What to do about dropping GFR?: I'm a 36 year... - Kidney Disease

Kidney Disease

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What to do about dropping GFR?

kden83 profile image

I'm a 36 year old female, not obese, healthy blood pressure, not diabetic.

In 2016 my GFR was 78, in 2018 it was 67, and a couple months ago it was 53. I had a sonogram to make sure I have two kidneys. My primary care doctor referred me to a nephrologist who told me I'm "probably fine." I understand that my numbers are not terrible, by any stretch, but I'm concerned about how they are dropping and that the doctor didn't feel like any follow-up would be necessary.

20 Replies

Your GFR does drop as we get older, but you are a long way from that age. When the nephrologist said you were "probably fine" did you ask for a more definitive explanation?

As a rule, never accept a vague answer from any physician when it's regarding your health.

There are many reasons why your GFR could be dropping. At the very least I would think he would order an ultrasound as a starting place. I don't like to assume, but, did he take a complete medical history of you and were there any other indications as to the cause of the continued drop? Did you receive a printed copy of the labs? How were your other numbers? Was anything else below or above the normal range?

The two leading causes of CKD are diabetes and high blood pressure. Since you aren't diabetic and don't have blood pressure issues, that's why I asked about him ordering an ultrasound. If you live somewhere where there is more than one nephrologist on staff, I'd suggest a second opinion and firmly ask for more information.

Best of luck.

kden83 profile image
kden83 in reply to Mr_Kidney

His explananation is that I'm fairly tall (5'10") and fairly athletic (not a bodybuilder or weightlifter, but fairly in shape) and he feels like that may have skewed the results. But I've been the same height and in the shape for the last 3 years. When I asked about follow-up he said he'd see me in 6 months if I wanted but he didn't feel like it was necessary.

Here are my labs:

Anion Gap 9

Bun Result 9

CO2 26

ALT/SGPT 17

Sodium 139

Albumin 4.2

Total Bilirubin . 5

Chloride 104

ASt/SGOT 19

Calcium 9.7

Creatinine 1.2

Glucose 85

Total Protein 6.9

ALP 54

Potassium 4.5

Mr_Kidney profile image
Mr_Kidney in reply to kden83

WOW! I've heard many things in the time since I was diagnosed with CKD but blaming a lowering GFR on being tall and appropriate weight is way beyond anything I've heard.

Did you notice, when you were in his office, where his medical degree was from? Six months seems a bit long to wait under the circumstances.

Do you have access to a different nephrologist?

Perhaps someone in this community will respond soon and have some insight into the "height" claim.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to Mr_Kidney

Holy smokes..... that's a first for me. My size has been the cause of all my diseases from the spider bite I had on my foot to and inherited blood disorder that my skinny father and his mother had and everything in between. BUT never have I heard anything more ridiculous than to blame it on height.... especially since you did not shrink. Run, do not walk from this doctor......

You need to be concerned about the decline. There are many things you can do to slow or impede that so find a better doctor. Ask any questions you need.

kden83 profile image
kden83 in reply to Mr_Kidney

Thank you for validating my feelings that the situation/his rationale seems absurd. I think I will find someone for a second opinion.

I agree with the other commenters. If you can get a second opinion do it. But, do you take any OTC medications, how much protein do you eat, do you drink enough water, have any family history of kidney disease? Do you have frequent UTI? Do you drink a lot of cola sodas?

Thank you for your reply.

I don't take any OTC medications. I eat a pretty healthy well-rounded diet. I drink a lot of water. No family history. Maybe 2 or 3 UTIs ever. Very little soda.

Jayhawker profile image
Jayhawker in reply to kden83

I’d definitely get to another nephrologist ASAP. This is a notable decline in renal function over a fairly short period of time. Frankly, if this was due to your height most basketball players would likely have chronic kidney disease!!

Jayhawker

I would definitely get another opinion. There is obviously something going on and it has nothing to do with how tall you are. Don't be slow about it.

