Tips for a new possible ckd diagnosis?

[FThomp]

As a new poster, A little about me, I’ve been body building for 10 years now and have remained in good shape physically but have had high bp. My doctor hasn’t said anything yet but he hinted at prescription now meds during my next visit. My gfr back in 2014 was 92 and now it was 67 recently. I’m 28 and have high bp 140-150 ish range. I haven’t been diagnosed technically but I’m pretty sure based on labs that I damaged my kidneys with high blood pressure all those years. It’s all new to me and I’m so scared. Other than lowering bp, do you guys have any tips or tricks that you use to deal with your ckd?

[Marvin8]

Unless you're totally ignoring your cardio, you need to find the reason for your elevated BP and fix that, whether by drugs or lifestyle change. Are you consuming crazy amounts of protein? If so, you're gonna need to back off of that. Be aware that protein is tough on the kidneys and if you're consuming more than needed for muscle repair, you're putting an unnecessary strain where it shouldn't be. Do you have any history of kidney disease in your family? What's your creatinine level? NEVER forget that the creatinine levels used to determine eGFR are based on AVERAGE people of your age, sex, height, and weight. The higher the percentage of lean muscle mass, the further you deviated from the average, and your doctor needs to take that into consideration. If you really start to freak out about this stuff, you could go see a nephrologist for another opinion.

[FThomp in reply to Marvin8]

Hello Marvin thank you for your reply. I definitely need to do more cardio. I’m fairly lean Prob 10-12 percent bf. I have been walking a lot more. Should I do jogs too? I do consume a lot of protein but prob not more than 1g per lb of body weight. Im around 249 at 6’2 but a lot of muscle. My creatinine is 1.10 and my bun tk creatinine ratio was 15.6. I’ve stopped all bodybuilding supplements that could be hard on kidneys. No history of kidney disease in my family but I really need to get this bp under control. This was a huge wake up call for me for sure. Im going to stop lifting weights so frequently as well bc I’ve heard muscle breakdown can increase creatinine and such. I think lifting 3 days a week and doing cardio 5 days a week would be better?

Oh and I also have mild sleep apnea which I’m waiting for my second sleep study to get a cpap machine. Hoping that helps with bp as well. I will be seeing a nephrologist to be safe as well.

Thank you for your reply Marvin

[Marvin8 in reply to FThomp]

You can lift probably lift every day of the week as long as you're not going heavy and exercising different muscles each time, but this is something you need to ask your doctor. Doing cardio 5 days a week is a great idea as long as you're not pushing too hard. And make sure you get adequate sleep! As for your protein consumption, most nephrologists would tell you that you're consuming more than twice the amount recommended for most ckd patients. The recommended amount is closer to .8 grams per kilogram of body weight, but if you don't consume enough to replace the protein lost through muscle repair, that'll be problematic as well. These are all the questions you should be asking your doctor who is preferably a nephrologist. Another suggestion: cut down (or out) on the red meat consumption. Aside from the health benefits, it'll throw off your creatinine numbers on your lab tests. Lastly, demand a Cystatin-C test the next time you have labs taken. It isn't affected by muscle mass nearly as much as creatinine.

[FThomp in reply to Marvin8]

Will do, thank you for your help! I will be cutting red meat out entirely. Would Brisk walks for an 30 mins to an hour be good? Praying my lab numbers are just off due to large amounts of muscle mass and high protein but we’ll see.

I did see that my African American gfr was in the high 80’s and although I’m not African American maybe that could be more accurate considering the African American version is based on individuals with higher muscle mass?

[Marvin8 in reply to FThomp]

I brisk walk for exercise all the time and it's excellent exercise! I'm 63 and only 5'6" in height, so you should be able to beat my 45 minutes at a 4.5mph pace which includes 10% jogging. If not at first, you'll build up quickly, and at your height, you should soon be able to leave me in the dust. As for the African American eGFR, they recently decided to get rid of it for various reasons. It also wouldn't suit you because we're talking AVERAGE populations. If you're body building, you're nowhere close to the average person. For my age, sex, height, and weight, I'm much more muscular than person as well. It's probably why my eGFR is only 49 based on creatinine and 88 based on Cystatin-C. My creatinine 25 years ago was 1.1. Today it's around 1.5, but even that fluctuates on a daily basis.

