Cortical Thinning

[LorrieC]

In May of 2014, I had an US before gallbladder surgery. Besides the gallstones, the report stated, "The right kidney demonstrates cortical thinning and increased cortical echogenicity suggestive of underlying medical renal disease". At the time, my creatinine was normal and my GFR was above 60. I questioned my internist who I had bee seeing for years and he made light of the US due to my labs being fine. After he retired, I never showed the report to my new doctor, but still my creatinine was within range and my GFR was over 60. Fast forward, Since 2016, my creatinine has been above normal and ranges from 90 to 130. The doctor just said I am dehydrated and drink more fluids.

Last November, I was admitted to the hospital for pneumonia and given IV fluids. My GFR rose to 59. I Wonder if this was due to the fluids. A week later, it dropped to 40!

I am now seeing a new doctor and he is sending me to a nephrologist. I emailed my former doctor and asked why she never told me about CKD Stage 3 and she said she looked up my old labs and I had it back then, but she seemed as if she never knew it.

My present doctor tells me not to worry and my kidneys are fine, but be on watch for nausea, losing weight, itching, etc. This scares me.

Has anyone here heard of cortical thinning and increased cortical echogenicity? For all I know, my left kidney can be the same. How long does it take for Stage3A CKD to increase to Stage 5?

[Hidden]

Bring all of your previous tests results with you to the nephrologist at your appointment. Discuss your concerns with that physician. Since you are in the USA I'd suggest that you look into a free 90-minute Kidney Smart class held in your area. You can find out when one is planned by going to the davita.com website. If you can do that before your next appointment there will be a lot of information available to you and give you solid information on CKD.

Having said that, the time from CKD Stage 3 to ESRD is frequently up to you. Yes, it can be quick if the CKD is caused by a genetic condition or something else beyond your control. However, most of us with CKD can slow the progression by switching to a kidney-friendly meal plan, establishing an exercise regimen to keep you active. Be sure to run any exercise plan by your doctors to make sure you aren't starting off by doing too much. The other thing you can do is to check all of your medications to be sure you aren't taking something that is counterproductive to your CKD.

CKD cannot be cured but you can control it to a great extent and live well by being proactive and aware of what has caused your illness and knowing what you can do to maintain your health.

[LorrieC in reply to Hidden]

The only risk factor I know of is being overweight. I have no clue whether or not my parents had it, but neither died from kidney disease. I will definitely look into the class. Thanks.

[Bassetmommer NKF Ambassador]

Its good you are going to a nephrologist. Along with your labs and meds, bring your questions written down so you do not forget them. BTW, do not let them tell you being overweight is the CAUSE of your kidney issues. It is not the cause as there are many overweight people who do not have kidney disease. But as I am sure you know, many doctors can't see past the weight. And....often the food we eat to lose weight is counterproductive to kidney health. Learn about what foods you should focus on. Ask your nephrologist for a referral to a renal dietician. If you are taking any form of NSAIDS...stop. Go over your medications with your doctor one by one.

Let us know how your visit goes.

[Hidden in reply to Bassetmommer]

While I agree with you about some things I disagree with others. Let me explain. I agree that weight loss is not the cause of CKD. I needed to lose some weight and went to a nutritionist. We set up a plan and I lost 146 pounds. When I found out I had CKD I made an appointment with a Renal Dietitian and found that the foods I had switched to in order to lose the weight were not kidney-friendly and had to be dropped from my meals.

Where I disagree with you is that all NSAIDs are to be stopped. I and many others take a daily low-dose aspirin for heart issues. Aspirin is an NSAID but it has been beneficial for me. Since I found out I have CKD, about 17 months ago my GFR has gone from a low of 32 to its current (from 30 days ago) 65. I take no other NSAIDs. The choice I had to make was to take a small dose of aspirin and risk my GFR dropping or discontinue the aspirin and risk a possible heart attack or stroke. Many others face the same choice and as I've said before, when I spoke to my doctors and did my research, it was a no-brainer.

'

[LorrieC in reply to Hidden]

Wow, how did you raise your GFR from 32 to 65? That's wonderful. I am wondering if the IV antibiotics I had when I had pneumonia a year ago did something to my kidneys. My GFR was 59 and a week later plummeted to 40. Perhaps it was the IV fluids that increased the GFR and it was not the antibiotics at all. I will never know. , too, take 81 mg of aspirin for my arrhythmias.

[Hidden in reply to LorrieC]

I was able to increase my GFR by switching to a kidney-friendly meal plan, maintaining a good exercise program, and watching all meds and dosages. Antibiotics can affect your GFR and I always remind my doctors that I have CKD when they want to write a script.

[Smokey2Gabby]

Get another Nephrologist. Find someone who is more proactive in slowing the progress of your disease. This disease is called the "silent epidemic" because the medical profession does not take it seriously until you're a candidate for dialysis. Put together a proactive medical team, Nephrologist and Nutritionist! It may take some time to find the team you're looking for but it will be well worth it! Hope this helps.