protein in urine

[bevgt]

My doctor rang today to say blood tests all fine but a slight trace of protein in urine and my GFR is 53 creatinine 93 making me compatible with stage 3A CKD when questioned she said she was not concerned as what you would expect at 66 years of age , and its only slightly under 60 will redo urine test in a few weeks , this has all come about because they found out i had really high blood pressure which is now being treated an come down nicely. This has really worried me would this be due to blood pressure and after a while of being in control get better or am i right to be worried .

[Bassetmommer]

Hi Bevgt, Worry is good when it brings a change. Yes, getting your blood pressure, BP, under control will change everything. You will feel better, and your kidney health may not get worse. If fact, it may get better. Did they say anything about watching your salt intake? Keeping salt to low or none will help keep both your BP and kidneys. Make sure the medications they give you for the BP is safe for the kidneys. Ask your doctor that simple question: Is this medication safe for my kidneys?

Best to you,

[orangecity41]

Here is a link expalining eGFR to age. kidney.org/atoz/content/gfr

[bevgt in reply to orangecity41]

Thank you for your kind reply

[RickHow]

A little confused by your numbers. You are female, age 66, Creatinine 93 umol, but you were told your egfr is 53. With the latest egfr calculators (modified late last year to eliminate race as a consideration) your Egfr is 58, not 53. Still stage 3a, but a lot closer to 60 which is considered "normal". You mentioned trace protein in urine. We all have some protein in our urine, even perfectly healthy people. Since your doctor mentioned it to you, it likely is above the usual amount. This can be caused, especially at trace levels, by MANY things not just CKD. Simple dehydration, elevated bp, inflamation, on and on, can cause this. You seem to have a great doctor, following the right protocols. Not worrying too excessively about egfr or 53/58, waiting a bit to investigate urine again after he gets the bp under control. Following up with you.

The hardest part about any human condition that produces "not in normal range" results, is waiting to see what happens. Will the actions of my doctor help resolve the situation? What is something serious is wrong? Could it be this, or could it be that? Etc. But unfortunately this will be on your mind until the next set of tests in a few weeks. But if it is of any solace, I have been stage 3 for five years, with no change, and currently 72 years of age. My bp was brought under control. One of my bp medications is lisinopril which is:

"Lisinopril is an angiotensin converting enzyme (ACE) inhibitor. ACE-inhibitors are used in chronic kidney disease (CKD) to protect kidneys, slow progression of CKD and to treat protein in the urine. Hence, Lisinopril is generally a safe and effective treatment of CKD. It must be monitored carefully by your doctor." At the same time I take amlodipine:

"

Amlodipine and lisinopril should not cause kidney damage and in fact are used to treat high blood pressure and slow the progression of chronic kidney disease (CKD)."

Now I was given these medications for bp control. The help that they provide the kidneys is just an "extra" benefit. My doctor did NOT prescribe them for CKD, but for BP.

Again, I'm holding steady with my egfr (there are always minor fluctuations up and down from test to test) for five years, and I have just one kidney, and also stage 4 cancer, so do NOT get overly worried and depressed. Just proceed forward with your doctor.

[bevgt in reply to RickHow]

Thank you for your reply ,yes on the print out the doctors gave me my creatine level is 93 umol and GFR 53 but when my Doctor rang me she did say 58 so its just under what it should be , but i thought i had heard her wrong or it was a slip up on her part will double check. They have put me on 100mg Losartan and 10mg Amlodipine and indrapamide blood pressure now 145/65 but doctor said would like to get top number to between 130 140 but we are getting there at the moment it seems like i got to 65 and everything started to go wrong ,thank you for being so helpful.

[RickHow in reply to bevgt]

I'm impressed with your doctor. The nurse gave you the right number, 58. Some labs are still using the old formula which shows 53. You doctor/nurse gave you the newer value. Your bp meds are excellent."Cozaar (Losartan) is a good blood pressure-lowering medicine that protects kidney function like an ACE inhibitor, but with fewer side effects. Lowers blood pressure. Zestril (lisinopril) is a good blood pressure-lowering medicine that protects kidney function."

Your bottom number (65) is GREAT. You are at where I was with my bp. A bit higher on the top number and good lower number. It becomes hard to tweak to lower one number and yet not make the bottom number too low. My doctor and my Cardiologist want me to be between 130 and 140. (They both say that the old goal of 120 is not a reasonable expectation and for people over 65 they like the mid 130's, and with an occasional reading in the lower 140s it is good.

Next time you see your doctor ask him about what my doctors did for me. Instead of taking 10mg of amlodipine, they changed me to 5mg in the morning and 5 at night. Same with my lisinopril. HAd me take half in the morning, 1/2 at night. It got me into the 130s.