[Skeptix]

Hi there,

As Marvin's pointed out, you need to start getting a professional handle on things - an eGFR of 67, whilst the envy of many of us, isn't a lot to have in reserve given your young age. You need to find out where you stand precisely so as to begin, if necessary, the process of preservation: maintaining whatever function you have for as long as you can.

Although BP is a chief cause of kidney damage, you'd want to find out, if you can, what the precise cause of your issue is - lest there be something else going on. And your doc will be wanting that BP down asap.

The latest movement in kidney preservation is low and very low protein diets. I've yet to understand precisely the range of issues involved in protein consumption but the chief issue is protein metabolism and the unavoidable waste products arising from it. That waste is reflected in your urea ( BUN) readings. It's not clear what your readings (plain BUN, not BUN/creatinine ratio) are, but if out of range then that means you're consuming too much protein (and so producing too much protein waste products) for your kidneys to handle. Urea (uremic toxins) have a detrimental effect on not only your kidneys but your body in general. Next to root cause and BP, urea is v. important to tackle.

1gr/lb is 2.2gr/kg, which, as Marvin says, is alot of protein. Low protein diets aim at 0.6g/kg and very low protein diets (indicated as most kidney preserving in the latest guidelines) aim for around 0.4gr/kg with a keto acid analogue supplement (a.k.a. protein with the urea waste stripped off) to get you back up to 0.6g/kg. This more or less means a plant based diet, not just red meat out (meat is too protein dense for the other calories/nutrients you need to get in your diet). At eGFR 67 you are not in CKD territory but at 60 you would be stage 3a CKD and these low/very low protein diets are indicated to commence then.

You could also join the kidney disease forum here at healthunlocked. There's a lot of knowledgeable folk there and you'll find out more on the diet aspect of disease slowing/halting.

Bear in mind that these very latest guidelines are from 2020 and it is recognised that it will take time for these guidelines to find expression in clinical practice. Being dietary guidelines, renal dieticians come into play in their application. But there are very few renal dieticians around - historically they only operate in the dialysis/transplant space. So you will, I think, need to educate yourself a bit so as to be able to ensure you find yourself a nephrologist who is abreast with the latest knowledge. Know that many come on here being told by their nephrologists that there is nothing to be done until end stage renal failure. They are told that because up to 2020, that was the knowledge / treatment paradigm.

[FThomp in reply to Skeptix]

Thank you for your reply. I’m hoping that lowering bp and lowering protein intake helps improve my functions so I have a bit more of a reserve later in life. I’d like to make it to 60 at the least

[Skeptix in reply to FThomp]

They'd be good starts but I promise you, when you get to 60 you'll want the rest of your life to be as healthy as can be.

It's only when health starts affecting you that you prize it and there's nothing like advancing years and naturally declining physical and mental powers to underscore things. Ask any sick billionaire.

Education is the root of it. Educating yourself and applying what you learn. You have time on your side - there are new developments (pig kidneys emerging as a future possibility, drugs, etc). But you and your fight for you .. will be your best bet

[Rck1]

Starting point would be another gfr test. You mention you are a bodybuilder, depending on your muscle mass and the GFR formula that may understate your true GFR. Did you train hard immediately before your last test? Again that can cause a false reading. Skip training for a few days before your next test and also stop any supplements to get a clean test. Having said that your BP readings seem high. Buy a BP monitor and test 3 times/day every day for a week. You have time to get a proper diagnosis, there is no cure for ckd, but if you have it keeping your blood pressure under control can stop it progressing further. But one bad test/ one high BP reading is not a diagnosis. You need a few tests showing low gfr and a series of tests showing high BP. If you don't have ckd that is easier, as once you are diagnosed life insurance/ travel insurance etc gets very expensive.