I understand your concerns and I don't understand why doctors feel that way that's why I always get a second opinion. I used to work for doctors including nephrologist two of them and I saw both of them when I needed to see a doctor for kidney infection. The problem Knights can foresee is it's hard enough to see one kidney doctor without a referral hopefully you can see another one without a referral. Good luck I'm having the same issue as you are but I I'm a lot older than you are

When I was diagnosed three years ago, my neph said I had a little bit of kidney damage (GFR was 58) based on my GFR and ultrasound. When I looked at labs from 20 years ago (I was 40 at the time), my creatinine was 1.1 . Now that my creatinine is in the 1.3-1.4 range, he said that my trend is pretty good and he isn't that concerned....yet. He also said that I'm carrying around more muscle than most folks my size and age. I'm 5'6" and around 145 lbs, but pretty muscular when you look in the mirror. More muscle mass = higher creatinine. Remember: the eGFR formulas really don't delve into muscle mass. They generally just look at age, gender, and race. Think about that for a moment. Btw, I would absolutely demand a Cystatin-C test. Look at some of my previous posts and you'll understand why.

This is very true and important to remember and research

Others have replied way better than I could, but I wanted to add:

1. Check for food or other allergies (you may be secretly allergic, to say, eggs; and a complex interplay of egg food proteins with your immune system may be damaging your kidneys). Eliminate allergens from your lifestyle. I switch to a simple boiled rice and veggies dish (Chinese Congee) when my blood pressure flares up.

2. Importantly, check for infections (especially sinus and respiratory infections). Some infections, even minor, trigger kidney issues - again, due to how your immune system reacts to the infection. For me, a flu or cold can trigger hematuria (blood in urine). Recently, I had a cold and the hematuria disappeared after a regimen of hot water salt gargles.

3. Also, discuss with the nephrologist(s) if a kidney biopsy is warranted. Note, the procedure carries risks. So check out the other options first.

4. Check out UTIs (you didn't mention urinalysis results; endoscopy and ultrasound also can diagnose what's wrong). Consider swigs of pure cranberry juice to help with UTIs.

I would request additional labs and testing, such as a US, urinalysis and maybe a biopsy. If you choose another nephroligists let him know your concerns and requests at least the above. My creatinine went from 1.15 to the following year 1.32. I had to request certain things from my PCP. Low and behold I had Polycystic kidney disease. I have changed my diet, my meds have been changed accordingly. I am watching my children as well. Knowing makes a difference my gfr has been the same for the past 2 yrs about. Let us how it plays out for you.

I was told my GFR was lower and to see a Nephologist which I have been doing for about three years.. I started with a 59 went down to 52 which scared me and back up again to 59.I was having blood work done every three months this past Sept she said lets go six months I didnt care for that so she said four and I am concerned.. but I was also told the older you get your GFR will lower.. I am 72 right now will be 73 in April.. I understand your worry , see a nephologist .. good luck

I agree, definitely run, not walk, to a new doctor. In the meantime, educate yourself about chronic kidney disease, and prepare a list of questions for your new doctor.

I agree with the others that more needs to be done to find the underlying cause. I’m not a doctor, but I see nothing that stands out based on what you described. There are many other possible causes of an increased creatinine level in your blood, and these test could be indicating another issue and not kidney damage. The Nephrologist you describe is , in my opinion, to understand your condition and offer treatment.

If this were me, I would seek additional help from other doctors to determine the underlying cause. The earlier you can find out, the better your chances at dealing with it before it becomes something serious.

Good luck!

James

Hi, kden83,

Everyone here will have opinions and advice, some more than others. You are now approaching stage 3A (eGFR of 59-45). Your best option is to educate yourself and take control of your CKD (opinion, but a vastly logical one).

Here is how I did it and the results it gave me:

healthunlocked.com/nkf-ckd/...

Stopping Kidney Disease is an up to date medical grade reference book available on Amazon for under $20 - Chapters 1-33 will tell you everything about CKD and chapters 34-40 will outline a CKD eating program that has been proven to appreciably increase eGFR for everyone who does it -- the whole book is backed up by published medical case studies included in the book, so it is not an opinion book or the latest diet fad.

Good luck.

When it comes to a kidney-friendly meal plan have your nephrologist refer you to a renal dietitian. When you meet bring with you as many of your past lab results as possible. Together, you and the RD will develop a personalized meal plan that fits you specifically and not a one-size-fits-all plan. Each of us is different and the meal plan will possibly change as we progress through it. I met with my RD for two visits about 2 and a half years ago. Since then when any of my numbers change significantly we exchange e-mails. Often the changes for me are temporary. If you prefer a vegetarian or vegan plan the RD will develop one with you. Best of luck.

Hi, and sorry if you already answered. Anyhow do you have protein in the urine? If not really good point!

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