Should I see a kidney doctor?: Hello everyone... - Kidney Disease

Kidney Disease

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Should I see a kidney doctor?

db79 profile image

Hello everyone,

Im new here and I have some questions about my GFR results. My GP found I have weak kidneys on routine tests and he had me retake them 3 months later. On the follow up I had improvement at 71 GFR (June 2019). I think I remember him doing a urine test too and he said it was good (no excessive protein in urine even tho it looks a little foamy). After that i had a cancer diagnosis and I had to take several tests over the past 4 months where they also checked my eGFR and the scores were like this : first 77 a week later 66 another week 67 another week 72 then after a month 75 and then a week ago dropped to 62. All my other tests are good like the BUN and all those are normal range. I'm 40 yo caucasian man and a little muscular, my job is a little physical and I try to go to gym 2-3 times a week. My unerstanding is that being more muscular like African American it adds 12 points to my GFR so for me I can add at least 6-10 points I would imagine. Also I am a little overweight 225lb 6.1ft tall. I have good blood pressue but high (bad) cholesterol. I work nights so i used to drink 2 Liters of coffee a day and 3-4 beers and also drink lots of water and eat protein rich foods like peanuts and peanut butter. I forgot to add that they also found a small 1cm simple kidney cyst (benign) on CT scan. What is my next step? Thank you.

23 Replies
Bassetmommer profile image
BassetmommerNKF Ambassador

Hi DB,

Not exactly sure what you are asking. If you want to improve your health, cut down on the coffee. That's a lot even with perfect kidneys. Coffee is a diuretic and will stress your kidneys and all that caffeine is not good for BP, even if it is normal. The beer is not helping you either. But not sure what you want to know and without knowing your medical history, including what the cancer diagnosis, I am hard pressed to offer advice.

Most referrals to a nephrologist are when you are at least stage 3b or more, which you are not.

db79 profile image
db79 in reply to Bassetmommer

Thank you for replying. I'm concerned because my GP didnt say anything regarding any sort of treatment or food restrictions or about seeing a kidney doctor. All he said was drink more water or something but in my case that is not good advice because I was already drinking too much water (without realizing it) and also other liquids (coffe and beer) and probably too much protein. I was probably overworking my kidneys and resulting in poor function. I did this for more than 10 years. I'm trying to get an idea of my situation, like how bad is it? Am I correct to add some points for extra muscles? What can you make of my GFR numbers? I already stopped drinking coffee and cut down the beer significantly and also took other dietary measures, all on my own no help/instructions from my doctor.

I had testicular cancer and they took out the offending fellow, and I had a choice to do adjuvant chemo to lower the chances of it spreading, but I chose not to do. But I am concerned that if I need chemo in the future that will have a significant impact on my kidneys. Thank you.

Alport67 profile image
Alport67 in reply to db79

If your medical insurance requires you to get a referral from your primary care physician to see a Nephrologist, I would do that. If no referral is needed, then find one that accepts your insurance and make an appointment. Doesn't hurt to see a specialist now.

If you have concerns regarding your diet check out Davita.com There are a lot of renal friendly recipes. Cutting out the beer and cutting back on protein is a good idea for now.

Good luck.

db79 profile image
db79 in reply to Alport67

Thank you for your reply. I will try and find a doctor but they usually require a referral even if my insurance doesnt but I will definetly look into it. I have cut back on beer to less than one a day I hope thats good enough for now. Thank you for your advice.

Alport67 profile image
Alport67 in reply to db79

You're welcome. Good luck. I hope you find answers.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to db79

HI again db,

So you have a lot going on. First of all, very good on cutting down on the coffee and beer. Yes water is good for you. But you really should talk to your doctor about how much is good for you. There could be other health conditions to consider. You are in stage 2 CKD which is not enough to see a nephrologist, usually. They often do not see patients until they are stage 3 b or 4. But since you have a cyst and a history of cancer, I would get a referral or find a nephrologist just to be sure and follow up with the cyst.

