Is it good news?

[Alara1]

My diabetes nurse complimented me on maintaining good sugar control, however my blood pressure was slightly elevated. Referring to her computer screen, she notes that I am already at maximum dosage with my Ramipril and suggested an additional pill. Agreed to refer back after three months of trying to cut out my high salt intake. Explained that I have a weakness for salted peanuts.

This seem to have prompted her to declare my GFR as being incredible for a 66 year old at >90 mL/min. This was so over the top of my head as I did not understand anything she was explaining. She even showed me a graph of how my GFR went down to 74 and the climb back up. So, of course when I came home, I started reading up and referring to my recent blood test records and note that two of my readings were off. (1) urine albumin 29 and (2) serum creatinine 38. So, instead of being pleased, I am now thinking do I have stage 1 or even maybe stage 2 CKD?

[Hidden]

Diabetes and High Blood Pressure are the two leading causes of CKD. Minimum salt intake is needed for both HBP and CKD.

Your GFR does dip as you age, some faster than others. There is no cure for CKD but there are many things you can do to slow the progression. Controlling diabetes and high blood pressure are part of that slowdown process.

If you do in fact have CKD, switching to a kidney-friendly meal plan is a needed first step. If you do find that you have CKD, request a referral to a nephrologist and then ask the kidney specialist for a referral to a renal dietitian. When you meet with the RD bring as many of your past lab reports with you and together you can develop a meal plan designed for you specifically.

Should you find out that you do have CKD, and you live in the USA you can go to the davita.com website and register for a free, 90-minute Kidney Smart class in your area. You'll be given a lot of information and resources to learn how to make the lifestyle changes to hold off dialysis. If you aren't in the USA or just want to begin the process of being proactive, go to kidneyschool.org

You can view the modules there and learn what you need from your own home. Either way, it will help you develop questions to ask your doctors to get their best medical advice to allow you to make the best decision of how your care should proceed.

I found out when I was sixty-six that I had CKD. My GFR at that time was 32. My research at that time showed me that I had it for a long time before any physician informed me about it. Needless to say, those physicians are no longer on my Care Team.

It was later determined that my T2D was the cause. A contributing factor was my hypertension. Just this past May I fired my previous cardiologist, hired a new one and we immediately began to get that under control. I take three different medications and my average pressure for the past seven months has been 122/72. My cardiologist has me doing my readings twice a day, recording the numbers and submitting them to him via his office patient portal. My PCP is also sent a copy so that my medical team all gets the same information.

[Alara1 in reply to Hidden]

Thank you for your reply and recommendations. I think it is going to be too hard for me to follow any diet as being an extremely fussy eater. Even with my diabetes control, I am unable to go on a LCHF diet despite this appearing to be the best treatment presently. It dawned on me from an early stage that I need to treat my conditions differently even though I am aware that there is no cure. My aim is to ensure that my blood glucose and GFR does not deteriorate but still managing a normal lifestyle. Now I have to concentrate on my blood pressure but somehow suspect that cutting out all salt is not going to be sufficient to lower my blood pressure.

[Hidden in reply to Alara1]

There is an excellent book available that I highly recommend you give a look. It's called "Help, I Need Dialysis! How to have a good future with kidney disease." I believe it's available from Amazon for about $7.50. It's an excellent source of material about options you will need to be aware of for dialysis.

[Bassetmommer NKF Ambassador]

Just one blood pressure reading does not make it a crisis. My BP can be 40 points higher at the beginning of the appointment and then at the end. My doctors tell me it is called white coat syndrome and it happens at all my docs. When I am home on my home BP machine, I do not have that fluctuation. so make sure there really is a problem before they start you on more medications. Ask for two readings or buy a home machine. They run about $40.00.

[lowraind in reply to Bassetmommer]

Besides white coat syndrome, I find that if I am hurried into the office right after arriving, I have a higher pressure. Case in point, when I saw my pcp in Dec. for my follow-up appointment, my pressure was 136/84, because I was rushed through the process. When I saw her in January, for my Medicare Wellness Check, it was 122/72. Was not rushed.

[Alara1 in reply to lowraind]

I intend to do one weeks reading at home before my next appointment and take it to her. Intend to also take my blood pressure machine with me so that she can compare it with her own machine. The last time, the nurse told me to also bring my machine in to ensure it is not faulty or giving inaccurate readings.

[Alara1 in reply to Bassetmommer]

Thanks for the advice. I do indeed own a home blood pressure kit and my readings at home are always lower. Must be suffering the white coat syndrome. The nurse certainly took me by surprise.