Do I need a second opinion?

[snapqueen]

My GFR is 41. I was just referred to a nephrologist this year by my GP. I have not been referred to a dietician or really asked much about my diet in general. My nephrologist just says not to worry, things aren't that bad. It seems that people here are seeing endocrinologists and getting professional guidance on their diet. I am 70 so maybe that's why I'm not getting referrals.

[Hidden]

How old is your nephrologist? Perhaps that doctor is in need of current information. I say that if s/he isn't directing you to an RD then ask/demand one and if they still won't, I wouldn't worry about a second opinion, I get a new nephrologist who will listen to you. It's your life and your health. Any physician who doesn't honor your requests because of your age is not someone you should trust to make your healthcare decisions. The decisions are up to you and all you should get from your physicians is their best medical advice.

[Jayhawker in reply to Hidden]

Agreed!

[lowraind]

Many of the people here have done their work and found out how to help themselves because too many of the doctors have told them "not to worry, things aren't that bad". We very much desire not to have things get worse.

[rabbit01]

I agree with Mr Kidney and Jayhawker and lowraind. My first nephrologist was a "well, lets see how it goes in another six months" kind of guy and consequently did nothing for probably the first year of my diagnosis. By that time I had worked out the guy was hopeless but all that dithering had cost me vital kidney function that I never got back. Diet is one of the key things to delaying kidney decline but there are others such as reducing protein in your urine, keeping your BP in check and looking after yourself. At 40% you are on the edge of being able to possibly halt or a least slow the decline or ending up like I did on the long slippery slope to dialysis. Honestly don't delay, get yourself a good medical team who will listen and help. If I had my time over again with the right medical team I am convinced I could have got a few more years dialysis free.

[orangecity41 NKF Ambassador]

I am age 78 and diagnosed 4 years ago at CKD 3b. My Primary Doctor put me on a CKD diet based on eGFR and other blood work (sodium, potassium, and phosphorus). I would definitely discuss your situation with your Primary Doctor, and go from there and if needed find a Doctor who will work with you on this condition. Maybe some Doctors care plans are age related?

[Bassetmommer NKF Ambassador]

HI Snapqueen,

I wish I knew then at GFR 41, what I know now. I would probably never have gotten to stage 4. Find a doctor who will work with you. Learn all you can about diet and lifestyle changes. And see a renal dietician. At Stage 3, there is lots you can do.

[Chucka]

Hi! I am age 60 and also at 41 eGFR and have been there for two years after dropping pretty fast from GFRs in the 50s. What actions can be taken to slow your progression depend in part on the cause of your CKD. Your nephrologist should discuss with you the type/cause of your CKD and a plan for managing it, not just wait for you to decline into kidney failure. Some of the plan will depend on your other labs like the phosphorus, potassium, chloride etc plus the amount of protein that is being leaked out of your system as “waste” rather than being retained in your blood where it is needed. Some medications will help reduce stress on kidneys and help them last longer. Getting protein from plant based sources rather than relying on animal protein can sometimes help. If you are in the US you can sign up for free classes from DaVita. It might be that your nephrologist believes that since you are 70, that your progression of kidney impairment might not reach failure stage in your lifetime. But they should discuss this with you at least. And you could still try to improve the situation with diet in case it will help. At eGFR of 41 you’re in a good spot to try to take action. While we dont give medical advice on this site, i would say that if your nephrologist won’t talk to you about these issues you might want to find a new doctor. Best of luck. Let us know how it goes.