you should go to their website and sign up for one to understand more
Thank you for taking the time to answer me. Like you her duff kidney is just a shadow of its former self, though we don't know when it happened. We do cook virtually everything from scratch so there is very little salt in her diet. It's the hospital that had her on a saline drip for so long that caused the fluid retention. Her consultant did say yesterday that a drip has to contain sodium otherwise it would kill her. So in future she may refuse excessive IV drips.
Good to know the situation was temporary! My husband asked me if I go to the hospital, should I refuse hydration? I go to the hospital with an allergic reaction about once every few years! They always give me a rehydration IV but it never occurred to me to ask about it. I am glad my husband thought about that for me! After a while it gets hard to talk about these things with doctors all time, it can feel overwhelming. But I write down my questions even if I don't have a dr. appointment for a few months
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