All kidney tests normal EXCEPT albumin/ creatinine ratio

[Cobalt2sister]

hi. Haven't posted in while. My duff went up from 40 to 70!! But now test just came back that my albumin/creatinine ratio is slightly above normal. Should I be concerned?

[Cobalt2sister]

Oops that autocorrect duff should read egfr

[BettysMom in reply to Cobalt2sister]

Ha ha! I was really wondering what a duff was.

[lowraind in reply to BettysMom]

Me too!

[userotc]

Personally I wouldn't be too concerned about a slightly high ACR and I'm quite my mum's nephro wouldn't be as he wasnt when it had steadily increased to well above normal range at 15.7 mg/nmol (or ~139 mg/g) last time out.

He seemed more content with her 24h protein fig of 0.26g (NHS unconcerned at least if <1g) and steadily increasing egfr. Hopefully no worse after today's retest 🤞🤞

What's your protein figures and I hope you've increased your egfr (or duff!!) naturally like mum ?

[Cobalt2sister in reply to userotc]

Thank you for responding. My duff ( hee hee) gfr went from 35 to 70!!! ( Had AKI).your response helpful and encouraging. I see my nephrologist Friday just for my six month check up. Will let you know what he says. Take care.

[userotc in reply to Cobalt2sister]

Thanks. If you know your protein figs eg ACR, 24h, after Friday I'm interested to compare.

It sounds like your egfr doubled because you recovered from an AKI? Rather than a similar % increase of mum's due to Nutritional Therapy.

[silverfox81 in reply to userotc]

A slightly high ACR means kidneys are still spilling protein. It is a cause for concern and should be investigated further to see what's causing and get on meds to help stop some of the protein spillage. Meds such as ARBs and SGLT2 are great for that

[userotc in reply to silverfox81]

Thanks. For >3y, we have continually questioned mum's nephrologist about her increasing urinary protein but he has been unconcerned. For example:

(i) 18m ago he stated that her increasing protein "won’t ever be a worry".

(ii) ~3y ago, he stated "ACE inhibitors are possible but N/A as BP is OK, so no action".

Meanwhile, her urologist's comment on her urinary protein 2.5y ago was "Nothing of concern, leakage varies from person to person".

It appears that they (NHS) believe that 24h protein is the gold standard and mum's has not exceeded the 1g lower level limit (at least yet 🤞🤞). nhs.uk/Livewell/Kidneyhealt...

And, to be fair, her ACR hasnt yet reached the "severely increased albuminuria" level (ACR >300) associated with progressive egfr decline. Her egfr doubled over 4y to ~60. 🤞🤞kidney.org/kidneydisease/si....

Re "what's causing it", I suspect that her increased protein is because she has a solitary kidney following a nephrectomy almost 7y ago. There's various scientific papers and expert comments supporting that view e.g. niddk.nih.gov/health-inform...

I'm unable to find references re the use of ARBs or SGLT2 that reduce protein specifically for solitary kidney - DO YOU have any? Im aware they may do that otherwise but even the above NIDDK solitary kidney article does not refer to ARBs for protein. And its maybe unwise to consider medication (with side effects) unless absolutely necessary.

So, in summary, we must reluctantly hope the medics know what they are doing in terms of monitoring mum's kidney. Test results today/tomorrow may influence matters 🤞🤞.

[silverfox81 in reply to userotc]

I don't have any information on solitary kidney and SGLT2. Thanks for giving me the info on your mom. That's interesting. Everyone has a different situation and story. I'm sure her Dr could answer those questions. I'm on an RlARB which knocks down my ACR into normal ranges and helps with hardening of arteries

[userotc in reply to silverfox81]

Sadly none of mum's medics including nephro have been very helpful and, as indicated, quite dismissive of her proteinuria. I will ask her to raise the specific case of solitary kidney and proteinuria in her next tel appointment and also to interrogate further the best indicator. As indicated, they appear sold on 24h rather than ACR (which has risen significantly again in yesterday's results).

Im unfamiliar with RIARB specifically but trust youre aware of the risk of serious side effects and some ARBs "pulled"? See 1st link below from medics, I have other scientific papers on this. Along with other side effects eg raised potassium (2nd link), this is mainly why Im concerned about mum being prescribed and using for a while.

medscape.com/viewarticle/96...

rxlist.com/angiotensin_rece...

[silverfox81 in reply to userotc]

I have been on ARB since 2017. I've had zero issues with potassium or any other side effects. It does knock down gfr by about 30 percent but my gfr has been raised by 15 points or so over the course of 7 years. I've been told it reduces proteinuria by 35 percent

[userotc in reply to silverfox81]

Maybe worth researching further as I think the cancer warnings are after ~3y use? If so, I'm happy to send scientific reports (which I'd use if mum is advised to take such a drug). Sounds like your doctor(s) wouldn't be much help there.

[silverfox81 in reply to userotc]

I understand about nephrologist not being very helpful. I've personally been frustrated with my Dr's as well. My family physician has been the most help in my situation

[silverfox81 in reply to userotc]

Anytime you have an elevated ACR it increases cardiovascular problems such as hardening of arteries so it should be treated seriously

[silverfox81]

What was your number? Mine was recently 17 mg/global creat. Anything from 0-30 is normal. 30-300 is moderately increased. If yours is above 30 then yes I would be concerned and investigate further. That is the #1 predictor of kidney decline.

[silverfox81]

17 mg/g is what I meant.

[Cobalt2sister in reply to silverfox81]

Hi silverfox. My ACR was 37 only a little elevated above the normal 30. This was as of last week in prep for Fridays appt. He'll probably retest I guess. Thanks for responding.

[silverfox81]

Do you know what's causing your high ACR? I would visit with your Dr about being put on ARB or SGLT2 meds if you're not already on one.

[Cobalt2sister in reply to silverfox81]

Hi silverfox. Thanks for all your input. Don't know what's causing higher acr but I see my nephrologist this Friday and will report back. I was put on losartan for kidney. Its an ARB, put on it when I had the AKI. But that got all better so don't know what's going on. Will report back friday! Thanks.

[silverfox81 in reply to Cobalt2sister]

I'm on losartan as well. Has helped me. You have high bp or high blood sugars? Do you smoke ? Do you take nsaids such as advice, aleve, etc? Do you take lithium? It could be a glomerular disease as well. It could be lots of issues causing your kidney problems

[silverfox81]

I meant advil above not advice. Autocorrect passes me off

[Cobalt2sister in reply to silverfox81]

Hate autocorrect as well! I'm an ex smoker. No diabetes. I had high blood pressure on and off but always controlled by meds. Never go near Nsaids!I don't know. Could it be some residual effect of AKI? Guess ill find out something tomorrow and will let you know. Peace and take good care.

[silverfox81 in reply to Cobalt2sister]

It could be a residual effect I think. I wonder the same scenario with myself. I mean once our kidneys are damaged it's kinda been done I think. I'm not sure though I'm not a Dr. The problem I have either my Dr's is they don't always give us all the information. That's why I think it's important to self educate ourselves.

[Cobalt2sister in reply to silverfox81]

Hi silverfox. Well, saw my nephrologist today. Because all my labs were good and ACR only slightly raised he thought ok...the losartan will help and we'll keep eye on it. I see him again in six months

[silverfox81 in reply to Cobalt2sister]

FYI, if you ever want to monitor your ACR on your own you can create a profile at labcorp online and order your own tests. That's what I do. I don't wait on my Dr to order and I do mine 2 times a year.

[Cobalt2sister in reply to silverfox81]

Wow, thanks, I had no idea! Will check it out.