Tomorrow nephrologist appt. first visit

[AuntMishee]

Tomorrow is my first appt with a Nephrologist. I referred myself, as my PCP is not taking my 3 month GFR range 52-57, dehydration, and anemia very seriously. His advice? Drink tons of h20 with lemon and reduce protein intake a lot. My potassium, sodium, and protein levels are normal. Blood pressure is well controlled with meds. Urinalysis was normal. My shrink took me off of lithium, a 10+ year maintenance drug, a few months ago when the labs showed troubled kidneys.

What questions should I ask the nephrologist? I want to get as much info as possible and take notes in the short appointment time. i need to know if my current diet is ok.

Also, how is phosphorus level tested, is it a seperate blood test or is it found in a CBC or CMP panel? Is it called “phosphorus” test? Phosphate?

Thank you anyone for helping me.

[Beckett24]

Hi, AuntMishee,

I am sure you will get lots of answers, but I think this is the most important question you can ask your nephrologist if you are not happy with your kidney health:

"Can you please refer me to a registered renal dietician?" This is the ONLY way you will know if your diet is OK for CKD.

Remember, virtually all doctors (including specialists) do not have any detailed knowledge of diet and nutrition (maybe that is why they have registered dieticians - which takes a college degree).

What did my nephrologist tell me about nutrition and a diet plan when I was in Stage 3A like you?

Cut back on the salt. (I forgot exact words which is why no quotation marks, but he did not even say sodium - that I remember, LOL.) And this is ALL he said about nutrition and a diet plan.

Most doctors will think you have no problem if your eGFR is close to 60 which is Stage 2.

[HealthBuddyMelissa in reply to Beckett24]

My Nephrologist told me the same thing cut back on salt. No explanation as to what that meant or how much. He still has not referred me to a RD but I am well controlled after much research. The point is Beckett24 is correct. Ask for a referral to a RD it is the best way.

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Bet117 just posted a list of 10 mistakes not to make at the doctor's appointment. In addition, go back to your post above and look at your complaints regarding your other physicians and ask the nephrologist how those issues will affect your kidneys.

Also, ask about a referral to a renal dietitian. If the doctor has one sign up for the patient portal.

Best of luck.

[Bassetmommer NKF Ambassador]

Hi Aunt Mishee,

Have your doctor nephrologist go over each line of the most current lab with you. Anemia can be caused by kidney issues, but can also be caused by other things, so have him/her explain what type of anemia you have. Have them review your current medicines with you also. It is true that lithium does cause CKD. So getting off it might be a real game changer. It will take some time. Make sure what ever you are on is best for renal function or say is it nephrotoxic? Ask for a referral to a renal dietician to make sure your diet is what you should be consuming. Bring a food list with you. We also can help you with that after you talk to the doc. Phosphorous can be separate or can be detected in a renal panel, which you should have done.

Let us know how you make out.

[MarBea]

You have been given great advice above, about what to ask the Nephrologist.

I want to congratulate you for taking your health seriously and self-referring yourself to a Nephrologist.

At some point, most people need to realize they are often their own best advocate, when it comes to their health.

Pat yourself on the back for being proactive and not reactive, and good luck!

[HealthBuddyMelissa]

Everyone has given you great advice. You need to figure out what is most important to you and your care. Not just your kidneys but your over all care. You want a doctor who will work with you in whatever your goals are. They should listen and answer all your questions. When I choose a doctor I want them to know that I am in control of my life and I will not work with a doctor who does not consider me as a whole person. I need a doctor who can teach me things I don't understand and understands my need to not take any drugs or procedures that will harm my good kidney.