For example Losartan lasts in the metabolism about 6 to 9 hours with 1/2 of it out of your system in just 2 hours. So if you divide your dose into 2 times a day, it is acting longer in your system.

You know what helped me with my bp the MOST? I go for a walk every day (well 6 days a week) for just 30 to 35 minutes. Not too slow, but a decent pace. My pressure reduced.

Lastly my cardiologist instructed me to take my bp as follows:

--do NOT just sit still for a minute, take your pressure and think it is accurate. That within a five minute span, a totally healthy person, has blood pressure changes (high, low, high, low, etc.). So to take it randomly is not accurate because you don't know if you are catching the high or the low

--Sit still for five minutes. Take it. Wait at least another 2 to 3 minutes (5 if you have the patience of sitting and waiting). Take it again. Now keep track of the average of the two readings. That is the most accurate way to monitor your actual bp.

--Do NOT take it within the first 30 minutes of getting out of bed (the body ramps up bp when you wake. Do NOT take it within 15 to 30 minutes of consuming caffeine. Do not take within 15 to 30 minutes of just eating. If you feel even a slight urge to urinate, be sure to do so before taking the bp.

[Skeptix]

If I had a $ for every time someone came on here saying their doctors said not to worry. You won't be aware of it, but many, many GP's and even nephrologists take a relaxed view on CKD. This is because there was very little by way of treatment options and you simply declined (whether faster or slower) to dialysis.

Sure, BP will be treated (although how aggressively will depend on your doc). Protein spillage in urine (spillage is a disease progresser) might be helped if the BP medication is ACE or ARB (it has a secondary ability to lower protein leakage).

This do-little approach changed in 2020 when new guidelines were issued in which diet (namely (very) low protein) was advocated from stage 3 onwards. The science indicates that diet has a significant impact on kidney preservation.

But it will take years for this latest recommendation to find expression at street level. And so doctors still say "don't worry" (because they are not aware of these guidelines). They might tell you to limit salt or not eat so much red meat. But there is far more to it

That age/eGFR chart orangecity linked indicates that you ought to be around eGFR 80 at your age. You're at 53 (or 58) and are classified at stage 3 CKD. CKD is a progressive disease and ordinarily would see your function declining. You can't recover the damage done as such but there are things you can do to give your kidneys the best help - your aim being to preserve the function (ample in your case) so that you die eventually of something unrelated to kidneys.

There isn't a need to panic - but neither would I advise your taking a back seat in your treatment. See what the results are like in a few weeks and post them on here. In preparation for the draw:

- don't go overboard on meat consumption (like 16oz steaks and bbq's) in the days leading up to the blood draw (cooked meat raises your creatinine and so will make your eGFR look lower than it truly is.

- Hydrate (but don't go overboard. Dehydration will skew the result)

- If you by any chance do weight lifting or strenuous exercise, that will raise your creatinine and also skew your eGFR result. Mention this to your doc.

You have a progressive disease but you have a decent amount of function and it's not like you have to stretch that function for 40 years or something. There will be some management to involve yourself in - the aim being to slow/halt disease progression. Come back when you've more results - there's plenty of folk here who can inform and guide. And try not to worry. It's a shock to hear you've something like CKD but you can get a handle on it..

In the meantime, you could do worse that buy Lee Hull's "Stopping Kidney Disease". It's an excellent way to bring you up to speed on the subject of CKD, treatment options and the basis for the latest dietary advice. There are two versions of the book, an overly long but packed-full-of-info 500 page version and a newly issued trimmed down version which is easier to digest. Depending on your appetite you can pick the thick or thin version. You don't have to run off full blown on his diet - the aim would be to start informing yourself and making moves in the right treatment/dietary direction.

[bevgt in reply to Skeptix]

Thank you I will definitely buy the book and let you know my next results .

[Marvin8 in reply to Skeptix]

Problemo: Low protein diet....good. Low fat (according to Lee Hull)....good. Since ckd is a potential causation of diabetes and vice versa, many nephs (including my own) said to take it easy on the carbs. I can do all three simultaneously by starving myself to death.

[RickHow in reply to Marvin8]

Well said! :). Don't forget to throw away salt! No salt, sugar, potassium, carbs, protein, phosphorus, magnesium, low or no fat and do take your bp and diabetes meds, and you can sustain your kidney for how much longer? :).

[Skeptix in reply to Marvin8]

I did a quick scan and it seems that its cholesterol and sat fat he advises to lower rather than fats generally. My appreciation for Lee's book comes more for it's strapping a rabbit-in-the-headlights CKD-newbie into the drivers seat better than any other single source, than it does from his National Socialist dietary advice.

[hghealth in reply to Skeptix]

Thanks for the insightful post and book recommendation. I just got it on Kindle. Who knows you might have just added years to my life!

[bevgt]

thank you everyone you have made me feel a lot calmer with your kind advice