We do not really diagnose on this forum. I am concerned that you are not doing what is needed for the prevention of your cancer. Please talk to your doctor to see what complications can be caused by the chemo, and what are your risks for taking it or not. The thing about CKD, although not curable, it often can be slowed down and the progression can be stopped. Is that true about the cancer?

You are also on the right track with your diet, so good for you.

As far as muscle mass and such, remember that GFR fluctuates. So when it is in a range of a few points for several lab draws, that's pretty stable. That is what you want no matter what your size. There are other things they look at such as creatinine on you labs to diagnose CKD. It looks like you dropped your GFR 10 points from your last two labs. I would do another draw and see where you are. Make sure you are hydrated before the lab and skip the workout the day before. Also check what meds you are on to see what if any renal connection they have.

Hope that helps some.

db79 profile image
db79 in reply to Bassetmommer

Hi Bassetmommer. They dont know if the cancer has spread, CT scans and blood tests are clear, and we wont know for sure for the next 5 years. If it hasnt spread then I can live to 100 without chemo or anything. As far as drinking water I was drinking over 2 gallons of water a day not including other liquids and my pee was always clear and i though that was good, the clearer the pee the better, but its really not. The reason I asked about higher muscle mass is beacuse on some test results I get two GFR numbers, one for African Americans, and one for all others. My egfr numbers for african American are close to 90 almost stage one. Like my 75 score it also says eGFR"AA" 87. I was not taking any meds besides melatonin which I took for sleeping because I work night shift.

I will try and get a refferal to see a kidney doctor. Thank you for your advice.

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to db79

Everyone gets those two readings. The difference on my labs is only 3 points, not the 12 points you have.

I did some reading on this and found what you were talking about with the higher muscle mass. Wow, I wonder how stereotypical this is and in fact if it is still relevant that all African Americans have more muscle mass. Why do they not just say muscle mass instead of tying GFR to a race. Then I found that there is the proposal for another status for Asians. Really...they should just get rid of the race and describe muscle mass. Well, anyways, it is true that more muscle mass will make a difference. But, focus on the up and downs in any GFR and try to keep it stable.

kidney.org/sites/default/fi...

KidneyCoach profile image
KidneyCoachNKF Ambassador in reply to db79

Look, most people needing dialysis don't start until at or around eGFR of 10. At the moment your results seem good. Consider watching your coffee intake, control blood pressure and weight. Exercise smartly, eat smartly by adding plenty of veggies, fruits and limit sugary or salty snacks if they are an issue. Limit salt intake as most Americans consume far too much sodium. Address infections promptly, avoid all NSAIDS. If you're unclear about anything get into a nephrologist and have a concise discussion.

Overall you may want to ask for dietitian referral. Check out kidneyschool.org. Blessings

1) See a nephrologist

2) Drinking 2 gallons of liquid a day is nutso

3) Coffee (caffeinated) is nephroprotective, but 2 liters a day is nutso

4) More muscle mass affects creatine levels, but how much to add to your GFR can only be discerned by asking your neph and doing some research yourself. Your neph probably can't answer that one.

5) Lose the beer and mega protein except on rare occasions

6) Exercise and lose some weight. Ckd patients are 20 times more likely to die from heart disease than from ckd.

7) Ask your nephrologist some tips on trying to maintain GFR levels. Perhaps a renal dietician may be of some help.

8) Best of luck.

Calvin18 profile image
Calvin18 in reply to Marvin8

#6- why are renal patients more likely to die from heart disease???

Bassetmommer profile image
BassetmommerNKF Ambassador in reply to Calvin18

Good question Calvin,

The primary cause of patients with greater than GFR 60 is cancer. Less than GFR 60, Cardiovascular disease. Think about it....it follows with normal living for anyone actually. But end stage and dialysis puts a strain on the heart. Things like calcification, which is normal, comes into play also with age. Today, many, many people live with CKD a much longer time than in the past and so it would follow they would also die with cardiovascular diseases along with the general population.

jasn.asnjournals.org/conten...

