Ckd stage 2 confirmed

[Didididi]

Gfr 76-89ml/min/1.73m2

The diagnosis of ckd is now officially because of my malformation (smaller pelvic right kidney) confirmed…

The doctor said I should be checking it once per year but is it actually enough? What could I do to prevent the progression? Is it ok to take medication (ACR or other drugs) without hypertension or diabetes? Is there evidence that those drug could slow the progression?

Im only 28 years old and I really want to be proactive..not just waiting and watching my gfr going down.. are there other young people in the same position? Is it possible to maintain that function for a longer time? Or the younger you are the greater the chance to reach esrd…

Are there young women and mothers with ckd? How did you tolerate a potential pregnancy? Thank you and take care

[orangecity41]

I am a male age 80 and was diagnosed stage 3b CKD 5 years ago.I also have one kidney smaller than the other. I was put on a CKD diet by my Doctor. The progression has slowed.

[RickHow]

When a doctor tells you there is evidence of CKD it sends panic throughout your brain. BUT take a breath. This may not be as terrible as you think. First of all the right kidney is usually smaller than the left. That is NORMAL. It is not a kidney disease. Now perhaps you are saying yours is abnormally small. This of course can affect your kidney tests. For example, I had 2 perfectly normal kidneys. No abnormal egfr (no ckd). One had to be removed (the left) due to a tumor. From that point on I was labelled as having CKD. But was the remaining kidney really diseased? No. I just then had one kidney doing the work of 2, and the 1 is smaller than the one that was removed. Thus my kidney tests (Creatinine and resulting egfr) were not in normal range. DO NOT TAKE DRUGS THAT ARE NOT NEEDED, such as ACR. Even if you have CKD (which I bet you don't and that you are only seeing the result of one kidney being abnormally small) taking for example blood pressure medications when you don't have high blood pressure, is harmful.

What were your Creatinine and egfr readings??

Stage 2 is MILD kidney damage, kidneys still functioning well.

I think your doctor is on the right course. You may never get lower results. Since the removal of my kidney my other kidney has NOT reduced in function.

Here is a quote from the kidney.org website:

There is good evidence to suggest that women with very mild kidney disease (stages 1-2), normal blood pressure, and little or no protein in the urine (called "proteinuria") can have a healthy pregnancy.

To be worried is natural but I don't think you should be so concerned. Your doctor isn't and he knows you better than any of us. BUT you have questions, valid questions, so sit with your doctor and ask him/her your questions. And add this one: "Doctor do I really have CKD, a disease, or are my results just lower because the one kidney is too small? "

[Didididi in reply to RickHow]

Wow what an amazing answer! Thank you very much! So my gfr has bern fluctuating in the last 3years between 74-89ml/min and the last one was 89.. no protein in urin. Crea was 78umol/ml..Its in comparison to other young women elevated but still acceptable so to say..

When you have like a congenital malformation that means automatically that you have ckd with or without functional changes. I think I wouldnt be so stressed about it but one Professor once said: people with one smaller kidney could expect to start dyalisis in their 40s…

[Skeptix]

To elaborate on what Rick says. eGFR (estimated kidney function) is calculated from a single blood metric - the amount of creatinine in your blood. They add things like age and race into the equation too, but serum creatinine level is the kidney-related metric that determines the eGFR number.

But - creatinine can be elevated for various reasons not at all to do with kidneys.

If, for instance, you lifted a lot of heavy weights (weighlifting), your creatinine (which is a waste product of muscle breakdown, accelerated due to the weightlifting) would be elevated. Your eGFR would, as a consequence, calculate out as less - without your having kidney disease.

Run elevated creatinine for two tests 6 months apart and you've be tagged CKD

So Ricks question is a great one: is it that your kidneys are perfectly healthy, but given size, are not filtering at the same rate that full sized kidneys would? And so creatinine is naturally elevated and so eGFR naturally down.

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Is there anything else out in your blood/urine results? Leaking protein in urine for example. Or elevated urea? Medications are given for specific reasons (e.g. ACE to reduce leaking protein in your urine (proteinuria) or to deal with the specific causes of a specific persons disease.

Creatinine in itself, unlike say urea, isn't toxic at even quite elevated levels. And so you would not be damaging your kidneys running elevated creatinine (which is not the case were you running elevated urea).

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Kidney disease is typically progressive but there are things you can do to slow (and some would say halt) the disease. The first thing is to establish whats going on and that ought to be your primary focus. Stay in touch here as the information comes in and folk will, I'm sure, help give a steer.

[RickHow]

Thanks for giving your Creatinine and Egfr level (you said 89 EFGR for latest). That must have been calculated using the prior egfr formula. The latest egfr formula (which was written and eliminated Race as a factor) says that with your data (women, 28, umol 78) your egfr is 91. (using the calculator on the kidney.org website). This is stage 1 CKD (but keep reading). So 91 egfr is STAGE 1 and even by the prior calculate it gave you 89 which technically is only 1 point below Stage 1. A one point difference can be caused by simply missing a glass of water. So this is all good. And further more, this is what is says about a woman with egfr 89/91. "Is it CKD?

Either of the following must be present for ≥3 months to be CKD:

GFR less than 60 ≥3 months

ACR ≥30 mg/g or other markers of kidney damage".

Further it says the risk of progression is "LOW"

Followup is says "monitor once a year" (exactly what your doctor said).

Further it says "‡In the absence of evidence of kidney damage, neither GFR category G1 nor G2 fulfill the criteria for CKD.

ACR 30-300 mg/g for > 3 months indicates CKD."

You say your right kidney is smaller than your left. This is NOT abnormal. Again I quote:

n adults, the normal kidney is 10-14 cm long in males and 9-13 cm long in females, 3-5 cm wide, 3 cm in antero-posterior thickness and weighs 150-260 g. The left kidney is usually slightly larger than the right"

You have a pelvic kidney. This does NOT mean you have CKD. If the kidney causes problems it can be removed. Millions around the world live normally with one kidney. When my doctor told me there was cancer in my left kidney I told him, well if I have to get cancer at least it happened in a part of the body I have two.

[Didididi]

Thank you again that you took time to do that for me! It means a lot! I did myself the same research and it sounds encouraging! I need to work on my mental situation because Im still scared.. 3 years later after that talk with that doctor.. and they just don’t realise the impact on a girls life when you just say something like that.. (I mean death at young age etc). All of a sudden you feel alone and confused without information and broken dreams. And I needed to become nephrologist myself just to calm down a little 😅

Maybe its my “normal” with one kidney smaller. Maybe I shouldnt let it kill my joy of life. Thank you for your help once again and wish you all the best ❤️ How is your function with one kidney now?