FNP of a husband with diabetic nephropathy

[Ryanandjen]

Hi all! My husband is a 36 year old type 1 diabetic with DN and CKD stage 3b and I am an FNP working in endocrinology. I have done tons of research trying to figure out how to best help manage his disease and help my endo CKD patients as well. My main question is what meds have directly caused anyone kidney damage other than NSAIDS. Some of the literature has been confusing!

[Hidden]

Hi,

I' m also at Stage 3 CKD and the cause was determined to be DN. The best advice is to get the diabetes under control. Mine is Type 2 and has been under control for years with diet and exercise. When I was told I had CKD I had to make lifestyle changes. He should meet with a Renal Dietitian, and with his previous lab results develop a kidney-friendly meal plan.

Using davita.com he can sign up for a Kidney Smart class that will provide a wealth of information and resources. DaVita also has a vast amount of recipes for diabetics with CKD. Tailor each recipe to his specific needs regarding protein, potassium phosphorus, sodium, and calcium. The RD will explain all this in detail.

Using the free account at drugs.com he can see which of his meds are problematic for those with any health issues, as well as with other meds and food. Depending on where his eGFR is metformin can be an issue for those with diabetes and CKD. Be sure all of his physicians have an updated list of his meds and health issues in order to steer him in the correct direction.

Best of luck

[RoadRunner44]

Hello.

I am so sorry to read about your husband but inspired by your quest for ways to help him.

I suspect its medication that instigated my kidney disease. Doctors didn't tell me I had it and it was by accident I found out. A new doctor gave me a print out of my health problems to give to a person who run a talk group for people with depression. I was astounded to say the least. This was 4 years ago and I had been on medication for bronchiectasis, high blood pressure, high cholesterol, depression and arthritis.

I am a young, 76 year old,10 stone female (not dreadfully overweight) and eat properlyand exercise regularly. It was a shock last year that I was told I was pre-diabetic! I started having neuropathic pains and pins and needles in my arms and legs a few months ago. I understand that all these things can be linked with kidney disease and diabetes. If I can help you in any way such as giving you a list of medication I take please ask. I'd be delighted to help you in your quest for answers.

😊

[Bassetmommer NKF Ambassador]

HI,

I was first diagnosed with CKD after taking a combination of prednisone and methotextrate. Previous to that, I had no issues that I know of. I had a lab draw done and all my readings were off the chart. MY A1c was 13. Did not have that issue before either.

Many years later, after seeing a nephrologist and being treated for DN, my PCP decided to take me off Januvia, and put me on Tragenta. My glucose readings again went through the roof and my CKD progressed. I took myself off the Tragenta and went back to Januvia and stabilized..

[Sammi_n_Munk]

Hi Ryanandjen! Welcome to the community! I know that aside from NSAIDs (Advil, Motrin, Aleve and even Aspirin, as well as some of these that are prescribed), many antibiotics, diuretics, high BP and steroid medications can also cause damage to kidneys. For pain relief, a good over-the-counter med would be Tylenol, providing he has no existing liver issues or allergies to acetaminophen.

That’s medication, but also high protein foods like chicken, pork, fish, dairy (cheese, yogourt, etc.), any whole grains such as oats, barley, whole grain rice and breads, quinoa, nuts, seeds and legumes (kidney beans, navy beans, lentils, chick peas, etc.), and protein powders and bars can also be rough on the kidneys and should be strongly limited unless otherwise advised by his physician. The rule, apparently, with regard to protein, is a portion size no bigger than a deck of cards. Even plant-based protein can be hard on our kidneys.

Also, weight-lifting exercises should also be limited or omitted altogether, as the muscles tend to release creatine into the bloodstream during this type of exertion, hence raising blood creatinine levels which can also hinder kidney function. A little walking daily (30 - 40 minutes, once or twice a day) is probably best. Also, speak to his doctor for further advice on this as well.

A high-fibre diet plan from fruits and vegetables that are lower in potassium and phosphorus is best for those of us with CKD. Also, the best thing would be to ask his PCP for a referral to a renal dietician. They will use his most recent bloodwork results to compose a diet plan that will work best for him specifically.

Steer clear of chocolate, regular coffee, dark sodas, smoking, and alcoholic beverages (or strongly limit these), as these can also cause trouble for those of us with decreased kidney function. And have him drink plenty of water daily. This helps in flushing the system. If you’re unsure of what a safe amount is for him, he should speak to his doctor about that. This can differ with everyone.

I hope you both will find these few tips helpful, dear. Do take good care, and please keep us posted on how he comes along! Once again, welcome to the forum! I wish you both all my best! Bye for now! 🙏😊👍✌️

[TrixG]

I am also Type 1 diabetic and I was told that the diabetes caused my kidney disease . Is his A1C under control? I have been diabetic for 44 years and have found that the Juicebox Podcast really helped me get better control of my A1C. ardensday.com/juicebox-podcast

Also, my dietitian recently started me on a mostly Vegan diet (Stage 4 CKD).

[Bet117 NKF Ambassador]

Hi Ryanandjen,

Life can be such a challenge but I promise that both you and your husband will get through this and see the light of day.

You know with diabetes that this is an ongoing process; glucose and lab monitoring, most current and best medications and diet to meet your husband's needs. My brother is a severe diabetic; my husband and I are his only family now; putting a lot on me to learn very fast as legally I am the next of kin and dealing with a stubborn mule. He has diabetic nephropathy as well has been through 3 years of laser surgeries to control broken visual blood vessels. He stays on top of things and sees the appropriate doctors to check on a regular basis.

As far as meds adding to this other than the NASID' s are all different as

everyone' s body responds different to various medicines. What works well with one person my make another feel sick. Since my brother's diagnosis, and even since I have been allowed a more communicative role, the amount of new medications amazes me.

You know from your work that it is finding the right combination of and diet to keep this under control as everyone's body responds differently to different medications.

You are on the right path to get everything straighted out and going forward.

Having a progressive endo who is on top of things and listens as well as communicates with both of you is key.

Stay strong and remember that this is a process.

Her we all walk together and support each other.

Please reach out again as we are happy to reach back.

Bet