WYOAnne profile image
WYOAnneNKF Ambassador in reply to Calvin18

Calvin18..heart disease.....I think that is why it is so important to keep your BP under control. When I was first diagnosed it took my PCP awhile to find the right combination of BP meds to get mine under good control. I had a kidney transplant and now have to have an ECHO and see a cardiologist yearly. All the high BP I had wound up scarring my heart. I would also ask your PCP how you are doing regarding heart disease. Have your lipid panel checked, it looks at your cholesterol. I am on Lipitor to keep my cholesterol in the normal range. I also try to eat a lot of fresh fruit and vegetables, drink plenty of water and try to follow a heart healthy diet. Best of luck to you.

Marvin8 profile image
Marvin8 in reply to Calvin18

The heart is the pump. The kidneys are the filter. Problems with one will always affect the other. High BP induces enlargement in the heart ventricles and atria. If your heart is pumping harder to push the blood through, that also raises the pressure of the blood flowing through the kidneys, thus causing long term damage. Same goes for when you're perpetually dehydrated; your blood thickens and your heart has to push harder to get it through the veins and kidneys. Those kidney nephrons are fragile and highly reactionary.

Heart = kidneys = thyroid (to a lesser extent). If atherosclerosis was reversible, one could probably halt kidney disease in its tracks through exercise, diet, and hydration.

Calvin18 profile image
Calvin18 in reply to Marvin8

do nephrologists typically recommend you to see a cardiologist? Is the only way to find out if you have heart disease or hardening of the arteries by seeing a cardiologist or can they tell by your blood?

Marvin8 profile image
Marvin8 in reply to Calvin18

No, they typically do not unless something shows up on an ecg or ekg, they hear a murmur, or you have a heart attack. Our medical profession isn't known for being particularly proactive.

Calvin18 profile image
Calvin18 in reply to Marvin8

My cholesterol and blood pressure are pretty normal so maybe that’s why my pcp never recommended it. My dad died early 50 s of heart disease so I think i will go get checked out.

Marvin8 profile image
Marvin8 in reply to Calvin18

If you have no symptoms, you're gonna have to push hard for your PCP to be concerned. Emphasize that you've got heredity working against you.

WYOAnne profile image
WYOAnneNKF Ambassador in reply to Calvin18

My nephrologist did order my first ECHO. The results were read by a cardiologist and a report given. Because of the scarring they found, plus an aneurysm I got a referral to cardiology. For now I go once a year...for both an ECHO and to see the doctor.

Good advice given. So we want a good life style - diet , exercise, sleep etc and regular check -ups and blood work. Also avoid medication that is not kidney friendly - check with a doctor if this is important- Good luck , always good to be pro-active and prevent problems

Next step: improve diet if applicable. Switch to plant-based whole food diet / with brocolli. Keep up the nuts. Get regular exercise but not excessive. Get normal sleep 7-9 hrs. Limit saturated fats. No eggs, dairy, meat or fish. Read “how not to die by Dr greger” & “the China Study” by T Colin Cambell. Monitor your labs over 6 months. You will lose weight.

I think switching to a day shift job probably a good idea. I diagnoised with IGAnephropathy in 2004..i used to do night shifts and lack of enough restful sleep for almost 3 years caused my body and immune system works inchorently... I recommand cutting coffee intake, seeing your nephrologist, change your life style and see if thatimproves your health and immune system.

regards

Nirmal.

D ear db79,

Should you see a Kidney Doctor, you ask, followed by 'seemingly' your whole History. You are CLEARLY, very worried, so YES you should make an appointment As Soon As Possible.

I haven't Beaten Around the Bush- I've given you a Strait answer, to a Strait question. Can I also suggest, that you, ask the Kidney Doctor(s) for their advice, regarding your Coffee consumption- maybe even your whole diet.

Please DO 'talk to' your Doctors db79.

AndrewT

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