[FThomp in reply to Rck1]

Hey there thank you for the reply. I train very hard but I recently took the week off but was still taking supplements as well as high protein .

My main plan right now from my doctor is to increase cardio exercise, low salt diet, (lower protein as well) and I will only be lifting weights 3 days a week now while doing more cardio like walking 30 mins a day minimum. Also, I have a bp monitor and will be monitoring it daily as well as taking bp meds my doct issued due to high bp for a long time. I’ve had high bp since I was prob 20 and I’m 28 now so I’m hoping changing diet, reducing load on kidneys, and lowering bp will help! I’ve heard many success stories of people who watch their diet closely and lowered their bp to remain in the given stage they are at. I’m hopeful that I can get some increased functioning with lower food intake, adequate hydration and lowering bp considering that’s prob what’s likely causing my issues. I check back in with the doc after 4 weeks of making these changes

[Rck1]

Those sound like sensible steps. My gfr has been stable in the 45-55 range for the last 15 yrs - latest test was 53 so it doesn't necessarily decline further if you look after yourself.. I still train, I hate cardio so just do weights. It's more important to keep up your fitness IMHO. I take BP tablets and my BP stays in the 120 to 130 range on those. Each GFR test result can be very different to the next so don't panic if you see a big drop, it normally means a big increase next time. Those tests are not very precise. My GFR numbers started to improve from the high 40's to low 50's after I started low dose statins around 7yrs ago. I've tried stopping the protein, then back on it for a few years, it didn't seem make any difference to my test results either way as long as I stopped them a week before the test, but my fitness is better when taking them. Ultimately your heart health is what you need to focus on, that's where the risk from ckd comes from so focus on keeping fit and keeping your BP under control and consider low dose statins if you are diagnosed.

[FThomp in reply to Rck1]

Thank you for your time Rck1 I’m hoping either it was a bad lab reading due to another issue that can be addressed or it’s something I can control for a long time once this bp is under control. I’ll keep in touch with progress if you want? This is a scary time for new people and it’s nice to talk to those who are also willing to talk

[BettysMom]

Relax, my friend. You are not in any danger of ever having kidney failure if you just make a few simple changes. A creatinine of 1.10 is fine for a heavily muscled male. You do need to get your BP down to about 120 systolic maximum. If you begin doing cardio exercise regularly and cut way back on salt, you may be able to avoid anti-hypertensive medications. But if you need some medication for awhile, just do it. As for the protein--1 gram per pound is about 3 times what you should be taking in if you want to protect your kidneys. And you can save some money if you stop overindulging on protein and stop taking the body building supplements! Remember, while you are lifting weights your BP temporarily goes way up. This can be dangerous for your brain and your heart as well as your kidneys. You don't need a nephrologist. They aren't interested in seeing patients as healthy as you. Their job is to take care of people in the later stages of CKD. You should make an internist you primary care doctor. He/she is well equipped to handle your medical issues. You are wise to be looking seriously at your health while you are young. Just don't get obsessed and don't beat yourself up over anything you have done in the past. You are going to be fine.

[FThomp]

Thank you Betty! I hope you are right. Im committed to cutting some weight and doing at least an hour of cardio every day. Im on losarten 25mg every night now and will be monitoring my bp as well as diet and stress as well. Thank you for your encouraging words. I’m hoping things like cutting out excessive protein and having 3 low sodium healthy meals a day will help. Oh and no more energy drinks as I was drinking one prob every morning. Don’t smoke or drink alcohol though. With that being said I hope I just have time to be a more healthy person. I’m hoping these changes can help me improve my gfr further. Will be on a cpap within a few months too bc I do have mild sleep apnea apprently according to the sleep studies.

Not to get hung up on numbers but Do you think my gfr may be higher since I’m such a heavily muscled individual and the African American reading may be more accurate? Bc I read the African American reading is based on individuals with higher muscle mass and not their actual race, just characteristics.