Possible Kidney Disease? Also, new here, hi!

[rieraclaelin]

Hi everyone! I am new here, and I'm a 37 year old female who is very overweight (my starting Weight was 390 pounds). I've been working with a dietician since June on losing weight and since then I've lost 78 pounds through dieting and exercise. Nothing strenuous, just some low impact cardio when I can, anywhere from 15-30 minutes, 3-5 days a week, and eating with a calorie deficit.

Also, just a heads up, I have severe health anxiety due to stuff that happened in June that put me on this weight loss journey, but am not taking any medication for it since my primary wants me to see a therapist for it. But my phone assessment for that isn't until February 3rd (which happens to be on my birthday, whee), so, I still have a ways to go.

I recently went into an Urgent Care because of a weird left shoulder burning pain I had. It didn't radiate, was in a fixed location, but I couldn't recreate the pain no matter how I moved.

They did an ECG to be safe (and let's be honest, heart attack was in my mind), found an abnormality (borderline prolonged qt), did some blood work to test electrolytes since that could be what was causing it.

I got my results back yesterday from the blood work, and most everything was in the normal range. Except, my Potassium levels was 5.4 (the normal range for my lab said below 5.3 was normal), and my Anion Gap was 15 (again, normal range through their lab was 13). In June, my Anion Gap was 14, and my Potassium was 4.0.

My eGFR, though, was 106? Creatinine was .73 and BUN was 15. (In June, my eGFR was 85, Creatinine was .87 and BUN was 12)

My eGFR has changed a lot through the years. According to my records it got down to 65 at one point, but that was also when I was in with this weird UTI that needed two rounds of antibiotics to clear it. The rest of the times it's in the 80s or 100s.

I am a type 2 diabetic, but my last A1C in November it was down to 5.9. They did test my glucose with my blood work when I went to Urgent Care, and it was 93.

My sodium was normal at 138, chloride was normal at 103, carbon dioxide normal at 25, and calcium was normal at 9.3.

In July of this year, I was negative for Protein in my urine, but it hasn't been tested since. Over the years they have all been negative except for twice, and both those times were for UTIs, I believe. My ketones have always been negative, but I think that's more a concern for diabetes than kidneys.

I guess I was just curious (or, well, my anxiety is concerned) that this could be early kidney disease?

I also wonder if it could have been from dehydration, but, I'm not sure if it would change the Anion Gap and Potassium that much?

I emailed my primary about the results, wondering if I should be concerned, but she's out of the office until next week. So until then, my anxiety is kinda having a good ol time thinking up all these worst case scenarios. I stumbled across this message board and thought I'd ask for your opinions? I know it's not a diagnosis, but, I still would appreciate your opinions/advice. Thank you!

[Hidden]

Hi and welcome to the community. Congratulations on the weight loss. However, be careful.Four years ago I began a weight loss program, designed by my doctors. I lost 142 pounds. On the day that I hit that mark, I found out I had CKD. The only good news was that I no longer had to take any medications for my T2D, just diet, and exercise.

With the CKD I had to change some things. ALL of the foods I had eaten for the previous 16 months to lose that weight were not compatible with my new kidney-friendly meal plan. I met with a nephrologist and then a renal dietitian. My weight since then has stabilized and my GFR went from its lowest of 32 to a high of 65, but more importantly my average since then has been 53.

Please check with your dietitian about foods you are eating that contain too much potassium. Foods like dairy, hot chocolate, eggnog, ice cream, sherbert, frozen yogurt, pudding, dried fruit, apricots, bananas, honeydew, orange juice, prune juice, kiwi, oranges, nectarines, nuts, seeds, whole grain, bran cereals, sports drinks, artichoke, avocado, fresh beets, Brussel Sprouts, dried beans, peas, greens, spinach, wax beans, okra, pumpkin, winter squash, tomatoes, tomato products, and potatoes (unless you leech them first) should be eaten sparingly and in small amounts.

If you do get a diagnosis for CKD then let us know and there are several other things you can do to slow the progression.

Best of luck.

[rieraclaelin in reply to Hidden]

Thank you so much for the reply!

Dieting has been hard because I was diagnosed with fatty liver in June (the fibroscan I did indicated I had stage four cirrhosis, but they think it over estimated because of my BMI, so I have to get that checked out again this July), so I'm already on a pretty strict diet for that. I was told to eat sweet potatoes, fruit, veggies as much as possible as well as whole grain/wheat foods for breads, rice and pastas and protein from chicken/turkey breast, low fat dairy and plant based. I have a harder time with plant based protein because they are higher in carbs and sometimes spike my sugar levels.

I have been eating more bananas and avocado than I used to, and sweet potato. Avocado because it's super good for the liver, and I tend to notice I have more liver pain whenever I stop eating it for extended period of time. But I usually only have half an avocado with some raw carrots or grape tomatoes. As for fruit, the only ones I eat are bananas, apples and sometimes strawberries or a peach cup with oatmeal. And even then I limit myself to only one or two fruits a day, though I know bananas are pretty high in potassium.

I'm hoping my doctor will want me to come back in for another round of blood tests to see if maybe the potassium was a fluke but... Who knows.

[Hidden in reply to rieraclaelin]

I provided you with a strong list of foods to avoid with potassium, or at least minimize the amount you eat. You have the right to request the labs. It's not up to the physician. As long as your insurance will cover it. It's important to know if you have CKD while your numbers aren't too low. If you do have CKD ask for a referral to meet with a nephrologist and then a renal dietitian. The RD is the person who will examine your labs and give you a meal plan that will work. Not all nutritionists have the knowledge to deal with a kidney meal plan. Hang in there.

[Jayhawker in reply to rieraclaelin]

I have a friend with nonalcoholic fatty liver disease. Her dietary needs as prescribed by her dietician include several higher potassium vegetables. So it may be tricky for you to balance that diet with a renal diet and your T2D diet. Consequently, I’d strongly suggest that you see a dietician who can advise you. Be sure to take all your labs and diagnoses information to you appointment.

Jayhawker

[Amrellessy66]

I’m not a doctor BUT I think you are doing great seeing a dietician : losing weight is paramount for kidney desease( or avoiding it) and good for your diabetes. Keep up the good work & don’t worry too much.